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Training family to assist with physiotherapy for older people transitioning from hospital to the community: A pilot randomized controlled trial

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Lawler, K ORCID: 0000-0002-1484-1113, Shields, N and Taylor, NF 2019 , 'Training family to assist with physiotherapy for older people transitioning from hospital to the community: A pilot randomized controlled trial' , Clinical Rehabilitation , pp. 1-11 , doi: 10.1177/0269215519853874.

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Abstract

Objective:To investigate the safety and effectiveness of augmenting physiotherapy with family-assisted therapy, to inform a future, fully powered trial.Design:Parallel pilot randomized controlled trial.Setting:Transition Care Program.Participants:Thirty-five older adults with multimorbidity, recently hospitalized, with a mean age of 84.1 years (SD = 6.1 years) and mean Modified Barthel Index of 67.8 units (SD = 19.2 units), and 40 family members.Interventions:The control group (n = 18) received usual physiotherapy care. The experimental group (n = 17) received usual physiotherapy care and family-assisted therapy from a family member trained by a physiotherapist.Main measures:Primary outcomes were falls-related self-efficacy measured by the Short Falls Efficacy Scale – International and falls during the intervention period. Secondary outcomes included daily steps, EQ-5D-3L (three-level version of the EuroQoL five-dimensional health-related quality of life questionnaire) and ICECAP-O (ICEpop CAPability measure for Older people), Modified Barthel Index and Modified Caregiver Strain Index.Results:There were no between-group differences for falls-related self-efficacy. Relative to the control group, the experimental group was observed to have a reduced risk of falling (relative risk = 0.38, 95% confidence interval (CI) = 0.09-1.60) and a reduced falls rate (incidence rate ratio = 0.22, 95% CI = 0.04-1.20) was of borderline statistical significance. The experimental group walked a mean of 944 daily steps more than the control group (95% CI = 139-1748) and had a significant reduction in activity limitation. There were no between-group differences for quality of life or caregiver strain.Conclusion:Augmenting physiotherapy with family-assisted therapy is feasible for older people transitioning from hospital to the community. A fully powered randomized controlled trial is indicated.

Item Type: Article
Authors/Creators:Lawler, K and Shields, N and Taylor, NF
Keywords: physiotherapy, family, caregiver, training, physical activity, older adults
Journal or Publication Title: Clinical Rehabilitation
Publisher: Sage Publications Ltd.
ISSN: 0269-2155
DOI / ID Number: 10.1177/0269215519853874
Copyright Information:

Copyright 2019 the authors

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