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Factors Associated with Nursing Home Placement of Patients Admitted for Inpatient Rehabilitation in Singapore
e90 Poster 282 Factors Associated with Nursing Home Placement of Patients Admitted for Inpatient Rehabilitation in Singapore Cynthia Chen (NUS SSHSPH) Objective: To (1) identify social and rehabilitation predictors of nursing home placement, (2) investigate the association between effectiveness and efficiency in rehabilitation and nursing home placement of patients admitted for inpatient rehabilitation from 1996 to 2005 by disease in Singapore. Design: case extraction. Data Sources: National data were retrospectively extracted from medical records of community hospital. Participants: There were 12,506 first admissions for rehabilitation in four community hospitals. Of which, 8,594 (90.3%) patients were discharged home and 924 (9.7%) patients were discharged to a nursing home. Interventions: Not applicable. Main Outcome Measure(s): Nursing home placement. Results: Those who were discharged to nursing home had 33% lower median rehabilitation effectiveness and 29% lower median rehabilitation efficiency compared to those who were discharged to nursing homes. Patients discharged to nursing homes were significantly older (mean age: 77 vs. 73 years), had lower mean Bathel Index scores (40 vs. 48), a longer median length of stay (40 vs. 33 days) and a longer time to rehabilitation (19 vs. 15 days), had a higher proportion without a caregiver (28 vs. 7%), being single (21 vs. 7%) and had dementia (23 vs. 10%). Patients admitted for lower limb amputation or falls had an increased odds of being discharged to a nursing home by 175% (p,0.001) and 65% (p Z 0.043) respectively compared to stroke patients. Conclusions: In our study, the odds of nursing home placement was found to be increased in Chinese, males, single or widowed or separated/ divorced, patients in high subsidy wards for hospital care, patients with dementia, without caregivers, lower functional scores at admission, lower rehabilitation effectiveness or efficiency at discharge and primary diagnosis groups such as fractures, lower limb amputation and falls in comparison to strokes. Key Words: Inpatient rehabilitation, Nursing home, Functional recovery Disclosure(s): None Disclosed.
Poster 283 Energy Expenditure During ADL in Korean Life Style Setting Hee Song Lee (Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University), MinYoung Kim Objective: To measure VO2, energy expenditure(EE) and metabolic equivalent of task(MET) values of activities of daily living and to compare each values between subjects and 11 activities. Design: Cross-sectional study. Setting: General teaching hospital. Participants: The subjects were normal adults with no specific medical history. Total 10 subjects were included. Interventions: We chose 11 daily activities that are relevant to Korean life style and tested it to subjects according to protocol respectively: typing (typing 2500 words or 10 min), sleeping, folding laundry (folding uniform made of wool), dish washing, cleaning the room (using a mop), studying (reading and writing), walking (4km/hr), running (8 km/hr), stair-climbing, walking uphill, and walking downhill. Duration of each activity was 10 minutes. Main Outcome Measure(s): Energy expenditure (EE) and metabolic equivalent of task (MET). Results: There were high internal consistency among the subjects for identical activities (Cronbach a Z 0.89). We obtained mean MET values
Diagnosis Independent of each activity: sleeping (0.77), typing (1.33), folding the laundry (0.85), washing the dish (2.76), cleaning the room (2.78), studying (2.30), walking (4.23), running (7.83), stair-climbing (6.89), walking uphill(5.70), and walking downhill(3.20). VO2 values were proportional to EE value (rZ0.997, pZ0.00). Conclusions: We identified intensity level of each activity according to the amount of EE and MET. We intend to provide a baseline for physical activity guideline development of normal adults. By integrating body weight, height, BMI in comparison to MET scores of different occupation groups in future studies. Key Words: Energy expenditure, Activity of daily living, Metabolic equivalents Disclosure(s): None Disclosed. Poster 284 Daily Activity Positively Impacts Motor Performance in Older Adults Jeanne Langan (University at Buffalo) Objective: Examine if meeting the steps/day recommendation for older adults, 7100 (Tudor-Locke et al., 2011), influenced performance on a computer-based cognitive/motor assessment. Design: Cross sectional. Setting: Computer assessments completed in a research lab, steps measured in home/community. Participants: 24 older adults 65-78 years (mean 70.3 +3.9 years, 11 male) with 3 years experience using a computer and who lived independently in the community. Interventions: Each participant underwent two computer-based cognitive/motor assessments, one as an orientation, the second representing the actual test. The assessment consisted of response time, verbal memory, spatial memory and motor performance (chase target using a mouse) tasks. Daily steps taken were measured using a Fitbit, an accelerometer device. Main Outcome Measure(s): Time and accuracy reported for computerbased assessment. The average number of steps was based on four weekdays and one weekend. Fitbit activity graphs were visually inspected and the number of days in which participants had 30 minutes of sustained activity was recorded. Using 7100 average steps/day as a cut point, participants were divided into two groups. Results: 10 participants, primarily women, fell below the recommended 7100 steps. They also had fewer days with 30 minutes of sustained activity. Despite the discrepancy in activity levels, the two groups performed similarly on the reaction time, verbal memory and spatial memory tasks. The more active group performed better on the motor task. Conclusions: Amount of daily activity impacted motor rather than cognitive performance. Intensity of daily activity should be further examined for influence on cognitive domains. Key Words: cognitive, older adults, motor performance, activity Disclosure(s): None disclosed.
Poster 285 Assessment of Gait Variability: Towards an Optimal Testing Protocol Lutz Schega (Otto-von-Guericke University Magdeburg), Daniel Hamacher, Dennis Hamacher Objective: Gait variability is frequently used to identify rehabilitation progresses in orthopedic and neurologic diseases by means of repeated testing. However, learning effects are a significant issue. This study examined if the inter-day reliability of gait variability parameters improves with an additional familiarization trial.
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Poster 283 Energy Expenditure During ADL in Korean Life Style Setting Hee Song Lee (Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University), MinYoung Kim Objective: To measure VO2, energy expenditure(EE) and metabolic equivalent of task(MET) values of activities of daily living and to compare each values between subjects and 11 activities. Design: Cross-sectional study. Setting: General teaching hospital. Participants: The subjects were normal adults with no specific medical history. Total 10 subjects were included. Interventions: We chose 11 daily activities that are relevant to Korean life style and tested it to subjects according to protocol respectively: typing (typing 2500 words or 10 min), sleeping, folding laundry (folding uniform made of wool), dish washing, cleaning the room (using a mop), studying (reading and writing), walking (4km/hr), running (8 km/hr), stair-climbing, walking uphill, and walking downhill. Duration of each activity was 10 minutes. Main Outcome Measure(s): Energy expenditure (EE) and metabolic equivalent of task (MET). Results: There were high internal consistency among the subjects for identical activities (Cronbach a Z 0.89). We obtained mean MET values
Diagnosis Independent of each activity: sleeping (0.77), typing (1.33), folding the laundry (0.85), washing the dish (2.76), cleaning the room (2.78), studying (2.30), walking (4.23), running (7.83), stair-climbing (6.89), walking uphill(5.70), and walking downhill(3.20). VO2 values were proportional to EE value (rZ0.997, pZ0.00). Conclusions: We identified intensity level of each activity according to the amount of EE and MET. We intend to provide a baseline for physical activity guideline development of normal adults. By integrating body weight, height, BMI in comparison to MET scores of different occupation groups in future studies. Key Words: Energy expenditure, Activity of daily living, Metabolic equivalents Disclosure(s): None Disclosed. Poster 284 Daily Activity Positively Impacts Motor Performance in Older Adults Jeanne Langan (University at Buffalo) Objective: Examine if meeting the steps/day recommendation for older adults, 7100 (Tudor-Locke et al., 2011), influenced performance on a computer-based cognitive/motor assessment. Design: Cross sectional. Setting: Computer assessments completed in a research lab, steps measured in home/community. Participants: 24 older adults 65-78 years (mean 70.3 +3.9 years, 11 male) with 3 years experience using a computer and who lived independently in the community. Interventions: Each participant underwent two computer-based cognitive/motor assessments, one as an orientation, the second representing the actual test. The assessment consisted of response time, verbal memory, spatial memory and motor performance (chase target using a mouse) tasks. Daily steps taken were measured using a Fitbit, an accelerometer device. Main Outcome Measure(s): Time and accuracy reported for computerbased assessment. The average number of steps was based on four weekdays and one weekend. Fitbit activity graphs were visually inspected and the number of days in which participants had 30 minutes of sustained activity was recorded. Using 7100 average steps/day as a cut point, participants were divided into two groups. Results: 10 participants, primarily women, fell below the recommended 7100 steps. They also had fewer days with 30 minutes of sustained activity. Despite the discrepancy in activity levels, the two groups performed similarly on the reaction time, verbal memory and spatial memory tasks. The more active group performed better on the motor task. Conclusions: Amount of daily activity impacted motor rather than cognitive performance. Intensity of daily activity should be further examined for influence on cognitive domains. Key Words: cognitive, older adults, motor performance, activity Disclosure(s): None disclosed.
Poster 285 Assessment of Gait Variability: Towards an Optimal Testing Protocol Lutz Schega (Otto-von-Guericke University Magdeburg), Daniel Hamacher, Dennis Hamacher Objective: Gait variability is frequently used to identify rehabilitation progresses in orthopedic and neurologic diseases by means of repeated testing. However, learning effects are a significant issue. This study examined if the inter-day reliability of gait variability parameters improves with an additional familiarization trial.
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