Hastings S Nicole, Sloane Richard, Morey Miriam C, Pavon Juliessa M, Hoenig Helen
Center for Health Services Research in Primary Care, Veterans Affairs Medical Center, Durham, North Carolina; Geriatrics Research, Education and Clinical Center, Veterans Affairs Medical Center, Durham, North Carolina; Division of Geriatrics, Department of Medicine, Duke University, Durham, North Carolina; Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina.
J Am Geriatr Soc. 2014 Nov;62(11):2180-4. doi: 10.1111/jgs.13095. Epub 2014 Oct 30.
An important contributor to hospital-associated disability is immobility during hospitalization. Preliminary results from STRIDE, a clinical demonstration program of supervised walking for older adults admitted to the hospital with medical illness, are reported. The STRIDE program consisted of a targeted gait and balance assessment by a physical therapist, followed by daily walks supervised by a recreation therapy assistant for the duration of the hospital stay. To examine program effectiveness, STRIDE participants (n = 92) were compared with individuals referred but not enrolled (because of refusal or because program was at capacity, n = 35). Median length of stay was 4.7 days for STRIDE participants and 5.7 days for individuals receiving usual care (P = .31). There was one inpatient fall in each group (not associated with a STRIDE walk). Overall, 92% of STRIDE participants were discharged to home (rather than a skilled nursing facility (SNF)) compared to 74% of individuals receiving usual care (P = .007). Thirty-day emergency department visit rates and readmission rates were not significantly different between the two groups. STRIDE, a supervised walking program for hospitalized older adults, was feasible and safe, and program participants were less likely to be discharged to a SNF than a demographically similar comparison group. STRIDE is a promising interdisciplinary approach to promoting mobility and improving outcomes in hospitalized older adults.
住院期间的活动受限是导致医院相关性残疾的一个重要因素。本文报告了STRIDE(一项针对因疾病住院的老年人进行监督步行的临床示范项目)的初步结果。STRIDE项目包括由物理治疗师进行有针对性的步态和平衡评估,随后在住院期间由娱乐治疗助理监督每日步行。为了检验项目效果,将STRIDE参与者(n = 92)与被转诊但未纳入项目的个体(因拒绝或项目已满员,n = 35)进行了比较。STRIDE参与者的中位住院时间为4.7天,接受常规护理的个体为5.7天(P = 0.31)。每组各有1例住院患者跌倒(与STRIDE步行无关)。总体而言,92%的STRIDE参与者出院回家(而非入住专业护理机构(SNF)),相比之下,接受常规护理的个体这一比例为74%(P = 0.007)。两组之间的30天急诊科就诊率和再入院率无显著差异。STRIDE,一项针对住院老年人的监督步行项目,是可行且安全的,与人口统计学特征相似的对照组相比,项目参与者出院后入住SNF的可能性更小。STRIDE是一种有前景的跨学科方法,可促进住院老年人的活动能力并改善其预后。