Peninsula Clinical School, Peninsula Health, Monash University, Frankston, Australia.
Department of Physiotherapy, Peninsula Health, Frankston, Australia.
Disabil Rehabil. 2021 Dec;43(25):3672-3679. doi: 10.1080/09638288.2020.1745906. Epub 2020 Apr 6.
We assessed the ability of patients discharging home from inpatient rehabilitation to meet criteria for community ambulation.
Cross-sectional observational study design. Participants were assessed, within 48-hours of discharge on their ability to: ascend/descend three steps, walk at a speed of 0.44 m/s, ascend/descend a slope, ascend/descend a kerb, and walk 315 m continuously. Demographic data were collected from medical records. Multiple logistic regression determined factors predictive of meeting criteria.
Of 200 participants (mean 73 years, 66% women, mixed diagnosis), 64 (32%) met all criteria. The least commonly met criteria were walking 315 m continuously (37%) and ascending/descending steps (70%). Participants who were female (OR: 0.27, 95%CI: 0.12-0.61), with a high comorbidity index (OR: 0.71, 95%CI: 0.56-0.91) or a traumatic orthopaedic diagnosis (OR: 0.22, 95%CI: 0.05-0.96) were less likely to meet all criteria. Participants with a higher admission functional independence walk item score (OR: 1.37, 95%CI: 1.05-1.78) or higher ambulatory self-confidence (OR: 1.02, 95%CI: 1.01-1.04) were more likely to meet all criteria.
Approximately, one-third of inpatients discharged home from a publicly funded rehabilitation centre met the community ambulation criteria, suggesting many may not be physically prepared to participate in their community.Implications for RehabilitationOnly about one in three inpatients discharging home from a publicly funded rehabilitation centre met physical criteria for community ambulation.Patients discharging home from inpatient rehabilitation have most difficulty walking long distances (≥315 m) compared to other criteria required for community ambulation (i.e., walking at a speed of 0.44 m/s, stepping up/down a kerb, ascending/descending a slope and ascending/descending three steps) and rehabilitation during this phase may require an increased focus on improving walking endurance/physical activity.Women with a high co-morbidity index, traumatic orthopaedic diagnosis, low self-confidence with ambulation on discharge and who require more assistance with walking on admission are least likely to meet the physical criteria for community ambulation at discharge, and therefore may require additional rehabilitation or supports.
评估从住院康复中出院的患者满足社区活动标准的能力。
采用横断面观察性研究设计。参与者在出院后 48 小时内评估他们是否有能力：上下三个台阶、以 0.44 m/s 的速度行走、上下斜坡、上下路缘、连续行走 315 m。从病历中收集人口统计学数据。多元逻辑回归确定了预测符合标准的因素。
在 200 名参与者（平均年龄 73 岁，66%为女性，混合诊断）中，有 64 名（32%）符合所有标准。最常见的不符合标准的是连续行走 315 m（37%）和上下台阶（70%）。女性（OR：0.27，95%CI：0.12-0.61）、合并症指数较高（OR：0.71，95%CI：0.56-0.91）或创伤性骨科诊断（OR：0.22，95%CI：0.05-0.96）的参与者不太可能符合所有标准。入院功能性独立行走项目评分较高的参与者（OR：1.37，95%CI：1.05-1.78）或较高的步行自信心（OR：1.02，95%CI：1.01-1.04）的参与者更有可能符合所有标准。
大约三分之一从公共资助的康复中心出院的住院患者符合社区活动的身体标准，这表明许多人可能没有身体准备好参与他们的社区活动。
只有大约三分之一从公共资助的康复中心出院的住院患者符合社区活动的身体标准。
从住院康复中出院的患者在进行社区活动时最困难的是走很长的距离（≥315 m），而不是其他社区活动所需的标准（即，以 0.44 m/s 的速度行走、上下路缘、上下斜坡和上下三个台阶），在此阶段的康复可能需要更加注重提高步行耐力/体力活动。出院时合并症指数高、创伤性骨科诊断、对步行的自信心低、入院时行走需要更多帮助的女性最不可能在出院时符合社区活动的身体标准，因此可能需要额外的康复或支持。
