Lorenzo O. Casertano, PT, DPT, NCS, is Advanced Clinician-Acute Care Neurology, Department of Physical Therapy, New York-Presbyterian Hospital, New York, NY;
Clare C. Bassile, PT, EdD, is Associate Professor, Program in Physical Therapy, Department of Rehabilitation and Regenerative Medicine, Columbia University Medical Center, New York, NY.
Am J Occup Ther. 2022 Jul 1;76(4). doi: 10.5014/ajot.2022.047381.
The American Heart Association and American Stroke Association recommend early identification of level of rehabilitative care as a priority after stroke.
To evaluate the utility of the Activity Measure for Post-Acute Care (AM-PAC) "6 Clicks" Daily Activity and Basic Mobility forms to determine the next level of rehabilitation after hospitalization for adults with stroke.
Retrospective cohort design using medical records from 2015 to 2016.
Major urban hospital.
Patients admitted to the stroke service, with a confirmed stroke, who were seen by a physical or occupational therapist; who had a 6 Clicks Basic Mobility or Daily Activity score at initial evaluation; and who were discharged to home, an acute inpatient rehabilitation facility (IRF), or a subacute skilled nursing facility (SNF).
Length of stay and discharge destination.
Seven hundred four participants (M age = 68.28 yr; 51.21% female) were included. Analysis of variance and receiver operating characteristic curves were performed. Daily Activity scores were highest for home discharge, lower for IRF discharge, and lowest for SNF discharge; Basic Mobility showed a similar pattern. Cutoff values distinguishing home from further inpatient rehabilitation were 44.50 for Basic Mobility and 39.40 for Daily Activity scores (area under the curve [AUC] = .82 for both forms), with scores of 34.59 (AUC = 0.64) and 31.32 (AUC = 0.67) separating IRF from SNF, respectively.
Therapists should incorporate 6 Clicks scores into their discharge planning. What This Article Adds: This research demonstrates the utility of an outcome measure in the acute care setting that assists in planning discharge destination for patients with stroke.
美国心脏协会和美国中风协会建议，将康复护理水平的早期识别作为中风后治疗的重点。
评估活动测量用于康复后护理（AM-PAC）“6 点击”日常活动和基本移动形式的效用，以确定住院成人中风后下一级康复治疗。
使用 2015 年至 2016 年的病历进行回顾性队列设计。
主要城市医院。
入住中风服务、经证实中风、接受物理或职业治疗师治疗的患者；在初始评估时具有 6 点击基本移动性或日常活动评分；出院到家庭、急性住院康复设施（IRF）或亚急性熟练护理设施（SNF）。
住院时间和出院地点。
共纳入 704 名参与者（M 年龄=68.28 岁；51.21%女性）。进行方差分析和接收者操作特征曲线分析。日常活动评分出院家庭最高，IRF 出院次之，SNF 出院最低；基本移动性显示出类似的模式。区分家庭和进一步住院康复的截止值为基本移动性为 44.50，日常活动评分 39.40（两种形式的曲线下面积[AUC]均为.82），IRF 与 SNF 分别为 34.59（AUC = 0.64）和 31.32（AUC = 0.67）。
治疗师应将 6 点击评分纳入其出院计划。这篇文章增加了什么：这项研究证明了在急性护理环境中使用一种结果测量方法的效用，该方法有助于为中风患者规划出院目的地。
