Title: Physical Functioning of Hospitalized Older Adults
1Physical Functioning of Hospitalized Older Adults
- Steve Fisher PT, PhD, GCS
- Assistant Professor
- Division of Rehabilitation Science
2Education Training
- MPT, TX Tech University, 1999
- PT experience
- Inpatient Acute Care
- The Institute for rehabilitation and research
(TIRR) - Geriatric Clinical Specialist (GCS)
- PhD, UTMB, 2008
- Post doctoral training at UTMB, 2008
3Career Goals
- Develop publication record in high impact
journals - Obtain NIH grant funding as a principal
investigator - Obtain a tenure track academic appointment at a
major medical research institution
4Research Career Development Activities
- Longitudinal Data analyses course
- Grant writing work shop
- Monthly Grant writing seminars
- Weekly research team meetings with senior
investigators
5Presentation Objectives
- Describe research environment
- Present published and current work
- Short Physical Performance Battery in
Hospitalized Older Adults - Gait Speed of Hospitalized Older Adults
- Chair Rise Ability and Length of Stay
- Step Activity of Hospitalized Older Adults
- Future Directions
6Acute Care for Elders (ACE) Unit
- First hospital unit in Texas designed exclusively
to care for acutely ill older adults - Post Ike, 20 beds
7Acute Care for Elders (ACE) Unit
- Patients receive their hospital care in a more
home-like setting
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9Patient Characteristics
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10Short Physical Performance Battery in
Hospitalized Older Adults
- Three objective tests of lower body function
- timed 8-foot walk
- 5 timed, repetitive chair stands
- hierarchical test of standing balance
- Scoring methods developed from large
epidemiological investigations of relatively
healthy older men and women living at home.
11Short Physical Performance Battery in
Hospitalized Older Adults
- Determine if SPPB information could be collected
in a broad sample of older adults hospitalized
for acute illness. - Compare community based SPPB scoring criteria
with revised scoring criteria based on
hospitalized older patients.
12Short Physical Performance Battery in
Hospitalized Older Adults
- Can be safely collected in older patients
- Revised hospital SPPB may be preferable in
inpatient or institutional type settings as
scoring criteria were developed using the
intended target population.
13Gait Speed of Hospitalized Older Adults
- Mean gait speed approximately 1/3 that of healthy
older adults living in the community - Evidence that separate normative standards should
be considered when evaluating the gait speed of
older patients
14Chair Rise Ability and Length of Stay
- Typically, combinations of variables are used as
a general set of risk indicators for prolonged
length of stay - Patients who could not perform the chair rise
task had expected lengths of stay about 50
longer than those who could - Implications for decisions regarding early
preventative measures
Adjusted for age, gender, BMI, pain report,
comorbidities, ADL limitations, and admitting
diagnosis
15Step Activity of Hospitalized Older Adults
- Objective
- Examine the ambulatory activity or hospitalized
older adults from admission to discharge
16Step Activity of Hospitalized Older Adults
- Collaborating with nursing staff
- Enrolling patients day of admission
- Patient wears monitor throughout hospital course
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18Step Activity of Hospitalized Older Adults
19Step Activity of Hospitalized Older Adults
20Step Activity of Hospitalized Older Adults
21Future Directions
- Study physical function during acute illness and
hospitalization - Expand step monitor study to post discharge
environment - Submit R01
22Career Development Needs
- Gain expertise in
- High level statistical analyses
- Mixed models for longitudinal data
- Manuscript writing
- Grant writing
23Research Team
- Glenn Ostir, PhD (mentor)
- Ken Ottenbacher, PhD, OT
- James Goodwin, MD (director, Sealy Center on
Aging) - Roxana Hirst (research coordinator)
- Shawn Goodlet (ACE unit interviewer)
- Harlow Ratzman (ACE unit interviewer)
- Deven Barriault (ACE unit nurse manager)
24Acknowledgements
- K12 HD055929 National Institutes of Health
National Center for Medical and Rehabilitation
Research (NICHD) and National Institute for
Neurological Disorders Stroke - National Institute of Health (R01AG024806),
(K01HD046682) Glenn Ostir, PI