Heart Failure Hospital Readmissions and Physical Therapy

NCT03517514 | Completed

• 1 other identifier: Pro00018201
• Study Type: observational
• Target: 102
• Locations: 1 country
• Sites: 1

Brief Summary

This is a dissertation study which is divided into three different studies in order to answer the main research question (Study 3). The primary aim of this research (dissertation) is to investigate all-cause 30-day hospital readmission using functional mobility (5mWT, 30STS, 6MWT, TUG), psychosocial attributes (KCCQ-12, HADS, ESSI), adherence to home exercise program, participation in a supervised exercise program, and number of follow up checkups with physicians or advanced health providers of patients with Acute Decompensated Heart Failure (ADHF) diagnosis who were discharged from a tertiary teaching hospital. Study 1: What is the effect of acute physical therapy on functional ability in individuals admitted with ADHF? Study 2: What is the effect of acute physical therapy on psychosocial attributes in individuals admitted with ADHF? Study 3: Which factors such as functional mobility (5mWT, 30STS, 6MWT, TUG), psychosocial attributes (KCCQ-12, HADS, ESSI), adherence to home exercise program, participation in a supervised exercise program, and number of follow up checkups with physicians or advanced health providers predict all-cause 30-day hospital readmission in patients discharged from a tertiary, teaching hospital with ADHF diagnosis?

Conditions

Acute Heart Failure

Keywords

Heart Failure; Physical Therapy; Hospital Readmission

Outcome Measures

Primary Outcomes (1)

• hospital readmission within 30 days

  Identification of patient hospital readmission within 30 days of discharge (day 0).

  less than or equal to 30 days

Secondary Outcomes (5)

• Six Minute Walk Test (6MWT)

  Comparing any change between pre-physical therapy treatment (Day 1) to post-physical therapy treatment (defined as time frame: Day 2 to 8 weeks)

• 30 seconds Sit to Stand Test (30STS)

  Comparing any change between pre-physical therapy treatment (Day 1) to post-physical therapy treatment (defined as time frame: Day 2 to 8 weeks)

• Five Meter Walk Test (5mWT)

  Comparing any change between pre-physical therapy treatment (Day 1) to post-physical therapy treatment (defined as time frame: Day 2 to 8 weeks)

• Time Up and Go Test of Fall Risk (TUG)

  Comparing any change between pre-physical therapy treatment (Day 1) to post-physical therapy treatment (defined as time frame: Day 2 to 8 weeks)

• Global Rating of Change Scale (GROC)

  End of study (post-physical therapy; defined as time frame: Day 2 to 8 weeks)

Other Outcomes (3)

• Kansas City Cardiomyopathy Questionnaire (KCCQ)

  Comparing any change between pre-physical therapy treatment (Day 1) to post-physical therapy treatment (defined as time frame: Day 2 to 8 weeks)

• Hospital Anxiety and Depresssion Scale (HADS)

  Comparing any change between pre-physical therapy treatment (Day 1) to post-physical therapy treatment (defined as time frame: Day 2 to 8 weeks)

• Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Social Support Instrument (ESSI)

  Comparing any change between pre-physical therapy treatment (Day 1) to post-physical therapy treatment (defined as time frame: Day 2 to 8 weeks)

Interventions

Physical Therapy service OTHER

routine physical therapy care

Eligibility Criteria

• Age: 50 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

All medically stable, admitted patients at the hospital that have an admitting diagnosis of acute heart failure (or similar diagnosis) will be screened as potential study participants.

You may qualify if:

• all admitted at Houston Methodist Hospital with a primary diagnosis of acute heart failure or similar type of medical diagnosis
• stable medical state (HR equal or greater than 50 bpm, mean BP of 60 mmHg or better, Oxygen saturation (with or without oxygen supplement) of 90% or better; RR of 15 or better
• years old and over and able to follow 2 simple commands
• establish discharge recommendation to home settings
• ambulatory with or without assitive device(s)

You may not qualify if:

• history of psychiatric disorder
• diagnosis of acute kidney injury requiring continuous renal replacement therapy
• diagnosis of major cognitive impairment (dementia, Alzheimer's dse, etc)
• inability to read and understand basic english language
• establish discharge recommendation to post-acute care settings (e.g. SNF, inpatient rehab, LTACH)
• inability to complete any functional mobility test due to musculoskeletal or other disorders

Sponsors & Collaborators

• The Methodist Hospital Research Institute: lead
• Texas Woman's University: collaborator

Study Sites (1)

Houston Methodist Hospital

Houston, Texas, 77030, United States

Location

Related Publications (27)

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• McCabe N, Butler J, Dunbar SB, Higgins M, Reilly C. Six-minute walk distance predicts 30-day readmission after acute heart failure hospitalization. Heart Lung. 2017 Jul-Aug;46(4):287-292. doi: 10.1016/j.hrtlng.2017.04.001. Epub 2017 May 24.

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• Fisher SR, Kuo YF, Sharma G, Raji MA, Kumar A, Goodwin JS, Ostir GV, Ottenbacher KJ. Mobility after hospital discharge as a marker for 30-day readmission. J Gerontol A Biol Sci Med Sci. 2013 Jul;68(7):805-10. doi: 10.1093/gerona/gls252. Epub 2012 Dec 19.

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• Fisher SR, Graham JE, Ottenbacher KJ, Deer R, Ostir GV. Inpatient Walking Activity to Predict Readmission in Older Adults. Arch Phys Med Rehabil. 2016 Sep;97(9 Suppl):S226-31. doi: 10.1016/j.apmr.2015.09.029. Epub 2016 Jun 2.

  PMID: 27264549 BACKGROUND

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• Wilson CM, Kostsuca SR, Boura JA. Utilization of a 5-Meter Walk Test in Evaluating Self-selected Gait Speed during Preoperative Screening of Patients Scheduled for Cardiac Surgery. Cardiopulm Phys Ther J. 2013 Sep;24(3):36-43.

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Related Links

• Heart Failure matters
• What is Heart failure?

MeSH Terms

Conditions

Heart Failure

Interventions

Physical Therapy Modalities

Condition Hierarchy (Ancestors)

Heart Diseases; Cardiovascular Diseases

Intervention Hierarchy (Ancestors)

Therapeutics; Rehabilitation

Study Officials

• Bobby C Belarmino, PT,DPT,MA

  The Methodist Hospital Research Institute

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Senior Physical Therapist (Level IV)

Study Record Dates

• First Submitted: April 6, 2018
• First Posted: May 7, 2018
• Study Start: February 1, 2018
• Primary Completion: January 31, 2019
• Study Completion: August 28, 2019
• Last Updated: August 29, 2019

Record last verified: 2019-08

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)