Article

Use of standardized assessments in acute rehabilitation is continuing
to grow, a key objective being to assist clinicians in determining services
needed postdischarge.
The purpose of this study was to examine how
standardized assessment scores from initial acute care physical therapist and
occupational therapist evaluations contribute to discharge recommendations for
poststroke rehabilitation services. DESIGN: A descriptive analysis was conducted.
METHODS: A total of 2,738 records of patients admitted to an acute care hospital
with a diagnosis of stroke or transient ischemic attack were identified.
Participants received an initial physical therapist and occupational therapist
evaluation with standardized assessments and a discharge recommendation of home
with no services, home with services, inpatient rehabilitation facility (IRF), or
skilled nursing facility (SNF). A K-means clustering algorithm determined if it
was feasible to categorize participants into the 4 groups based on their
assessment scores. These results were compared with the physical therapist and
occupational therapist discharge recommendations to determine if assessment
scores guided postacute care recommendations. RESULTS: Participants could be
separated into 4 clusters (A, B, C, and D) based on assessment scores. Cluster A
was the least impaired, followed by clusters B, C, and D. In cluster A, 50% of
the participants were recommended for discharge to home without services, whereas
1% were recommended for discharge to an SNF. Clusters B, C, and D each had a
large proportion of individuals recommended for discharge to an IRF (74%-80%).
There was a difference in percentage of recommendations across the clusters that
was largely driven by the differences between cluster A and clusters B, C, and D.
LIMITATIONS: Additional unknown factors may have influenced the discharge
recommendations. CONCLUSIONS: Participants poststroke can be classified into
meaningful groups based on assessment scores from their initial physical
therapist and occupational therapist evaluations. These assessment scores, in
part, guide poststroke acute care discharge recommendations.
CI - (c) 2015 American Physical Therapy Association.

Langue : ANGLAIS