Differences in Daily Activity Performance Between Inpatient Rehabilitation Facility and Home Among Stroke Survivors.
Emily Somerville, Gabrielle Blenden, Danielle Kretzer and 7 others
PMID 38602200WHAT IT FOUND
Stroke survivors scored significantly worse on daily activities in their own homes than in the rehab facility, even just days before discharge.
This gap suggests that facility-based tests overestimate real-world independence, particularly for stairs and bathing.
Key findings
01Scores for all daily activities at the home visit were significantly higher (indicating greater impairment) than at IRF discharge.
02The greatest differences between home and facility performance were observed for shower/tub transfers and going up and down stairs.
03Over 40% of participants had a discharge score indicating no-to-mild impairment, but the home visit score indicated moderate-to-complete impairment for shower/tub transfer, walking, and stairs.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study used a secondary analysis of baseline data, so the order of assessments was not randomized; home visits always occurred before IRF discharge assessments. Different raters (study OTs vs. IRF staff) conducted the assessments, and interrater reliability between these groups was unknown. The analysis required crosswalking FIM and Section GG scores to an ICF scale, which reduced data precision. The sample was relatively small (n=57) and excluded younger patients or those who were dependent in daily activities before their stroke, limiting generalizability. Natural recovery during the short timeframe between home visit and discharge could have contributed to some of the observed differences, though the authors argue this is unlikely to account for the large effect sizes.
Declared interests
The study was supported by the National Institutes of Health (U.S. Gov't, P.H.S.).
The easy way to misread this
Do not interpret these findings as proof that home visits improve patient outcomes. This study only demonstrated that performance is worse at home than in the facility; it did not test whether conducting home visits leads to better discharge planning or safety.