Executive Function Moderates Functional Outcomes of Engagement Strategies During Rehabilitation in Older Adults.
Baris Ercal, Thomas L Rodebaugh, Marghuretta D Bland and 6 others
PMID 34131093WHAT IT FOUND
No overall difference between Enhanced Medical Rehabilitation and standard physical and occupational therapy was found in this exploratory analysis.
Higher clock drawing scores were associated with higher discharge function in patients receiving the Enhanced Medical Rehabilitation approach.
Key findings
01No overall difference between Enhanced Medical Rehabilitation and standard care was found for Barthel Index at discharge in the final model.
02In the Enhanced Medical Rehabilitation group, higher clock drawing scores were associated with higher Barthel Index at discharge, while standard care showed little relationship.
03The clock drawing effect did not extend to patient active time or participation scores, and the Readiness for Rehab interview did not predict functional outcome.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The analysis was post-hoc and exploratory, so the clock drawing finding could be due to multiple comparisons. The parent trial used two skilled nursing facilities and a limited sample, so results may not generalize. The study excluded people with moderate to severe cognitive impairment, so it does not tell clinicians what to do for more impaired patients. The clock drawing interaction was not explained by patient active time or participation scores, so the mechanism is unclear. The Readiness for Rehab interview was not validated against other scales, and it did not predict functional outcome.
Declared interests
The supplied text states that the parent trial was NIH-sponsored.
The easy way to misread this
Do not use clock drawing scores to decide that a patient should not receive Enhanced Medical Rehabilitation. This was an exploratory secondary analysis, and no overall treatment difference was found in the final model.