Functional Activities to Optimize Patient Outcomes in Home Health: A Pilot Randomized Controlled Trial.
Chiung-Ju Liu, Dorian K Rose, Peihua Qiu and 3 others
PMID 41796612WHAT IT FOUND
Adding HARP to usual home health therapy showed no significant difference in daily task performance compared with usual therapy alone.
The trend favored usual care.
Key findings
01Adding HARP to usual home health therapy did not improve the primary ADL motor skills outcome compared with usual therapy alone.
02Secondary functional outcomes did not differ significantly between groups at post-intervention or follow-up.
03HARP was feasible: 21 treatment participants completed all six visits, and 20 of those completers reported high acceptance.
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
This was a pilot trial with 47 randomized participants, so it cannot establish whether HARP helps, harms, or has no effect. The primary outcome was not statistically significant, but the trend favored usual care alone. 11 treatment participants and 5 control participants had usual care end one month or two months before post-intervention assessment, and this difference was statistically significant. The usual therapy dose was low, with an average of seven physical therapy visits. Usual therapy providers were not blinded to group assignment, which may have affected care delivery. Only selected assessments were repeated at the three-month phone follow-up. The sample included 25% of participants over 90 years old, 57% with cognitive impairment, and 68% with severely limited lower extremity function, so results may not apply to less impaired home health patients.
Declared interests
Funding support is listed as NIH extramural. The authors declared no conflicts of interest.
The easy way to misread this
Do not treat the non-significant primary outcome as proof that HARP is ineffective for all home health patients. This was a small pilot with delayed start, low usual therapy dose, and unblinded providers.