PTOTCohortInternational journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation2018

The baseline speed of 10-m gait predicts ambulatory discharge for hospitalized frail elderly after DOPPO rehabilitation.

Akifumi Uehara, Hiroaki Obata, Hiroshi Watanabe and 3 others

PMID 30085995

WHAT IT FOUND

In frail hospitalized older adults after DOPPO rehabilitation, baseline 10-m walking speed above 0.84 m/s predicted reaching 300 m in 6 min, the ambulatory discharge goal.

Key findings

01Binomial regression identified baseline 10-m gait speed as the best independent predictor of achieving more than 300 m on the 6MWD.

02The identified baseline 10-m gait speed cut-off was 0.84 m/s, and 71.8% of patients above it achieved more than 300 m on the 6MWD.

0388 (64.2%) patients completed the 6MWD test, and 39 (44.3%) walked more than 300 m.

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

Single-center study, so findings may not apply elsewhere. Single-arm design with no control group, so improvement cannot be attributed to DOPPO. Only 88 (64.2%) patients completed the 6MWD test; 49 stopped because of unstable walking. The 0.84 m/s cut-off was derived from this cohort. Participants were selected: they had to consent and complete the program, and mental or social frailty, extremely low prior activities of daily living, and high fall or fracture risk were excluded. The DOPPO program combined several exercise domains and team members, so the contribution of any single component cannot be separated. Underlying causes of hospitalization varied widely, so results may not apply to one specific diagnosis.

The easy way to misread this

Do not read the 83.2% discharge rate or improved gait speed as proof that DOPPO works. The study had no control group, and 49 patients could not complete the 6MWD test, so the result cannot show the program caused the improvement.

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