Date of Award

2014

Document type

Thesis

Degree Name

Masters theses/dissertations - taught courses

First Supervisor

Dr Frances Horgan

Keywords

Frailty, Elderly, Rehabilitation Outcome

Abstract

The projected increase in the older population over the coming decades will place a greater demand on health-care services. Frailty is highly prevalent in the hospitalised older adult. There is a lack of research examining the impact of frailty on determinants of physical function, quality-of-life and falls self-efficacy.

Aims and Objectives:

The primary aim of this research was to evaluate the changes in physical function, quality-oflife and falls self-efficacy in frail older adults undergoing inpatient rehabilitation. A secondary aim was to examine the association between frailty and rehabilitation outcomes of physical function, quality-of-life, self-efficacy, time spent in therapy, length of stay and discharge destination.

Methods:

A prospective cohort study design was employed using a sample of convenience. Forty-one subjects attending an inpatient post-acute rehabilitation unit were assessed on admission and at discharge. A range of physical determinants were used to assess function. They included the Clinical Frailty Scale (CFS), Grip-strength, Timed-Up-and-Go (TUG), ten meter walk test (10MWT), Elderly Mobility Scale (EMS), Tinetti Balance and Gait Assessment, Barthel ii Index (BI). The EuroQol-5D Visual Analogue Scale (EQ-5D-VAS) was used to assess quality-of-life and the Falls Efficacy Scale (FES) as a measure of falls self-efficacy.

Results:

The mean (±SD) age of the sample was 80.3(±7.1) years and the majority were female. Statistically significant changes from admission to discharge were found in the CFS (p≤0.001), grip-strength (p≤0.001), TUG (p≤0.001), 10MWT (p≤0.001), Tinetti (p≤0.001), BI (p≤0.001), EQ-5D-VAS (p≤0.001) and FES (p≤0.001). Moderate positive correlations were found between admission CFS and TUG (r=0.438, p

Conclusions:

Frailty on admission was shown to have a modest relationship with many physical determinants of function, time spent in therapy and length of stay. It is evident that frailty iii alone does not provide the clinician with a definitive clinical evaluation of an older person's potential outcome following rehabilitation.

Implication of Findings:

This research provides the clinician with a better understanding of the relationship between frailty and specific functional outcomes of the older person. Policy makers are also more informed of the influence of frailty on health-service provision in the older adult undergoing post-acute rehabilitation.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 License.

File Size

2.6MB

Comments

A thesis submitted in partial fulfilment of the requirements for the degree of MSc in Neurology and Gerontology to the Royal College of Surgeons in Ireland in 2014.

Included in

Physiotherapy Commons

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