Can Mobility Rehabilitation for Older Adults Prevent Adverse Health Outcomes after one year of follow up?

Research Objectives: To investigate the impact of the Live Long Walk Strong (LLWS) physical therapy (PT) program on hospital admissions and emergency department (ED) visits among the Veterans treated with LLWS in comparison to matched controls.

Design: Concurrent matched cohort design over 1 year of follow up

Setting: Ambulatory physical therapy care within a VA medical center

Participants: There were n=69 older adult Veterans that completed LLWS care between 2018-2019. Using the electronic medical record data, controls were initially selected based on being from the same healthcare system and referred to physical therapy care at the same time with the same diagnostic codes. They were matched based on measures of age, gender, comorbidity and fall history using Inverse Proportional Weighting of Treatment creating a control group of n=1470 Veterans.

Interventions: LLWS is an innovative program of PT that delivers care addressing three domains: 1) treating physiologic impairments scientifically linked to mobility decline ; 2) behavioral coaching targeting physical activity promotion: and 3) case management linking the patient to community based physical activity programs. LLWS was provided through a VA funded clinical demonstration project.

Main Outcome Measures: The occurrence of a hospitalization or of an ED visit over one year of follow up after discharge from PT care.

Results: Participants within both cohorts were successfully matched using IPTW techniques. They were predominately male (92-94%), were of similar mean age (75-77 years) and had similar rates of falls and mobility limitation diagnostic codes. After one year we observed a 42% lower odds of having a ED visit ( OR .58 95% CI .47, .73), but there was no difference in the rate of ER visits over one year. We observed a significantly reduced liklihood of having any hospitalization (OR.61, 95% CI .48,.77) if treated with LLWS.

Conclusions: LLWS, a PT program previously demonstrated to create significant and clinically meaningful improvements in function, has the potential to substantially reduce the odds of ER visits and hospitalization after one year of follow up. Validation of these findings within a larger sample older would be beneficial.

Author(s) Disclosures: None