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Implementing 3-Step Workout for Life in Home Health

Date:

Node: 253841

Studies

Study First Submitted Date 2021-01-07
Study First Posted Date 2021-01-14
Last Update Posted Date 2023-07-13
Start Month Year May 26, 2022
Primary Completion Month Year April 3, 2023
Verification Month Year July 2023
Verification Date 2023-07-31
Last Update Posted Date 2023-07-13

Detailed Descriptions

Sequence: 20792699
Description Medicare beneficiaries admitted to home health agencies are often in a frail status with decreased muscle strength and difficulty in performing activities of daily living. The purpose of the proposed research is to study how to adapt and implement the 3-Step Workout for Life program by the physical therapists and occupational therapists in a local home health agency. A series of learning cycles will be conducted to adjust the treatment dose and delivery mode, so that the program can be implemented at low cost but remains effective in improving self-care ability for Medicare beneficiaries. The specific aims include to evaluate the implementation outcomes and clinical outcomes, and to identify facilitators and barriers associated with the implementation.

Facilities

Sequence: 200734483
Name University of Florida
City Gainesville
State Florida
Zip 32610
Country United States

Conditions

Sequence: 52353882 Sequence: 52353883
Name Frailty Name Disability or Chronic Disease Leading to Disablement
Downcase Name frailty Downcase Name disability or chronic disease leading to disablement

Id Information

Sequence: 40289436
Id Source org_study_id
Id Value IRB202001011

Countries

Sequence: 42711533
Name United States
Removed False

Design Groups

Sequence: 55796275
Group Type Experimental
Title Implementation Arm
Description Participants will receive the 3-Step Workout for Life program and other rehabilitation services based on the plan of care.

Interventions

Sequence: 52664796
Intervention Type Other
Name 3-Step Workout for Life
Description Participants will receive the 3-step Workout for Life program given by their physical therapy or occupational therapy providers. The program includes single-joint and multiple joint progressive resistance exercise and activities of daily living exercise training. During the resistance exercise sessions, participants will use resistance tubing to strengthen major muscle groups of the upper extremity and lower extremity. During the activities of daily living exercise, participants will practice activities of daily living that they experience difficulty. The intervention volume, duration, and frequency will be modified to enhance practicality in a home health care setting over the implementation phase. In addition to the 3-Step Workout for Life, participants may also receive other routine rehabilitation treatment determined and provided by their therapists to facilitate their functional recovery.

Design Outcomes

Sequence: 178052861 Sequence: 178052862 Sequence: 178052863 Sequence: 178052864
Outcome Type primary Outcome Type secondary Outcome Type secondary Outcome Type secondary
Measure Self-care items from the Outcome and Assessment Information Set (OASIS) Measure Mobility items from the Outcome and Assessment Information Set (OASIS) Measure EuroQoL (EQ-5D-5L) Measure Activity Measure Post Acute Care (AM-PAC): Home Care Short Form
Time Frame Change from admission to discharge which is a period of about two months Time Frame Change from admission to discharge which is a period of about two months Time Frame Change from admission to discharge which is a period of about two months Time Frame Change from admission to discharge which is a period of about two months
Description The self-care items are selected from the OASIS. OASIS is a comprehensive assessment to collect information in home health Medicare patients. The self-care items evaluate the degree of independence in seven activities: eating, oral hygiene, toileting hygiene, upper body dressing, lower body dressing, shower/bathe, and putting on/removing footwear. Each activity is scored on a six-point Likert scale ranging from 1 (totally dependent) to 6 (totally independent). The home health care provider scores the patient based on information obtained from observation and interview. If an activity was not attempted, the reason would be documented (for example, the patient refused, not applicable because the patient did not perform this activity prior to the current illness, not attempted due to environmental limitations, medication conditions, or safety concerns). A ratio score will be computed to adjust for items that are not attempted. Description The mobility items are selected from the OASIS. The mobility items evaluate the degree of independence in the following activities: roll left and right, sit to lying, lying to sitting on side of the bed, sit to stand, chair/bed-to-chair transfer, toilet transfer, car transfer, walk 10 feet, walk 50 feet with two turns, walk 150 feet, walking 10 feet on uneven surfaces, 1 step (curb), 4 steps, 12 steps, picking up an object from the floor, wheel (use a wheelchair or scooter) 50 feet with two turns, & wheel 150 feet. Each activity is scored on a six-point Likert scale ranging from 1 (totally dependent) to 6 (totally independent). The home health care provider scores the patient based on information obtained from observation and interview. If an activity was not attempted, the reason would be documented. A ratio score will be computed to adjust for items that are not attempted. Description EuroQoL is a self-reported, health-related, quality of life questionnaire. It measures the quality of life on 5 domains, including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each domain is rated on a 5-level scale, with a higher level indicates a better outcome. Description AM-PAC home care short form is a patient-report outcome measure. It assesses patients' degree of difficulty doing daily activities, basic mobility, and functional cognition tasks (e.g., remember to take medications). A higher level indicates a better outcome.

Browse Conditions

Sequence: 194181228 Sequence: 194181229 Sequence: 194181230 Sequence: 194181231
Mesh Term Frailty Mesh Term Chronic Disease Mesh Term Pathologic Processes Mesh Term Disease Attributes
Downcase Mesh Term frailty Downcase Mesh Term chronic disease Downcase Mesh Term pathologic processes Downcase Mesh Term disease attributes
Mesh Type mesh-list Mesh Type mesh-list Mesh Type mesh-ancestor Mesh Type mesh-ancestor

Sponsors

Sequence: 48489166 Sequence: 48489167
Agency Class OTHER Agency Class OTHER
Lead Or Collaborator lead Lead Or Collaborator collaborator
Name University of Florida Name American Occupational Therapy Foundation

Overall Officials

Sequence: 29381861
Role Principal Investigator
Name Chiung-ju Liu, PhD
Affiliation University of Florida

Design Group Interventions

Sequence: 68398259
Design Group Id 55796275
Intervention Id 52664796

Eligibilities

Sequence: 30870675
Gender All
Minimum Age 65 Years
Maximum Age N/A
Healthy Volunteers No
Criteria Inclusion Criteria: is a Medicare beneficiary admitted to the partnered home health agency show or experience muscle weakness demonstrate functional limitation on at least one of the OASIS self-care items Exclusion Criteria: has an acute fracture with surgical or weight-bearing restrictions has elective joint replacement surgery has a lower extremity amputation is receiving active treatment for cancer diagnosis has on-going dialysis treatment had acute cardiac surgery with acute stroke or neurologic disorder that limits motor movements in terminal stages of congestive heart failure has been referred to hospice care has severe cognitive deficits limiting verbal communication has significant medical complications that preclude safe participation in resistance exercise
Adult False
Child False
Older Adult True

Calculated Values

Sequence: 254031064
Number Of Facilities 1
Registered In Calendar Year 2021
Actual Duration 10
Were Results Reported False
Has Us Facility True
Has Single Facility True
Minimum Age Num 65
Minimum Age Unit Years
Number Of Primary Outcomes To Measure 1
Number Of Secondary Outcomes To Measure 3

Designs

Sequence: 30616473
Allocation N/A
Intervention Model Single Group Assignment
Observational Model
Primary Purpose Other
Time Perspective
Masking None (Open Label)

Responsible Parties

Sequence: 28983011
Responsible Party Type Sponsor

Study References

Sequence: 52256835 Sequence: 52256836 Sequence: 52256837
Pmid 26583695 Pmid 28769559 Pmid 32073464
Reference Type background Reference Type background Reference Type background
Citation Liu CJ, Jones LY, Formyduval A RM, Clark DO. Task-Oriented Exercise to Reduce Activities of Daily Living Disability in Vulnerable Older Adults: A Feasibility Study of the 3-Step Workout for Life. J Aging Phys Act. 2016 Jul;24(3):384-92. doi: 10.1123/japa.2015-0070. Epub 2015 Nov 19. Citation Liu CJ, Xu H, Keith NR, Clark DO. Promoting ADL independence in vulnerable, community-dwelling older adults: a pilot RCT comparing 3-Step Workout for Life versus resistance exercise. Clin Interv Aging. 2017 Jul 19;12:1141-1149. doi: 10.2147/CIA.S136678. eCollection 2017. Citation Liu CJ, Donovan J, Wolford CL. Feasibility of staff-led 3-Step Workout for Life to reduce late-life activities of daily living disability: a community-based translational study. Int J Rehabil Res. 2020 Jun;43(2):141-147. doi: 10.1097/MRR.0000000000000396.