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Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
S107
a non-acute multi-disciplinary safe environment with the aim to
allow them to return to living independently.
Methods:
The team take a holistic patient-centred multi-
disciplinary approach. This includes interaction in the communal
areas, for example group physiotherapy sessions and meals. The
multidisciplinary team works closely together with excellent
communication using daily board round and weekly MDT meetings
to discuss complex discharges with the patient and families.
Results:
73% of patients were discharged to their own home, 90%
within 6 weeks, 78% within 28 days. Functional and mobility scores
improved with an increase of 3 on Bartel, a 5.5% gain in body weight,
no pressure sore development, and a significantly lower usage of
antibiotics. All patients viewed their stay as a positive experience.
Conclusions:
Overall the patient experience is excellent, with great
outcomes both qualitative and quantitative. The unit is meeting
the needs of the most frail and vulnerable older patients in a safe
and health-improving environment. The vision to improve quality
of life and increase independence has enabled a vast majority to
go home, rather than inappropriate transfer to 24 hour care or the
increased complication from unnecessary high length of stay in the
acute hospital.
P-282
Falls as an indicator of the reduced motor function and quality
of life in elderly patients with stroke
E. Goz
1
, A. Genc
1
, V. Ozturk
1
1
Dokuz Eylul University, Izmir, Turkey
Objectives:
Falling is a common problem among elderly people,
especially in patients with stroke. Falls are related functional
limitations, reduced mobility and activity, fear of falling as a
consequence of this quality of life reduced after stroke. This study
investigate the relationship between frequency of falls and quality
of life, motor function, functional capacity and balance in elderly
stroke patients.
Methods:
Thirty-one stroke patients who were over 60 years of
age included in this study. Patients with aphasia, orthopedic and
other neurologic problem, and recurrent stroke were excluded.
Quality of life [Stroke Impact Scale (SIS)], motor function [Stroke
Rehabilitation Assessment of Movement Measure (STREAM)],
balance [Activities-specific Balance Confidence (ABC) Scale] and
functional capacity [6 Minute Walk Test (6 MWT)] were evaluated.
Results:
Fifteen patients (48.4%) reported fall. A significant
correlation was found between falls and quality of life, motor
function, functional capacity, balance measurements (Spearman
Correlation test, SIS; r = −0.514, p = 0.003, STREAM; r = −0.514,
p = 0.003, 6 MWT; r = −0.458, p = 0.01, ABC; r = −0.410, p = 0.02).
While there was a statistically significant difference in motor
function and quality of life scores between fallers and non-
fallers (Mann–Whitney U test, p
<
0.05), the difference in functional
capacity and balance scores was not significant (Mann–Whitney U
test, p
>
0.05).
Conclusions:
As a result of this study, elderly stroke patients
who had fallen have poor motor function and this situation
affects their quality of life. This study suggests that fall preventing
approach should add to the rehabilitation programs for elderly
stroke patients.
P-283
Feasibility study of motivational interviewing to improve
rehabilitation in an intermediate care hospital
N. Gual
1
, A. Calle
2
, J. Casino
1
, P. Lusilla
3
, A. Gual
4
, M. Inzitari
5
1
Parc Sanitari Pere Virgili, Barcelona, Spain;
2
Parc Sanitari Pere Virgili,
Spain;
3
Hospital Universitari Vall Hebron, Barcelona;
4
Hospital Cl´ınic
de Barcelona, Barcelona, Spain;
5
Spain
Objective:
Our main objective was to test the feasibility of
adding a patient centered motivational intervention to the usual
rehabilitation in an Intermediate Care (IC) Hospital for patients
admitted after a hip fracture or stroke.
Methods:
20 patients
>
65 years (10 hip fracture;10 stroke)
participated in the study, receiving two motivational interviewing
sessions by a trained geriatrician, the first within the 72 hours
after admission, the second one week later. All patients were
given leaflets informing about different rehabilitation exercises to
perform besides formal physical therapy provided in the hospital,
among which they could choose those they felt more suitable. Data
collected included socio-demographics, comorbidity, and clinical,
cognitive and functional status.
Results:
The motivational intervention was accepted by all
patients and all felt it to be appropriate. Opportunities for this
intervention were high, 4–5 patients per week, best time for the
interventions was in the afternoons, which avoided interferences
with hospital activities. In patients with mild cognitive impairment
the intervention was harder, and in 3 occasions the primary
caregiver was invited to participate, with high acceptance and
enthusiasm. Patients at baseline were already highly motivated
to do rehabilitation, and ambivalence was not big. Therefore most
of the interviews focussed on empowering patients and helping
them to identify and set their own goals during rehabilitation.
Conclusions:
Adding specific motivational interventions to usual
rehabilitation treatment in older patients admitted after a hip
fracture or stroke, is feasible and acceptable in our IC Hospital.
Since patients are quite prone to rehabilitation, interviews tend to
focus on empowerment. Further, rigorous research is needed.
P-284
Novel use of the Nintendo Wii board for measuring isometric
lower limb strength: A reproducible and valid method in older
adults
M.G. Jorgensen
1
, S. Andersen
1
, J. Ryg
2
, T. Masud
3
1
Aalborg University Hospital, Aalborg, Denmark;
2
Odense University
Hospital, Odense, Denmark;
3
United Kingdom
Objectives:
Portable, low-cost, objective and reproducible
assessment of muscle strength in the lower limbs is important
as it allows clinicians to precisly track progression of patients
undergoing Geriatric rehabilitation. The Nintendo Wii Balance
Board (WBB) is portable, inexpensive, durable, available worldwide,
and may serve the above function. The purpose of the study was
(1) to explore reproducibility and (2) concurrent validity of the
WBB for measuring isometric muscle strength in the lower limb.
Methods:
A custom hardware and software was developed to
utilize the WBB for assessment of isometric muscle strength. The
study design was a test-retest intra-rater reproducibility study,
which followed international guidelines for reporting reliability
and agreement (GRRAS). Thirty older adults (69.0
±
4.2 years of
age) were studied using both relative and absolute measures of
reproducibility. Concurrent validity was explored by comparing the
WBB against a stationary isometric dynamometer (SID).
Results:
No systematic difference between test-retest was observed
for the WBB. The Intra-class correlation coefficients (ICC 3.1) ranged
from 0.911 to 0.967, Standard Error of Measurement from 9.7 to
13.9%, and Limit of Agreement from 20.3 to 28.7% for the WBB when
averaging one to three recordings. Concurrent validity between the
WBB and the SID on session one were all statistically significant
and range from 0.691 to 0.846.
Conclusions:
The WBB had a high relative reproducibility and
acceptable absolute reproducibility in older adults. Concurrent
validity was good as the WBB correlated significantly with the
SID.