Figure 1
iREAP Model of Care.
Table 1
Reimagining Day Rehabilitation – evolution of the iREAP model of care.
| TRADITIONAL DAY HOSPITAL | iREAP |
|---|---|
| Post-acute referral pathways | Referral direct from primary care, specialist physicians, Aged Service Emergency Team (ASET), community allied health and self-referral |
| Post crisis, post illness, post-injury, post-surgical intervention | Anticipatory – pre-crisis intervention for those at risk of, or experiencing frailty and/or falls; or early in course of a neurodegenerative condition |
| Focus on physical outcomes and ADL’s | Holistic across physical, psychological and social domains |
| Fixed treatment protocol | Individualised care plan related to the individual’s goals of care |
| Didactic education approach | Health coaching, education and enablement |
| Single discipline lead | Geriatrician and Care Coordinator lead Multi-disciplinary case conferencing and intervention |
| Discharge home exercise program | Individualised enablement strategies through health coaching process |
| Physical outcome measures | Outcome measures across all health domains |
Table 2
Baseline Characteristics of Participants.
| CHARACTERISTIC | TOTAL GROUP (n = 99) | FALLS/FRAIL GROUP (n = 47) | ND GROUP (n = 52) |
|---|---|---|---|
| Age (years) | |||
| Mean | 76 | 80 | 72 |
| Range | 57–91 | 57–91 | 59–85 |
| Sex, n (%) | |||
| Female | 41 (41.4%) | 23 (48.9%) | 17 (32.7%) |
| Male | 58 (58.6%) | 24 (51.1%) | 35 (67.3%) |
| Cognition, n (%) | |||
| Intact | 38 (38.4%) | 24 (51.1%) | 14 (26.9%) |
| MCI | 26 (26.3%) | 11 (23.4%) | 15 (28.8%) |
| Dementia | 25 (25.2%) | 09 (19.1%) | 16 (30.8%) |
| Unknown | 010 (10.1%) | 03 (06.4%) | 07 (13.5%) |
| Polypharmacy, n (%) | |||
| Present | 60 (60.6%) | 17 (36.2%) | 35 (67.3%) |
| Not present | 31 (31.3%) | 25 (53.2%) | 14 (26.9%) |
| Unknown | 08 (08.1%) | 05 (10.6%) | 03 (5.8%) |
Figure 2
Clinical Frailty Scale and Patient Activation Measure (PAM-13).
*Pre-FS – pre-program CFS; Post FS – post-program CFS.
Table 3
Physical measures.
| PHYSICAL TEST | MEAN | RANGE (min–max) | P-VALUE | |
|---|---|---|---|---|
| Timed Up and Go in 3m (s) | Pre | 16.99 | 4.79–62.00 | 0.007 |
| Post | 14.25 | 4.97–49.52 | ||
| Berg Balance* | Pre | 44.44 | 15–56 | 0.00002 |
| Post | 48.54 | 21–56 | ||
| 6-minute walk test (m) | Pre | 293.81 | 43.5–605 | 0.001 |
| Post | 336.06 | 133–600 |
[i] * The Berg Balance Scale total maximum score of 56 indicates no balance issues detected.