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Age Ageing. 2016 April; 45(Suppl 1): i1.
Published online 2016 April 4. doi:  10.1093/ageing/afw024.01
PMCID: PMC4890359

1
INTRODUCING GAIT SPEED TO ASSESS FRAILTY OUTCOMES IN DAY HOSPITAL PATIENTS

Topic There is evidence to suggest that multidisciplinary interventions can have a positive impact on frailty (Cameron et al 2013) and exercise is an important component of frailty intervention (Theou et al 2011). This project looked at whether patients referred to day hospital (DH) were frail and if so, whether usual DH care including physiotherapy could achieve similar outcomes to those within the evidence base.

Intervention It is usual physiotherapy practice to measure both physical performance and quality of life pre and post DH attendance, but these have not been used specifically to define frailty. This project aimed to shift the emphasis with routine outcome measurement (gait speed) towards assessing frailty and rehabilitation outcomes linked to frailty.

Improvement ‘Fit for Frailty’ (FFF) (BGS 2014) suggests using gait speed as one simple measure of frailty with a speed of <0.8 m/s indicative of frailty. Changes in gait speed in DH patients discharged over a 6 month period were benchmarked against:

  1. The <0.8 m/s suggested in FFF: 95% of DH patients were defined as frail on assessment and 76% frail on discharge
  2. Pereira et al (2010) who found that 21% had gait speed improved by >0.2m/s following DH intervention. In our project 43% of patients improved gait speed by >0.2 m/s
  3. A minimal clinically important difference (MCID) of 0.1 m/s (Perera et al 2006): 63% of DH patients improved gait speed by >0.1 m/s

Discussion Shifting our focus to specifically define and improve frailty levels as defined by gait speed within DH was simple and effective, as this information was already routinely collected. It enabled physiotherapy goal setting which focussed on making a MCID and improving frailty. The outcomes appeared similar or indeed better to those found in relevant literature. Future work includes looking at whether DH attendance influences emergency admissions.

References British Geriatric Society 2014 London: British Geriatrics Society

Cameron ID, Fairhall N, Langron C. BMC Medicine 2013; 11:65

Pereira SRM, Chiu W, Turner A BMC Geriatrics 2010; 10:82

Perera, S J, American Geriatric Society 2006; 54(5), 743–749.

Theou O, Stathokastas L, Roland KP. 2011 Journal of Aging Research


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