DELIVERING TAILORED REHABILITATION THROUGH AN ELECTRONIC PATIENT RECORD TO PROMOTE PHYSICAL FUNCTION

Rehabilitation has potential to exploit technology to address changes in physical functioning associated with chronic diseases and aging. This cohort study was designed to determine feasibility of using an electronic patient health record to prevent the physical functional decline in persons ≥44years with and without chronic diseases/conditions. Participants completed self-report measures including assessments of function and preclinical disability, the Rapid Assessment of Physical Activity (RAPA), at baseline, 6, 12, and 18 months. Participants, 97 persons with chronic diseases/conditions (CD) and 50 persons without (NCD), identified goals using the Patient Specific Functional Scale (PSFS). Using the assessment results, physical and occupational therapists tailored recommendations delivered electronically to address the goals. A library of therapist intervention pages (TIPs) on rehabilitation strategies was created, with topics such as back pain, energy conservation, managing arthritis, balance exercises etc.. Forty-two percent of persons with CD had no difficulty or preclinical changes at baseline compared to 92% without chronic disease; 35% with CD and 8% (NCD) had early changes or difficulty; while 23% (CD) had established difficulty in physical functioning, experiencing significant or longstanding difficulties with physical functioning, mobility, or activities of daily living. Although the range of health-related activities identified with the PSFS varied, functional mobility and exercise/physical activity items were prominent. After 6 months, significant changes in physical activities (RAPA; p=0.05) were detected in the CD group. Findings suggest that on-line monitoring and delivery of rehabilitation strategies support improvements in physical activities and thus promote physical functioning for people with chronic conditions.