Multicomponent Telerehabilitation to Engage Veterans in Effective Self-Management of ComplexHealth Conditions
VA Office of Research and Development
Summary
Medically complex older Veterans are at greater risk for progressive declines in physical function, lower quality of life, and increasing care needs. Additionally, older Veterans experience social isolation and loneliness, and have low levels of physical activity. While the Veterans Health Administration has established programs to address rehabilitation needs, these programs tend to be diagnosis-focused, lack self-management approaches, include low-intensity rehabilitation, and typically require in-person attendance. A MultiComponent TeleRehabilitation (MCTR) program that includes high-intensity rehabilitation and self-management interventions, social support, and telehealth and technology supports may be more effective in improving and sustaining physical function for older Veterans with complex health conditions. Therefore, this project is designed to determine whether the MCTR program improves strength and physical function more effectively than traditional interventions.
Description
The proposed MultiComponent TeleRehabilitation (MCTR) program addresses current healthcare deficiencies by using a multicomponent approach that includes both high-intensity rehabilitation interventions and self-management interventions that are not part of traditional physical therapy interventions. Therefore, the investigators propose a two-arm, parallel randomized trial using a crossover study design to determine the effectiveness (AIM 1) of a 12-week multicomponent telerehabilitation program to improve physical function. The investigators will also measure Veterans' clinical outcomes to eva…
Eligibility
- Age range
- 60+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * 60 years of age and older * Multiple chronic conditions (Functional Comorbidity Index \> or = 3) * Impaired physical function (\< or = 8 repetitions on 30 second sit to stand test) Exclusion Criteria: * Life expectancy \< 12 months * Acute or progressive neurological disorder (e.g. amyotrophic lateral sclerosis, recent stroke) * Moderate to severe dementia (\<11 on telephone Montreal Cognitive Assessment(T-MoCA)) * Medical conditions precluding safe participation in high-intensity rehabilitation (e.g. unstable angina)
Interventions
- BehavioralMotivational Interviewing Techniques
Motivational Interviewing Techniques including but not limited to open-ended questions, reflection, affirmations, and summary will be used to build participant rapport, support behavior change (physical activity), and facilitate program engagement.
- OtherPhysical Therapy Interventions
Strengthening, balance, functional activities, stretching, breathing, aerobic endurance exercise.
- OtherEducation
Education on general health topics which may include the following: basic nutrition, stress reduction, sleep hygiene, etc.
- OtherHealth Status Updates
Health Status Updates will be completed by a trained assessor. The assessor will ask about adverse events, general health topics, medication changes, and changes in social circumstances.
- OtherPhysical Therapy Consult
Participants in the control condition will be offered a physical therapy consult at the end of their 24 week study involvement.
Location
- Rocky Mountain Regional VA Medical Center, Aurora, COAurora, Colorado