Functional Activities to Optimize Patient Outcomes in Home Health: A Pilot Randomized Controlled Trial.

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Occupational Therapy

Background:

• Home health therapy aims to improve daily living activities (ADL) and physical functioning in older adults.
• Gradually increasing task demands during rehabilitation may enhance patient outcomes.
• The Home-based Activity Reactivation Program (HARP) was developed to combine compensatory and restorative approaches.

Purpose of the Study:

• To examine the feasibility and preliminary effects of HARP as an adjuvant to usual home health therapy.
• To assess HARP's impact on ADL performance and physical functioning in home health patients.

Main Methods:

• A single-blind, pilot randomized controlled trial with repeated measures was conducted.
• Forty-seven home health patients (mean age 82.3 years) were randomized to HARP plus usual therapy or usual therapy alone.
• Outcomes included the Assessment of Motor and Process Skills, Activity Measure for Post-Acute Care, and physical performance tests.

Main Results:

• HARP demonstrated high feasibility (88% completion) and patient satisfaction (95%).
• No severe adverse events were reported.
• No significant differences in functional outcomes or physical functioning were observed between the HARP and control groups.

Conclusions:

• Adding HARP to usual home health therapy is feasible and safe but does not improve functional outcomes.
• Challenges in implementation, such as therapy visit frequency and intervention timing, may have affected results.
• Integrating adjuvant interventions into real-world home health care presents inherent difficulties.