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144 Musculoskeletal & Neurological Rehabilitation KCE reports 57 7.5.2.7 Intensity of therapy None of the pathways gave information on the amount of therapy in hours a day. All pathways describe daily therapy. No information is given on therapy during the weekends. 7.5.2.8 Type of therapy All pathways contain physical therapy. Physical therapy includes mobilisation, isometric exercises and ambulating with a walking aid. Eight of the ten pathways include occupational therapy. The content of the therapy varies between pathways: supplying the necessary walking aid, ADL-assessment, kitchen assessment, stair climbing… 7.5.2.9 Expected outcomes and the use of outcome measurement tools In Figure 7.3 a detailed overview is given of the milestones needed to be reached at discharge. In general we conclude that ambulating independently with a walking aid, be able to climb stairs and be able to perform ADL independently are the milestones needed to be achieved for discharge.
KCE reports 57 Musculoskeletal & Neurological Rehabilitation 145 Figure 7.3: Benchmark of discharge criteria after total hip replacement Length of Stay Physical Therapy discharge criteria Occupational Therapy discharge criteria Belgium 23-40 March with 1 elbow crutch March 400 m Walk stairs Active flexion, extension and abduction of hip Lakes US 5 Knows home exercise program Able to ambulate independently with safe gait with crutches/walker on level surface and stairs Correct total hip precautions ADL independently Hip ergonomy Proper use of ADL-equipment Self care independent Independent transfers Outpatient rehabilitation services? No information Discharge to appropriate level of care, with appropriate level of care St John’s US 4 No information No information DC: home, home care, rehabilitation centre, LTAC, ECF, home with community referral. Germany 6 Walks partially independent Stair climbing Full weight bearing Able to perform car transfer Not involved Physical therapist at home Australia 7 Ambulating independently using walking aids Able to perform safe hygiene needs Not involved No information UK Airedale 6 Able to mobilise independently using appropriate walking aids Able to negotiate stairs. Understands precautions to be taken following hip replacement Able to dress independently using appropriate aids. Services/ aids in place to enable safe discharge to take place Isle of Wight UK 11 No information No information No information London UK Peterborough UK Acute phase: 3 (rehabilitation facility) Post-acute phase: 7 (home-based) Acute phase: transfers independently bed to chair; Independently mobile with frame/elbow crutches; attempt stairs Post-acute phase: Mobile independent with aid, ascend and descend stairs safely with aid, able to mobilize outside home Acute: not involved Post-acute phase: transfers independently, able to prepare a light meal No information 7 Discharge checklist Discharge checklist Physical therapy Rotherham 7 Physical therapy assessment of sitting, mobilise with elbow crutches, stair climbing Transfers, kitchen and dressing practice. No information
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Dépôt légal : D/2007/10.273/19
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35. Etude relative aux coûts poten
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