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Objective This is the first study to examine Wolf Motor Function Test (WMFT) tasks among EXCITE Trial participants that could not be completed at baseline or 2 weeks later. Methods Data were collected from participants who received constraint-induced movement therapy (CIMT) immediately at the time of randomization (CIMT-I, n = 106) and from those for whom there was a delay of 1 year in receiving this intervention (CIMT-D, n = 116). Data were collected at baseline and at a 2-week time point, during which the CIMT-I group received the CIMT intervention and the CIMT-D group did not. Generalized estimating equation (GEE) analyses were used to examine repeated binary data and count values. Group and visit interactions were assessed, adjusting for functional level, affected side, dominant side, age, and gender covariates. Results In CIMT-I participants, there was an increase in the proportion of completed tasks at posttest compared with CIMT-D participants, particularly with respect to those tasks requiring dexterity with small objects and total incompletes (P < .0033). Compared with baseline, 120 tasks governing distal limb use for CIMT-I and 58 tasks dispersed across the WMFT for CIMT-D could be completed after 2 weeks. Common movement components that may have contributed to incomplete tasks include shoulder stabilization and flexion, elbow flexion and extension, wrist pronation, supination and ulnar deviation, and pincer grip. Conclusion CIMT training should emphasize therapy for those specific movement components in patients who meet the EXCITE criteria for baseline motor control.

Study Objectives: To describe the Geriatric Acute and Post-acute Fall Prevention Intervention (GAPcare), a multidisciplinary intervention to reduce recurrent falls in older adults who seek care in the emergency department (ED). To determine its feasibility in the ED setting, its acceptability to patients and caregivers, and discuss lessons learned from study implementation.Methods: This is a single-blind, randomized pilot study of adults 65 years old who presented to one of two urban academic EDs within 7 days of a fall. Patients who resided in a nursing home, were altered or intoxicated, or likely to be admitted were excluded. Participants were randomized to an intervention (INT) or usual care (UC) arm. The INT arm consisted of a medication therapy management session delivered by a pharmacist and a fall risk assessment conducted by a physical therapist (PT). A medication-related and PT action plan were provided to participants and faxed to primary care providers at the conclusion of the visit. INT participants received referrals for outpatient PT services. UC participants received routine care as directed by the ED clinician and a home safety brochure. We used participant and caregiver surveys, as well as electronic health record review to characterize the participants, program, and determine feasibility and acceptability.Results: Of 110 participants, median age was 81, 67% (n¼74) were female, 16% (n¼18) had cognitive impairment, and 94% (n¼103) were white. All but one INT participant received the pharmacy consult, while the PT consult was delivered to most (46/55) participants. Median consult time was 20 minutes for both pharmacy and PT consults. ED LOS was not significantly increased in the INT arm. Acceptability surveys were completed by 99 participants and 35 caregivers. Patient and caregiver satisfaction were high in both arms (INT patient satisfaction 97%, INT caregiver satisfaction 94%; UC patient satisfaction 92%, UC caregiver satisfaction 94%).Conclusions: A multidisciplinary fall prevention intervention delivered by pharmacists and PTs in the ED is feasible and acceptable to patients and caregivers. GAPcare could provide a model of care for other US EDs to address and modify future fall risk of older adults.

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