Minimally Clinically Important Change in the Activity Measure for Post-Acute Care (AM-PAC), a Generic Patient-Reported Outcome Tool, in People With Low Back Pain

Lee, Natalie; Thompson, Nicolas R.; Passek, Sandra; Stilphen, Mary; Katzan, Irene

doi:10.1093/ptj/pzx083

Cited by 6 publications

(6 citation statements)

References 42 publications

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“…Moreover, the AM-PAC-CAT is the only functional assessment tool that has been shown to be responsive among functionally impaired patients with advanced-stage cancer . Its minimal clinically important difference (MCID) for improvement in this population is 1, which agrees with other reports . Pain was assessed with the Brief Pain Inventory (BPI) average and total interference scores.…”

Section: Methodssupporting

confidence: 80%

Effect of Collaborative Telerehabilitation on Functional Impairment and Pain Among Patients With Advanced-Stage Cancer

Cheville

Moynihan

Herrin³

et al. 2019

JAMA Oncol

106

136

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IMPORTANCE Most patients with advanced-stage cancer develop impairment and pain-driven functional losses that jeopardize their independence. OBJECTIVE To determine whether collaborative telerehabilitation and pharmacological pain management improve function, lessen pain, and reduce requirements for inpatient care. DESIGN, SETTING, AND PATIENTS The Collaborative Care to Preserve Performance in Cancer (COPE) study was a 3-arm randomized clinical trial conducted at 3 academic medical centers within 1 health care system. Patient recruitment began in March 2013 and follow-up concluded in October 2016. Participants (N = 516) were low-level community or household ambulators with stage IIIC or IV solid or hematologic cancer. INTERVENTIONS Participants were randomly assigned to the (1) control arm, (2) telerehabilitation arm, or (3) telerehabilitation with pharmacological pain management arm. All patients underwent automated function and pain monitoring with data reporting to their care teams. Participants in arms 2 and 3 received 6 months of centralized telerehabilitation provided by a physical therapist-physician team. Those in arm 3 also received nurse-coordinated pharmacological pain management. MAIN OUTCOMES AND MEASURES Blinded assessment of function using the Activity Measure for Postacute Care computer adaptive test, pain interference and average intensity using the Brief Pain Inventory, and quality of life using the EQ-5D-3L was performed at baseline and months 3 and 6. Hospitalizations and discharges to postacute care facilities were recorded. RESULTS The study included 516 participants (257 women and 259 men; mean [SD] age, 65.6 [11.1] years), with 172 randomized to 1 of 3 arms. Compared with the control group, the telerehabilitation arm 2 had improved function (difference, 1.3; 95% CI, 0.08-2.35; P = .03) and quality of life (difference, 0.04; 95% CI, 0.004-0.071; P = .01), while both telerehabilitation arms 2 and 3 had reduced pain interference (arm 2, −0.

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Section: Methodssupporting

confidence: 80%

Effect of Collaborative Telerehabilitation on Functional Impairment and Pain Among Patients With Advanced-Stage Cancer

Cheville

Moynihan

Herrin³

et al. 2019

JAMA Oncol

106

136

View full text Add to dashboard Cite

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“…about 17% of patients showed AM-PAC scores that improved 5 points or greater. The minimally clinically important difference (MCID) in AM-PAC Basic Mobility Short Form, generated from outpatient data in patients with low back pain 33 , ranges from 3.3 to 5.1. Future research is needed to determine if positive changes in functional status and mobility levels are higher with PT-led programs compared to nursing-led programs and to establish the MCID of the AM-PAC Basic Mobility Short Form in acute care patients.…”

Section: Discussionmentioning

confidence: 99%

“…Project BOOST and ITIM. Project BOOST is a care transition and readmission reduction program designed to improve patient outcomes and control the resulting costs, and was used on the unit prior to the QI project 33 . Hallmarks of the program include an emphasis on discharge planning communication among team members with the patient 15 .…”

Section: Settingmentioning

confidence: 99%

BOOSTing patient mobility and function on a general medical unit by enhancing interprofessional care

Johnson

Kuperstein

Graham

et al. 2021

Sci Rep

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Low mobility during hospitalization remains prevalent despite associated negative consequences. The goal of this quality improvement (QI) project was to increase patient mobility and function by adding a physical therapist (PT) to an existing interprofessional care team. A mobility technician assisted treatment group patients with mobility during hospitalization based on physical therapist recommendations. Change in functional status and highest level of mobility achieved by treatment group patients was measured from admission to discharge. Observed hospital length of stay (LOS), LOS index, and 30-day all cause hospital readmission comparisons between treatment group and a comparison group on the same unit, and between cross-sectional comparison groups one year prior were used for Difference in Difference analysis. Bivariate comparisons between the treatment and a cross-sectional comparison group from one year prior showed a statistically significant change in LOS Index. No other bivariate comparisons were statistically significant. Difference in Difference methods showed no statistically significant change in observed LOS, LOS Index, or 30-day readmission. Patients in the treatment group had statistically significant improvements in functional status and highest level of mobility achieved. Physical function and mobility improved for patients who participated in mobility sessions. Mobility technicians may contribute to improved care quality and patient safety in the hospital.

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“…The AM‐PAC has a minimal administration burden and excellent reliability, validity and sensitivity to changes (Coster et al, 2006 ; Haley et al, 2004 ). The minimal clinically important change lies between 3.9 and 5 points (Lee et al, 2017 ). Therefore, in this study participants were labelled as ‘recovered’ when their postoperative AM‐PAC score reached their preoperative score minus 5 points.…”

Section: Methodsmentioning

confidence: 99%

Physical functioning and physical activity after gastrointestinal or bladder oncological surgery: An observational cohort study

Bor

Leeuwerk

Valkenet

et al. 2022

European J Cancer Care

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Objective: The aim of this study was to investigate the recovery of physical functioning and objective physical activity levels up to 3 months after oncological surgery and to determine the association between physical activity levels and the recovery of physical functioning.Methods: A longditudinal observational cohort study was conducted in patients who underwent gastrointestinal or bladder oncological surgery. Recovery of physical functioning was measured preoperatively, and 1 and 3 months after discharge. Physical activity was objectively measured with an accelerometer during hospitalisation, and 1 and 3 months after discharge.Results: Between February and November 2019, 68 patients were included. Half of the patients (49%) were not recovered in physical functioning 3 months after surgery.During hospitalisation, physical activity increased from 13 to 46 median active minutes per day. At 1 and 3 months after discharge, patients were physically active for 138 and 159 median minutes per day, respectively. Patients with higher levels of physical activity 1 month after discharge showed to have higher levels of physical functioning up to 3 months after discharge. Conclusion:At 3 months after surgery, physical functioning is still diminished in half of the patients. It is important to evaluate both physical activity levels and physical functioning levels after surgery to enable tailored postoperative mobility care.

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Minimally Clinically Important Change in the Activity Measure for Post-Acute Care (AM-PAC), a Generic Patient-Reported Outcome Tool, in People With Low Back Pain

Cited by 6 publications

References 42 publications

Effect of Collaborative Telerehabilitation on Functional Impairment and Pain Among Patients With Advanced-Stage Cancer

Effect of Collaborative Telerehabilitation on Functional Impairment and Pain Among Patients With Advanced-Stage Cancer

BOOSTing patient mobility and function on a general medical unit by enhancing interprofessional care

Physical functioning and physical activity after gastrointestinal or bladder oncological surgery: An observational cohort study

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