The Jintronix technology to prevent functional decline in pre-frail/frail seniors consulting Emergency Departments
Screening and identification of seniors at risk is crucial in emergency departments (EDs) in order for effective interventions to be implemented. Therefore, this project will measure the feasibility and effectiveness of a screening-intervention process in two Québec EDs.
Possible Research Results
Anticipated findings: Anticipated findings include an increase = 2/12 points on the SPPB 12 weeks after the intervention (3 months post-injury), and a 30% improvement in frailty status is possible.
Impact of findings: With a growing senior population in EDs, changes are needed to organize care accordingly. EDs must develop better tools to reduce preventable ED visits and thereby lower the associated health care costs. This innovative interdisciplinary study will be the first to implement frailty-based screening tools in the EDs for this population and to quickly direct patients to evidence based physical activity interventions accordingly. The Jintronix platform, JRS, allows the clinician to conveniently assign new exercises and monitor progress anytime and anywhere. By using JRS and the individualized physical activity program at home, prefrail and frail seniors can now feel they are getting the attention they need to maintain their independence.
About the Project
Each year in Canada, nearly 400,000 community-dwelling seniors sustain injuries that are not fatal but that limit their mobility and activities of daily living. The vast majority of them seek medical care in EDs and two thirds are discharged back home with various minor injuries. The Canadian Emergency Team Initiative has recently shown that these minor injuries can trigger a downward spiral of functional decline in seniors who are still independent at the time of injury. Moreover, these injuries may mask undetected early signs of physical impairments as well as a pre-frail or frail status. As there are no ED management guidelines for these pre-frail or frail injured seniors, their mobility and functional status deteriorate within six months post-discharge.
The main objective of this study is to implement frailty-based tools in EDs to screen seniors at risk of post-injury functional decline and to link them, at the time of consultation, to post-ED community-based mobility retraining interventions or to newly designed home-based rehabilitation technology.
For more details on the project rationale, hypothesis, objectives and research plan, click here.
Project Team
Principal Investigators:
Marie-Josée Sirois, OT, PhD — Université Laval/CHU de Québec
Mylène Aubertin-Leheudre, PhD — Université du Québec à Montréal
Raoul Daoust, MD, CSPQ, MSc — Hôpital du Sacré-Coeur de Montréal
Marcel Émond, MD, MSc — Université Laval
Knowledge Users and Partners:
CETI
CEVQ-CHI de Québec
JINTRONIX
Programmes PIED
UQAM
YMCA
Project Contact: Marie-Josée Sirois — marie-josee.sirois@rea.ulaval.ca
FRA 2015-B-14
Screening and identification of seniors at risk is crucial in emergency departments (EDs) in order for effective interventions to be implemented. Therefore, this project will measure the feasibility and effectiveness of a screening-intervention process in two Québec EDs.
Principal Investigators
Marie-Josée Sirois, OT, PhD — Université Laval/CHU de Québec
Mylène Aubertin-Leheudre, PhD — Université du Québec à Montréal
Raoul Daoust, MD, CSPQ, MSc — Hôpital du Sacré-Coeur de Montréal
Marcel Émond, MD, MSc — Université Laval
Rationale: In the ED there is no standard approach to risk assessment and management for subsequent functional decline for independent seniors discharged with minor injuries. This practice gap is unfortunate as there are effectiveness community-based interventions and emerging technologies for physical rehabilitation. Individualized home based exercise programs for seniors can benefit those unable to transport themselves to community centers. Jintronix inc. has developed a telerehabilitation system (JRS) that can be calibrated for seniors and allows clinicians to tailor exercise programs to each patient.
Hypothesis: The use of the JRS, which can be supervised and monitored by the clinician will be a positive driver of progress in health and well-being for pre-frail seniors by extending their mobility and function, which also will reduce health care costs.
Objectives: Assess and compare the capacity to implement the JRS versus group community-based exercise interventions following a visit to the ED in pre-frail seniors at risk of functional decline after a minor injury with respect to functional status, frailty status and its clinical markers, as well as on ED use.
Research plan: A pilot study will be conducted, targeting seniors at risk of functional decline after minor injury, discharged from EDs at HSCM and CHU de Québec hospitals. Patients will be screened for frailty in the ED and allocation to 12 weeks-interventions programs (e.g. usual ED discharge, YMCA program or individual/home Jintronix system). Individuals will be assessed 3 and 6 months post-ED visit.