Center for Large Data Research and Data Sharing in Rehabilitation

Association Between Rehabilitation and Nursing Outcomes in Skilled Nursing Facilities

Lynn Freeman, PhD
PATH Clinical Research Institute

Brief Bio
Dr. Freeman is Director and Postdoctoral Fellow at Path Clinical Research Institute.

Mentors
Ken Ottenbacher, PhD, OTR and Amol Karmarkar, PhD

Description
The long-term goal of this proposal is to investigate the influence of multiple chronic conditions in elderly on post acute care outcomes and resource utilization and to reduce adverse events by investigating the transitional basis for management of movement disorders in this population.

Ankle Prosthetic Use

Kevin Franck, PhD, MBA
BiOM

Brief Bio
Dr. Franck is a research assistant professor at Boston University. He received his PhD in Speech and Hearing Sciences from the University of Washington in 1999 and a MBA from the University of Pennsylvania in 2006. Dr. McDonough's research interests include health economics and bionic medical devices.

Mentor
Ken Ottenbacher, PhD, OTR

Description
This project utilizes worker compensation medical and indemnity claims data to examine the use and benefits of a bionic ankle, the cost of illness analysis associated with indemnity/disability, compare outcomes of users vs. non-users.

Ankle Prosthetic Use

Kevin Franck, PhD, MBA
BiOM

Brief Bio
Dr. Franck is a research assistant professor at Boston University. He received his PhD in Speech and Hearing Sciences from the University of Washington in 1999 and a MBA from the University of Pennsylvania in 2006. Dr. McDonough's research interests include health economics and bionic medical devices.

Mentor
Ken Ottenbacher, PhD, OTR

Description
This project utilizes worker compensation medical and indemnity claims data to examine the use and benefits of a bionic ankle, the cost of illness analysis associated with indemnity/disability, compare outcomes of users vs. non-users.

Examining Rehabilitation Outcomes for Patients with Stroke Discharged From Inpatient Rehabilitation Facility in Riyadh: A Cohort Study

Saad Bindawas, PhD
Assistant Professor
Department of Rehabilitation Sciences
College of Applied Medical Sciences
King Saud University

Brief Bio
Dr. Bindawas received his BSc in Physical Therapy from King Saud University, Riyadh, Saudi Arabia, his MHSc in Orthopedic Physiotherapy from the University of Sydney, NSW, Australia, and a PhD in Rehabilitation Sciences from the University of Texas Medical Branch at Galveston. He recently received a certificate in clinical research from the University of California, San Francisco (UCSF). Dr. Bindawas' research interests include physical functioning and disability in older adults.

Mentors
Ken Ottenbacher, PhD, OTR; James Graham, PhD, DC; Amol Karmarkar, PhD

General Description
Stroke is one of the major health issues in Saudi Arabia and it was included as a priority topic for 2013-2014 by King Abdulaziz City for Sciences and Technology (KACST). The risk of hip fracture is significantly higher among patients with stroke compared to the general population. This project is designed as an examination of the functional outcomes after hip fractures in patients with stroke, using large datasets.

Arthritis and Work Disability

Nancy Baker, ScD, OTR/L
University of Pittsburgh

Brief Bio
Dr. Baker received a ScD in Therapeutic Studies from Boston University and a MPH from the University of Pittsburgh. Her research focuses on the prevention of work disability related to musculoskeletal disorders.

Mentor
Soham Al Snih, MD, PhD

Description
This project utilizes the National Health Interview Survey and the Behavioral Risk Factor Surveillance System to examine the prevalence of work disability in people with chronic disorders.

Functional Measures After Fragility Fractures in Older Adults

Christine McDonough, PhD, PT
Boston University

Brief Bio
Dr. McDonough is a research assistant professor at the Health & Disability Research Institute, Boston University. She received her PhD in Evaluative Clinical Sciences from Dartmouth College in 2007. Dr. Horn's research interests include functional assessment and measurement.

Mentors
Ken Ottenbacher, PhD, OTR; James Graham, PhD, DC

Description
This project utilizes Medicare data to address the important problem of fragility fractures, and in particular risks for second fracture. In addition, it incorporates measurement of function after incident fracture.

Patient Outcomes from Inpatient Rehabilitation

Patrick Mahaney, MD
Louisiana State University Health Science Center

Brief Bio
Dr. Mahaney is the Research Chief Resident in Physical Medicine & Rehabilitation at Louisiana State University Health Science Center.

Mentors
James Graham, PhD, DC

Medicare Beneficiaries After Stroke

Natalie Leland, PhD, OTR/L
Assistant Professor
University of Southern California

Brief Bio
Dr. Leland received her BS in Occupational Therapy from the University of New Hampshire and her MS and PhD in Gerontology from the University of Massachusetts-Boston. She completed a postdoctoral fellowship at the Center for Gerontology and Health Care Research at Brown University. Dr. Leland has extensive geriatric clinical experience in a variety of rehabilitation settings. She has joint faculty appointments in the USC Division of Occupational Science and Occupational Therapy and the Davis School of Gerontology.

Mentor
Ken Ottenbacher, PhD, OTR

Description
This study uses Medicare administrative data to follow a national cohort of community-living Fee-for-Service Medicare Beneficiaries discharged from the acute care hospital to a skilled nursing facility (SNF) or inpatient rehabilitation facility (IRF) after a stroke. The outcomes will include: the time spent consecutively in the community before re-entry into the health care system, the site of re-entry (e.g. acute care hospital, SNF, IRF, nursing home, psychiatric hospital), and the date of death. The proportion of patients remaining in the community less than 30 days will be determined and patient level characteristics associated with this outcome will be examined. Covariates will include demographics, acute care hospital stay characteristics from stroke hospitalization, and first PAC site characteristics (e.g., functional status, length of stay).

Common characteristics of falls in the older adult population in the acute care, inpatient rehabilitation and skilled nursing facility settings

Cheryl Lehman, PhD, RN
Clinical Associate Professor,
School of Nursing
UT Health Science Center San Antonio

Brief Bio
Dr. Lehman received her BSN from Maryville University and her MSN in adult nursing and PhD in Preventive Medicine & Community Health (Rehabilitation Sciences track) from UTMB. Her clinical experiences include medical-surgical nursing, rehabilitation nursing and geriatric nursing. Dr. Lehman is board certified as a rehabilitation nurse, as a gerontological nurse, and as a clinical nurse specialist. Her research interest includes issues such as access to care and community reintegration.

Mentors
Amol Karmarkar, PhD; Ken Ottenbacher, PhD, OTR

Description
Falls in older adults cause significant morbidity and mortality in the United States healthcare system, and, as such, incur a significant amount of expense. It is not known if there are common characteristics of older adults who fall in varied settings. It makes sense that, if common characteristics exist, these characteristics can be addressed in a coordinated manner rather than in setting-specific isolation. Falls are of course multifactorial. Some risk factors may be exclusive to setting, some to patient characteristics, and some to particular illnesses or disabilities. We hope that through examination of the Medicare data in the 3 settings (acute care, SNF and IRF) we can extract factors that can be addressed to reduce the incidence of falls in the older adult admitted to acute care, skilled nursing facility or inpatient rehabilitation facility.

Young Children's Participation and Environment Measure

Mary Khetani, ScD, OTR
Assistant Professor
Department of Occupational Therapy
Human Development and Family Studies
Colorado State University

Brief Bio
Dr. Khetani joined the CSU Occupational Therapy Department as an Assistant Professor in October 2011 and holds a joint appointment in Human Development and Family Studies. She earned an Honors BA in Psychology and Biomedical Sciences from Marquette University in 2000, her MA in Occupational Therapy from the University of Southern California in 2002, and her Sc.D. in Rehabilitation Sciences from Boston University in 2010. Dr. Khetani completed postdoctoral training from 2010-2011 at the Slone Epidemiology Center in Boston, MA.

Mentor
James Graham, PhD, DC

Description
The Young Children's Participation and Environment Measure is designed to fill an important need for adequate documentation on participation as a service-related outcome in the early intervention field.

Association between Lower Extremity Performance and Health-Related Quality of Life in Elderly Mexican-Americans

Saad Bindawas, PhD
Assistant Professor
Department of Rehabilitation Sciences
College of Applied Medical Sciences
King Saud University

Brief Bio
Dr. Bindawas received his BSc in Physical Therapy from King Saud University, Riyadh, Saudi Arabia, his MHSc in Orthopedic Physiotherapy from the University of Sydney, NSW, Australia, and a PhD in Rehabilitation Sciences from the University of Texas Medical Branch at Galveston. He recently received a certificate in clinical research from the University of California, San Francisco (UCSF). Dr. Bindawas' research interests include physical functioning and disability in older adults.

Mentors
Ken Ottenbacher, PhD, OTR; James Graham, PhD, DC; Amol Karmarkar, PhD

Description
This project is designed as a population-based longitudinal cohort study that examined the association between lower extremity performance and health-related quality of life (HRQoL) using data from the Hispanic EPESE study. The lower extremity performance was measured by the Short Physical Performance Battery (SPPB) and HRQoL was measured by using the Medical Outcomes Study Short Form (SF-36).

Social and Economic Burden of Chronic Neck Pain

Maggie Horn, PhD, PT
University of Oklahoma

Brief Bio
Dr. Horn is an adjunct faculty member at the University of Oklahoma. She received her PhD in Rehabilitation Sciences from the University of Florida in 2012. Dr. Horn's research interests include musculoskeletal pain, treatment of low back pain, and mechanisms of manual therapy.

Mentor
Ken Ottenbacher, PhD, OTR

Description
This project utilizes the National Ambulatory Medical Care Survey (NAMCS), Medical Expenditure Panel Survey (MEPS) and/or the Medicare Health Outcomes Survey (HOS) to examine the relationship of health status (including clinical outcomes, functional status, or other available outcome measure that relates to pain or function), healthcare utilization and expenditures in a nationally representative sample of patients with neck pain.

Functional Independence Thresholds and Hospital Readmissions Following Inpatient Rehabilitation for Stroke

Ching Wang, PhD
Professor, School of Physical Therapy
Chung Shan Medical University,
Taichung, Taiwan

Brief Bio
Dr. Wang is a professor in the School of Physical Therapy at Chun Shan Medical in Taiwan. She received her PhD in Physical Therapy from Texas Woman's University. Dr. Wang's research interests include physical functioning in older adults.

Mentors
James Graham, PhD; Ken Ottenbacher, PhD

Description
The goal of this project is to identify potential thresholds within established physical and cognitive performance measures that can help differentiate patients who are rehospitalized from those who are not following inpatient rehabilitation for stroke. Data will be obtained from the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) files from the Center for Medicare and Medicaid Services (CMS). The outcome of interest is 30-day rehospitalization following discharge from inpatient rehabilitation. Discriminative abilities of different subscales of the FIM Instrument will be tested to determine which functional domains may be best monitored and managed to reduce the risk of rehospitalization among patients with functional deficits.

Functional Status and Community Participation Following Inpatient Rehabilitation for Unilateral Hip and Knee Arthroplasty

Saad Bindawas, PhD
Assistant Professor
Department of Rehabilitation Sciences
College of Applied Medical Sciences
King Saud University

Brief Bio
Dr. Bindawas received his BSc in Physical Therapy from King Saud University, Riyadh, Saudi Arabia, his MHSc in Orthopedic Physiotherapy from the University of Sydney, NSW, Australia, and a PhD in Rehabilitation Sciences from the University of Texas Medical Branch at Galveston. He recently received a certificate in clinical research from the University of California, San Francisco (UCSF). Dr. Bindawas' research interests include physical functioning and disability in older adults.

Mentors
Ken Ottenbacher, PhD, OTR; James Graham, PhD, DC; Amol Karmarkar, PhD

Description
This project is designed to compare the inpatient rehabilitation experiences of patients receiving hip replacements with patients receiving knee replacements. The data sources include the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) from the Center for Medicare and Medicaid Services (CMS) and follow-up interviews from MedTEL, Inc. Outcomes of interest include rehabilitation length of stay, discharge setting, functional status trajectory (admission at discharge at 3-month follow-up), and self-reported community participation at 3-month follow-up.

Transition Patterns, Readmissions, and Outcomes for Patients with Stroke and Hip Fracture following Inpatient Rehabilitation

Almas Dossa, PhD
Health Services Researcher at the Center for Health Quality, Outcomes, and Economic Research
Bedford VA Medical Center

Brief Bio
Dr. Dossa is a Health Services Researcher at the Center for Health Quality, Outcomes, and Economic Research, Bedford VA Medical Center. She received her PhD in 2007 from the Heller School for Social Policy and Management and completed a postdoctoral fellowship at the Center for Health Quality, Outcomes, and Economic Research. Her research interest includes continuity during transition between levels of care.

Mentor
James Graham, PhD

Description
This research examines transition patterns and associated predictors of readmissions, and how readmissions are associated with outcomes for patients with stroke and hip fracture. It will provide a more detailed analysis of patterns of transitions than has been previously reported for patients with stroke and patients with hip fracture following inpatient rehabilitation discharge. We expect to identify sub-groups of patients who are most at risk for readmission, functional decline, and/or institutionalization. We anticipate that our readmission measures will be associated with longer-term functional status in both patient groups.

Comparison of Rehabilitation Outcomes of Veterans and Medicare Beneficiates

Brief Bio
Dr. Collins was previously an assistant professor in the Department of Rehabilitation Science and Technology at the University of Pittsburgh. She recently accepted a faculty position at the University of Texas Medical Branch, Department of Occupational Therapy. Dr. Collins obtained her PhD in Rehabilitation Science and Technology at the University of Pittsburgh in 2004. Her research interests include functional performance, quality of life and social participation of individuals with disabilities.

Mentor
Amol Karmarkar, PhD

Description
This research examines the impact of assistive devices on functional status in veterans and civilians post-stroke, using the Veteran Affairs' Functional Status Outcomes Database and National Patient Prosthetic Database and comparing these databases with outcomes data of Medicare beneficiaries. This project will generate systematic evidence to support development of healthcare policy that improves access to and equitable provision of assistive technology devices (ATDs) for persons with disability. To study a more homogenous Medicare-age population, the study focus is on the Veterans and civilians who are inpatient for acute post-stroke treatment.

Inpatient Rehabilitation Outcomes in Medicare Hip Fracture Patients

Michael Cary Jr., PhD
Assistant Professor
School of Nursing
Duke University

Brief Bio
Michael Cary is received his PhD in Nursing from the University of Virginia in August 2012 and has secured a position as an assistant professor in the School of Nursing at Duke University. Michael's research interests include the effectiveness of rehabilitation health services for aging and chronically ill persons across the post-acute care continuum.

Mentors
Ken Ottenbacher, PhD; James Graham, PhD, DC

Description
This research explores the types of patients with hip fracture and the subgroups within this population that will benefit from Inpatient Rehabilitation Facilities (IRFs) services using data from the Inpatient Rehabilitation Facilities-Patient Assessment Instrument and the Provider of Service (POS) file from the Centers for Medicare and Medicaid Services. IRFs are considered by the Centers for Medicare and Medicaid Services (CMS) as an appropriate setting for the rehabilitative treatment for hip fractures; however, evidence is lacking in identifying the individual characteristics of patients with hip fracture that warrant the need for intensive inpatient rehabilitation, or how these factors impact the effectiveness of IRFs in improving outcomes. The primary objective of this research is to determine which individual and contextual (the organization and delivery of rehabilitation services in IRFs) characteristics result in improved rehabilitation outcomes.