Abstract:

OBJECTIVES: To examine the effect on mobility selfefficacy of a multifactorial, individualized, occupational/ physical therapy (OT/PT) intervention delivered via teletechnologyor in-home visits. DESIGN: Randomized, clinical trial. SETTING: One Department of Veterans Affairs and one private rehabilitation hospital. PARTICIPANTS: Sixty-five community-dwelling adults with new mobility devices. Thirty-three were randomized to the control or usual care group (UCG), 32 to the intervention group (IG). INTERVENTION: Four, once-weekly, 1-hour OT/PT sessions targeting three mobility and three transfer tasks. A therapist delivered the intervention in the traditional home setting (trad group n516) or remotely via teletechnology (tele group n516). MEASUREMENTS: Ten-item Likert-scale measure of mobility self-efficacy. RESULTS: The IG had a statistically significantly greater increase in overall self-efficacy over the study period than the UCG (mean change: IG 8.8, 95% confidence interval (CI)53.8–13.7; UCG 1.2, 95% CI5 5.8–8.2). Descriptively, the IG exhibited positive changes in self-efficacy for all tasks and greater positive change than the UCG on all items with the exception of getting in and out of a chair. Comparisons of the two treatment delivery methods showed a medium standardized effect size (SES) in both the tele and trad groups, although it did not reach statistical significance for the tele group (SES: tele50.35, 95% CI5 2.5–0.95; trad50.54, 95% CI50.06–1.14). CONCLUSION: A multifactorial, individualized, homebased OT/PT intervention can improve self-efficacy in mobility-impaired adults. The trend toward increased self efficacy irrespective of the mode of rehabilitation delivery suggests that telerehabilitation can be a viable alternative to or can augment traditional in-home therapy. J Am Geriatr Soc 54:1641–1648, 2006.