Importance: The American Heart Association and American Stroke Association recommend early identification of level of rehabilitative care as a priority after stroke.
Objective: To evaluate the utility of the Activity Measure for Post-Acute Care (AM-PAC) “6 Clicks” Daily Activity and Basic Mobility forms to determine the next level of rehabilitation after hospitalization for adults with stroke.
Design: Retrospective cohort design using medical records from 2015 to 2016.
Setting: Major urban hospital.
Participants: Patients admitted to the stroke service, with a confirmed stroke, who were seen by a physical or occupational therapist; who had a 6 Clicks Basic Mobility or Daily Activity score at initial evaluation; and who were discharged to home, an acute inpatient rehabilitation facility (IRF), or a subacute skilled nursing facility (SNF).
Outcomes and Measures: Length of stay and discharge destination.
Results: Seven hundred four participants (M age = 68.28 yr; 51.21% female) were included. Analysis of variance and receiver operating characteristic curves were performed. Daily Activity scores were highest for home discharge, lower for IRF discharge, and lowest for SNF discharge; Basic Mobility showed a similar pattern. Cutoff values distinguishing home from further inpatient rehabilitation were 44.50 for Basic Mobility and 39.40 for Daily Activity scores (area under the curve [AUC] = .82 for both forms), with scores of 34.59 (AUC = 0.64) and 31.32 (AUC = 0.67) separating IRF from SNF, respectively.
Conclusions and Relevance: Therapists should incorporate 6 Clicks scores into their discharge planning.
What This Article Adds: This research demonstrates the utility of an outcome measure in the acute care setting that assists in planning discharge destination for patients with stroke.