How well does the 30-second Chair Stand Test predict rehabilitation needs?

Background The assessment of acutely admitted elderly medical patients’ need for rehabilitation is statutory and important for their independence. However, in an emergency department the assessment can be difficult as it has to be performed within 48 hours, when functional performance may be affected by various factors such as the symptoms leading to admission or by conditions at admission and in the period before hospitalization. Conversely, the performance may be unaffected or improved by adequate treatment. Internationally, focus is on developing screening tools to identify patients at risk of functional decline. The 30-Second Chair Stand Test (30s-CST) is recommended by the Danish Health and Medicines Authority for screening of functional decline in elderly citizens living in their own home. However, its validity with hospitalized patients is undocumented, and it is unclear whether loss of mobility (30s-CST < 9) in combination with symptoms for hospitalization and identified risk factors can predict the need for rehabilitation. To evaluate the mobility of acutely admitted patients with 30s-CTS=0, the assessment also uses the De Morton Mobility Index (DEMMI), which has been validated for use with such patients whose stay exceeds 48 hours. Our study aims to: - Investigate the face validity of 30s-CST and DEMMI for mobility assessment of acutely admitted elderly medical patients - Identify predictive indicators of hospitalized elderly medical patients’ need for rehabilitation (30s-CST <9) Methods Our prospective cohort study will include 156 elderly patients (65+) with medical complaints. Assessments will be undertaken at the time of hospitalization and 7-9 days later. The risk factors studied are: a) symptoms for hospitalization, b) number of prescribed drugs, c) number of falls, d) habitual functional performance, e) patient-related data. Both patients and health professionals will contribute to the face validity assessment. Results The results will be available by the end of 2014. Conclusions Face validations of 30s-CST and DEMMI are relevant as validated tests for short-term hospitalized patients are needed. Health professionals’ work and, ultimately, patients will benefit from the identification of valid predictors of rehabilitation needs.