Patient-Reported Global Change Following Individualized Exercise Prescription for Autonomic Disorders
Melissa Cortez1, Kelsi Schiltz2, Lauren Ziaks3, Ryan Pelo2, Kathryn Johnson2
1University of Utah Neurology, 2University of Utah, 3Intermountain Health Care
Objective:
To characterize self-reported global change after receiving education and individualized exercise prescription using the Utah Autonomic Disorders adaptive Physical Therapy (ADaPT) protocol.
Background:
Exercise programs are routinely recommended for patients with autonomic disorders. Current literature reports high dropout rates and unclear functional benefit from existing graded exercise programs. Utilization of individualizable exercise protocols, paired with point of care prescription, may improve outcomes and adherence. Patient’s perceived global change following such administration has yet to be examined.
Design/Methods:
Patients who met with a physical therapist (PT) as part of their autonomic evaluation were prescribed an exercise program using the ADaPT protocol. As part of a prospective clinical outcome assessment, patients completed Global Rating of Change (GroC) reporting regarding their overall condition (worsened, improved, or stayed the same) following initiation of treatment. Possible GroC scores ranged from -7 (worse) to +7 (better), on a 14-point Likert scale. This study is considered exempt by the University IRB, based on its implementation as a program evaluation/quality improvement project.
Results:
A total of 65 patients, seen between 2/23/2024 and 10/4/2024 for PT consult, met inclusion criteria, and were asked to complete the GroC survey (follow-up period 9-233 days since initial exercise prescription); data collection ongoing. Of the 16 responses received at the time of this submission, 38% reported a change of +4 or +3 (somewhat or moderately better), 44% reported a change of +2 or +1 (a little bit better), and 19% reported inability to engage in the prescribed exercise program.
Conclusions:
The Utah ADaPT protocol, when prescribed by a point-of-care physical therapist, results in stable, and/or modest improvements in patient’s self-reported overall condition. Future studies are needed to understand how GroC relates to quality of life and function in patient’s receiving therapeutic exercise for autonomic disorders.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.