{"id":198,"date":"2017-09-12T09:54:28","date_gmt":"2017-09-11T23:54:28","guid":{"rendered":"http:\/\/homebaserehab.net\/?page_id=198"},"modified":"2023-06-16T11:16:27","modified_gmt":"2023-06-16T01:16:27","slug":"home-visit","status":"publish","type":"page","link":"https:\/\/homebaserehab.net\/assessment\/home-visit\/home-visit\/","title":{"rendered":"Home Visit"},"content":{"rendered":"\t\t
Before entering the home, if alone, SMS or ring a colleague and confirm your location and estimated time of departure.<\/p>
Confirm consent from the patient on arrival – this may include signing a\u00a0Patient Consent Form<\/a><\/p> Explain the structure of the program:<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t Exercise program prescribed today<\/p> Patient performs exercise routine at home or in the local area at least 5 times per week<\/p> Visiting health professional will call at a designated time every week for 7 weeks to discuss their progress and any health issues<\/p> Patient will be contacted to attend the hospital or community health centre for a follow up assessment at the completion of the program<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t Arrange the weekly appointment time for calls from the health professional. Explain that this is a professional appointment. If the patient is not able to keep the appointment they need to email, SMS or phone the person(s) listed on their home diary to re-schedule their phone call session.<\/p> Confirm that the patient knows who to contact if they have any issues that need to be answered before their weekly call.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t Discuss which measurement tool they plan to use and set up as necessary:<\/p> Practice Walk<\/strong><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t Taking into account the results of the field walking test (6MWT<\/a> or ISWT<\/a>) or modified incremental step test (MIST)<\/a>, and the 10 minute walk at home, prescribe the lower limb endurance component of their program.<\/p> Walking Training<\/strong><\/p> For walking training aim for 20 mins total endurance exercise at an intensity of 80% of their 6 Minute Walk Test (6MWT<\/a>) distance.<\/p> If walking inside home, measure the track length with a measuring wheel and prescribe either by time, distance or pedometer steps:<\/p> Step Training<\/strong><\/p> For step training, aim for 20mins of cumulative stepping. This may be broken into shorter periods interspersed with rest breaks.<\/p> The initial training load for endurance step training is equivalent to 44% of the final MIST level achieved e.g. if a participant finished the MIST on level 10, initial step training would be prescribed at level 4. Select the corresponding audio level for endurance step training here.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t As well as lower limb endurance training<\/a> (such as walking), a pulmonary rehabilitation program should also include:<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t Some patients may also require stretching and balance exercises as per their assessment.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t Both upper and lower limb strength training exercises are recommended. Generally, two upper limb and two lower limb exercises are prescribed but this will depend on the patients’ co-morbidities.<\/p> See examples in:<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t The following exercises are preferred examples of upper limb strength training exercises in the home but may need to be modified or substituted based on the patients\u2019 co-morbidities:<\/p> * Patients may choose to use purchased weights or use home items such as packets of spaghetti or bottles filled with water.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t The following exercises are preferred examples of lower limb strength training exercises in the home (weights can be added if progression is required):<\/p> For more information on exercise prescription, go to the Pulmonary Rehabilitation Toolkit.<\/a><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t To assist with feedback and encourage adherence to the program, the patient is asked to complete a home exercise diary.<\/p> The following are useful resources:<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\tAerobic Training<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
How to prescribe exercise intensity<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Strength Training<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Prescribing strength training<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Home Diary<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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