Slow Stream Rehabilitation: A New Model of Post-Acute Care

Grace Leung, Paul R. Katz, Jurgis Karuza, Greg W. Arling, Angela Chan, Anna Berall, Shafagh Fallah, Malcolm A. Binns, Gary Naglie

Research output: Contribution to journalArticle

4 Scopus citations


Objectives: To identify characteristics and outcomes of elderly patients admitted to a slow stream, low-intensity, and long-duration inpatient rehabilitation (SSR) program after an acute hospitalization because they were unable to tolerate traditional inpatient rehabilitation. Design: Single group pre-post study with assessments conducted on admission and discharge. Setting: Baycrest's 30-bed SSR Unit in Toronto, Ontario, Canada. Participants: A total of 104 patients older than 60 years admitted between September 2011 and December 2012. Measurements: Admission assessments included demographic data, Functional Independence Measure (FIM), and ability to ambulate. Discharge outcomes included change in motor and total FIM scores from admission to discharge, discharge residential status, and length of stay. Results: Mean age was 81.6 ± 8.4 years and 68.3% were women. Mean changes in motor and total FIM were 21.0 ± 12.2 (P < .001) and 22.6 ± 14.0 (P < .001), respectively. On admission, only 30.8% of patients were ambulatory even with mobility assistive devices, while on discharge, 68.3% of patients were ambulatory; 61.5% of patients returned to their preadmission living arrangement; 8.6% went from their own home to a retirement or relative's home. Only 16.3% were discharged to long-term nursing home care and 13.4% were transferred to an acute hospital. Mean length of SSR stay was 82.5 ± 26.4 days. Conclusion: SSR programs can benefit elderly patients at risk for institutionalization after acute hospitalization by improving their functioning and mobility, and allowing them to return to the community.

Original languageEnglish (US)
Pages (from-to)238-243
Number of pages6
JournalJournal of the American Medical Directors Association
Issue number3
StatePublished - Mar 1 2016
Externally publishedYes


  • Functional outcome
  • Geriatrics
  • Rehabilitation

ASJC Scopus subject areas

  • Nursing(all)
  • Health Policy
  • Geriatrics and Gerontology

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    Leung, G., Katz, P. R., Karuza, J., Arling, G. W., Chan, A., Berall, A., Fallah, S., Binns, M. A., & Naglie, G. (2016). Slow Stream Rehabilitation: A New Model of Post-Acute Care. Journal of the American Medical Directors Association, 17(3), 238-243.