[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-427786-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-427786-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","high-intensity-rehabilitation-in-skilled-nursing-facilities-from-theory-to-practice","HIGH INTENSITY-REHABILITATION IN SKILLED NURSING FACILITIES: FROM THEORY TO PRACTICE","","Implementing evidence-based, physiologic dosing of high-intensity resistance rehabilitation (HIR) in skilled nursing facilities (SNFs) is critical for improving functional outcomes in medically complex, vulnerable populations. This study evaluated an implementation program using prospective convergent mixed methods, measuring proximal clinician knowledge, self-efficacy, and HIR perspective and distal adoption and implementation outcomes. Thirty-eight clinicians and 16 leaders from eight rural VA SNFs participated in interviews and focus groups. The program improved clinician HIR knowledge, self-efficacy, and perspective with acceptable adoption, though implementation effects were marginal. Only HIR perspective correlated with adoption (rho=0.47, p=0.004), supporting distal outcomes through clinician engagement and team cohesion; clinician creativity and adaptability influenced implementation.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/high-intensity-rehabilitation-in-skilled-nursing-facilities-from-theory-to-practice/427786/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/high-intensity-rehabilitation-in-skilled-nursing-facilities-from-theory-to-practice/427786.png","ImageObject",300,407,{"name":42,"@type":43},"Aria Callaghan","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-04","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":30},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What was the main purpose of the rehabilitation program in SNFs?","Question",{"text":62,"@type":63},"To promote high-intensity resistance rehabilitation (HIR) in skilled nursing facilities using evidence-based, physiologic dosing, improving functional outcomes in a vulnerable medically complex population.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"Which outcomes did the study evaluate?",{"text":67,"@type":63},"Proximal clinician outcomes (knowledge, self-efficacy, and HIR perspective) and distal outcomes including HIR adoption and implementation, plus program processes influencing distal outcomes.",{"name":69,"@type":60,"acceptedAnswer":70},"What factor was most strongly linked to HIR adoption?",{"text":71,"@type":63},"Clinician HIR perspective, which correlated with adoption (rho=0.47, p=0.004).","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},427786,1790673035,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":92,"show_sort_weight":93,"slug":94},"Exam",70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":30,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":30},962084926284,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Innovation in Aging, 2025, Vol. 9, No. S2 719  \nUnited States, 3. University of Delaware, Newark, Delaware, United States, 4. Naval Medical Center, San Diego, California, United States  \nImplementing evidence-based, physiologic dosing of rehabilitation in skilled nursing facilities (SNFs) is essential to improve functional outcomes in a vulnerable, medically-complex population. We evaluated an implementation program to promote high-intensity resistance rehabilitation (HIR) in SNFs.  \nMethods: Using a prospective convergent mixed-methods design, this study 1) measured proximal (clinician knowledge, self-efficacy, and HIR perspective) and distal (HIR adoption and implementation) outcomes; 2) explored how the program influenced distal outcomes (program processes); and 3) investigated clinician factors influencing HIR implementation. Thirty-eight rehabilitation clinicians and 16 leaders in eight rural Department of Veterans Affairs SNFs participated in interviews and focus groups. Outcomes included validated questionnaires on HIR perspective (Perceived Characteristics of Intervention Scale) and adoption (Commitment to Change Scale), and study-specific questionnaires on clinician HIR knowledge, self-efficacy, and implementation. Results: The program improved clinician HIR knowledge, self-efficacy, and perspective and led to acceptable adoption rates; however, implementation was marginally affected. Only clinician HIR perspective correlated with adoption (rho = 0.47, p = 0.004). The program supported distal outcomes by keeping HIR at the forefront of clinicians’ mind, fostering positive outcome expectations, and enhancing team cohesion and accountability. Clinician creativity, adaptability, resilience, professional discipline, and previous experience influenced implementation. Conclusion: The program influenced HIR adoption primarily by enhancing clinicians’ positive perspectives of HIR. Future efforts could strengthen implementation by fostering team cohesion, accountability, and clinician creativity while assessing environmental factors influencing implementation. Strategies that enhance clinician perspective and creativity, maintain HIR top of mind, and foster team cohesion and accountability may improve adoption.  \nAbstract citation ID: igaf122.2448  \nHIGH INTENSITY-REHABILITATION IN SKILLED  \nNURSING FACILITIES: FROM THEORY TO PRACTICE  \nLauren Hinrichs-Kinney1, Mattie Pontiff1, Elizabeth Staton2, Katie Butera3, Emma Beisheim-Ryan4, Dawn Magnusson2, and Jennifer Stevens-Lapsley2, 1. VA Eastern Colorado Health Care System, Aurora, Colorado, United States, 2. University of Colorado Anschutz Medical Campus, Aurora, Colorado,","cbCaivMTDBTTf2sH","https://ap.wps.com/l/cbCaivMTDBTTf2sH","pdf",653432,"English","# Methods\n## Outcomes and measures\n# Results\n## Adoption and implementation effects\n# Conclusion and future directions","[{\"question\":\"What was the main purpose of the rehabilitation program in SNFs?\",\"answer\":\"To promote high-intensity resistance rehabilitation (HIR) in skilled nursing facilities using evidence-based, physiologic dosing, improving functional outcomes in a vulnerable medically complex population.\"},{\"question\":\"Which outcomes did the study evaluate?\",\"answer\":\"Proximal clinician outcomes (knowledge, self-efficacy, and HIR perspective) and distal outcomes including HIR adoption and implementation, plus program processes influencing distal outcomes.\"},{\"question\":\"What factor was most strongly linked to HIR adoption?\",\"answer\":\"Clinician HIR perspective, which correlated with adoption (rho=0.47, p=0.004).\"}]","HIGH INTENSITY-REHABILITATION IN SKILLED NURSING FACILITIES: FROM THEORY TO PRACTICE | PDF",1790644811]