Comparison of Community Reintegration Interventions When Using a Simulated Environment

February 24, 2026 updated by: Weill Medical College of Cornell University

Comparison of Community Reintegration Interventions Relative to the Institution of a Simulated Environment in Inpatient Rehabilitation and Pilot Study of the Impact of Simulated Environment on Functional Outcomes

The investigators believe that rehabilitation specialists will use community reintegration treatments more if a simulated environment is available.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

Community reintegration training has always been a significant aspect of inpatient rehabilitation recovery. Community reintegration training involved therapists and patients going into the actual community to evaluate and practice their functional tasks such as negotiating curbs, crosswalks, or marketplaces. During the COVID-19 pandemic, this option was not available. The absence of this intervention made it challenging for therapists to evaluate a patient's safety to return home. Creating a simulated environment within the inpatient rehabilitation department became an alternative to taking patients to an outside environment. Saji, et al. (2015) demonstrated that utilization of a simulated environment enhanced functional improvements of post-acute stroke patients at 12 convalescent rehabilitation wards. New York Presbyterian Weill Cornell Medical Center (NYP- WCMC) has constructed a simulated environment for the purposes of enhancing community reintegration training. This project will test its use and efficacy.

The availability of this simulated environment may be more time-efficient and safer than community reintegration training outside of the department or hospital. Training in the simulated environment may improve the functional ability of individuals undergoing inpatient rehabilitation, in accordance with the degree of use of the simulated environment. Greater use of the simulated environment may predict greater functional improvements. This study will collect pilot data about functional outcomes and patient perspectives about their balance confidence, their ability to perform functional tasks, and the efficacy of the use of simulated environment for community reintegration. This pilot data will seed a future efficacy study with a comparison group.

Study Type

Interventional

Enrollment (Actual)

13

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • New York
      • New York, New York, United States, 10065
        • NewYork Presbyterian Hospital Baker Pavilion

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Medical records of patients admitted to the IRU from January 1, 2015 through December 31, 2019 will be queried for number of minutes billed for Community Integration.
  • Medical records of patients admitted to the IRU from April 2
  • Patients admitted to the Inpatient Rehabilitation Unit (IRU) of at least 18 years of age and older
  • Patients who can read and provide informed consent in English.
  • Patients who will be discharged to home after inpatient rehabilitation.
  • Patients who are ambulatory with a minimal QI score of 3 on "Walk 10 feet".
  • Patients who utilized the simulated environment during their inpatient stay.
  • Patients who score 8 or greater on the BIMS on initial evaluation.

Exclusion Criteria:

  • The investigators will exclude medical records of patients admitted to the IRU from January 1, 2020 through December 31, 2021 because of the COVID restrictions that were in place.
  • Patients who are less than 18 years of age.
  • Patients who are not ambulatory due to medical reasons.
  • Patients who cannot read and provide informed consent in English.
  • Patients who were discharged to acute care, skilled nursing facility or long-term care facility after their inpatient rehabilitation stay.
  • Patients who did not use the simulated environment during their inpatient stay.
  • Patients who score 7 or lower on the BIMS on initial evaluation.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Community Reintegration in Simulated Environment
Behavioral: PT and OT with a simulated environment
Upon admission to the inpatient rehabilitation unit, participants will undergo a physical and occupational therapy evaluation. The evaluations will include the outcome measures chosen to track for this study (10-meter walk test and Quality Indicators). If a patient meets inclusion/exclusion criteria, informed written consent will be obtained. Throughout the patient's stay, therapists will have the opportunity to perform community integration treatments using the simulated environment. This could include activities such as negotiating a curb, crossing a street, or shopping at a marketplace. The therapist will document the amount of time (units billed) spent performing these interventions. The research investigators will not act as a patient's therapist throughout their admission.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Utilization of community reintegration, as measured by number of 15-minute units billed
Time Frame: Duration of IRU stay, an average of 11 days

Current Procedural Terminology (CPT) code 9753, is a billing code where one unit of the code is used for each 15 minutes the provider spends with the patient teaching them return to work and the community.

For this measure, the therapist will document the amount of time spent performing each study activity when utilizing the simulated environment, as measured by number of 15-minute units billed..

This will be compared to units billed in 2015 - 2019 prior to the implementation of the simulated environment for this study.
Duration of IRU stay, an average of 11 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Quality Indicators
Time Frame: Duration of IRU stay, an average of 11 days
Qualitative assessment by the therapist of 1 step onto and off a curb
Duration of IRU stay, an average of 11 days
Quality Indicators
Time Frame: Duration of IRU stay, an average of 11 days
Qualitative assessment by the therapist of picking up an object
Duration of IRU stay, an average of 11 days
Quality Indicators
Time Frame: Duration of IRU stay, an average of 11 days
Qualitative assessment by the therapist of walking 10 feet on uneven surface
Duration of IRU stay, an average of 11 days
Quality Indicators
Time Frame: Duration of IRU stay, an average of 11 days
Qualitative assessment by the therapist of car transfer
Duration of IRU stay, an average of 11 days
Gait Speed
Time Frame: Duration of IRU stay, an average of 11 days
Meters/second
Duration of IRU stay, an average of 11 days
Activities Specific Balance Confidence Scale
Time Frame: Duration of IRU stay, an average of 11 days

The Activities-specific Balance Confidence (ABC) scale is scored by adding up the ratings for each item and dividing by 16, the total number of items.

The scale uses a range of 0-100%, with 0 representing no confidence and 100 representing complete confidence.

The resulting score indicates the participant's overall balance confidence. 80% or higher: The participant has a high level of physical functioning and is at low risk for falls 50-80%: The participant has a moderate level of physical functioning Less than 50%: The participant has a low level of physical functioning and is at a high risk of falling Less than 67%: The participant has a substantial risk of falling
Duration of IRU stay, an average of 11 days
Patient satisfaction
Time Frame: Date of Discharge (at approximately Day 11)
Likert scale, with a low score of 1 and a high score of 5.
Date of Discharge (at approximately Day 11)
Patient satisfaction
Time Frame: 30 days post discharge
Likert scale, with a low score of 1 and a high score of 5.
30 days post discharge
Length of Stay
Time Frame: Duration of IRU stay, an average of 11 days
Days
Duration of IRU stay, an average of 11 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Weill Medical College of Cornell University

Collaborators

Hunter College of The City University of New York

Investigators

  • Principal Investigator: Nasim Chowdhury, MD, Weill Medical College of Cornell University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 5, 2023

Primary Completion (Actual)

December 9, 2025

Study Completion (Actual)

December 9, 2025

Study Registration Dates

First Submitted

October 2, 2024

First Submitted That Met QC Criteria

October 15, 2024

First Posted (Actual)

October 17, 2024

Study Record Updates

Last Update Posted (Actual)

February 25, 2026

Last Update Submitted That Met QC Criteria

February 24, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 22-07025042

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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