# Enhancing function for Veterans post-stroke at the system and individual level

> **NIH VA IK2** · PHILADELPHIA VA MEDICAL CENTER · 2024 · —

## Abstract

Background: Stroke is the leading cause of long-term disability, characterized by complex impairments that
require ongoing, multidisciplinary care to improve function and promote disease self-management. Many
Veterans with stroke will receive a period of formal post-acute rehabilitation after a stroke. Rehabilitation
services improve function and facilitate community reintegration, but the degree of functional impairment that
remains at discharge from post-acute rehabilitation is poorly understood. Functional status at discharge from
post-acute rehabilitation is associated with long-term morbidity, hospital readmissions, and quality of life. In
order to design a system that enables Veterans with stroke to achieve their full recovery potential, it is critical to
characterize the degree of residual functional impairment Veterans experience at the end of post-acute
rehabilitation and how this may vary by Veteran subpopulations. Understanding this will help identify Veterans
who may be most likely to benefit from further programs to improve function, health, and promote disease self-
management. At the individual level, regular physical activity post-stroke can improve function, prevent further
decline, and is an essential component of disease self-management. Scalable interventions to improve
physical activity for older Veterans after stroke are not well-defined or well-studied in VA.
Significance/Impact: This project addresses the complex, chronic care needs of Veterans after stroke at the
system and individual level. It addresses the HSR&D priority areas of complex chronic disease management;
disability, function, long-term care and aging; and access to care/ rural health in addition to the ORD-wide
priorities to increase the substantial real world impact of VA research and putting VA data to work for Veterans.
Project findings will yield actionable insights at the system and individual level to help ensure the VA is
providing high quality stroke care for older Veterans.
Innovation: This is the first national, contemporary evaluation of post-stroke function at the conclusion of post-
acute rehabilitation for older Veterans (≥65 years of age) that includes care provided in the community and VA.
This proposal uses data from a standardized, identical functional assessment across post-acute settings
(inpatient rehabilitation, skilled nursing, home health) to quantify function. This will provide a comprehensive
understanding of the amount of functional impairment Veterans have at such a critical period in the recovery
process and how this varies by Veteran subpopulations. At the individual level, this proposal addresses the
lack of scalable interventions that leverage behavioral science and remote technologies to help increase
physical activity in this older, often medically complex population. Remote designs extend the reach of novel
physical activity programs to Veteran populations, such as rurally residing Veterans, who are often excluded
from physi...

## Key facts

- **NIH application ID:** 10999831
- **Project number:** 1IK2HX003787-01A2
- **Recipient organization:** PHILADELPHIA VA MEDICAL CENTER
- **Principal Investigator:** Kimberly Waddell
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-10-01 → 2029-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10999831

## Citation

> US National Institutes of Health, RePORTER application 10999831, Enhancing function for Veterans post-stroke at the system and individual level (1IK2HX003787-01A2). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/10999831. Licensed CC0.

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