Which Factors Influence Functional Patients Improvements During Rehabilitation?

Background: Rehabilitation in patients with disabilities is an important aspect of tertiary prevention. Severity of disability, evaluated by global measures of autonomy, are essential for functional outcome evaluation.

Aim: To determine the effectiveness of a rehabilitation programme in terms of percentage functional improvement (PFI); to verify the role of gender, age and length of stay (LOS), by motor and cognitive domains, on PFI. Design: longitudinal study. Setting: An intensive rehabilitation hospital. Population: 305 inpatients.

Methods: The disability has been investigated using the Functional Independence Measure (FIM). Percentage differences between discharge and admission were calculated for FIM score. Wilcoxon matched pair test for the six areas and the two domains of the FIM score were calculated. The effect of LOS, gender and age on PFI were studied with Robust regression.

Results: Neurological and Orthopaedic patients had improvements on Motor and Cognitive domains. The greatest gains were in the Self Care, Sphintere Control, Transfer and Locomotion Areas (p=<0.001). LOS was associated (p<0.001) with PFI while age resulted borderline significant (p=0.049) in the cognitive domain in Neurological patients.

Conclusion: The rehabilitation improved the overall conditions of neurological and orthopaedic patients. LOS emerged as the most important determinant in PFI.