The association between patient participation and functional gain following inpatient rehabilitation

• Published in: Aging clinical and experimental research Vol. 29; no. 4; pp. 729 - 736
• Main Authors: Morghen, Sara, Morandi, Alessandro, Guccione, Andrew A., Bozzini, Michela, Guerini, Fabio, Gatti, Roberto, Del Santo, Francesco, Gentile, Simona, Trabucchi, Marco, Bellelli, Giuseppe
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.08.2017; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Female; Frail Elderly - statistics & numerical data; Frailty - rehabilitation; Geriatrics/Gerontology; Humans; Inpatients; Logistic Models; Male; Medicine; Medicine & Public Health; Original Article; Outcome Assessment (Health Care); Patient Discharge - statistics & numerical data; Patient Participation - statistics & numerical data; Physical therapy; Physical Therapy Modalities - statistics & numerical data; Recovery of Function; Rehabilitation; Rehabilitation - statistics & numerical data; Retrospective Studies; Stroke; Stroke Rehabilitation; Treatment Outcome; Functional gain; Participation; Rehabilitation; Physical therapy
• ISSN: 1720-8319; 1594-0667; 1720-8319
• DOI: 10.1007/s40520-016-0625-3

Objectives To evaluate patients’ participation during physical therapy sessions as assessed with the Pittsburgh rehabilitation participation scale (PRPS) as a possible predictor of functional gain after rehabilitation training. Methods All patients aged 65 years or older consecutively admitted to a Department of Rehabilitation and Aged Care (DRAC) were evaluated on admission regarding their health, nutritional, functional and cognitive status. Functional status was assessed with the functional independence measure (FIM) on admission and at discharge. Participation during rehabilitation sessions was measured with the PRPS. Functional gain was evaluated using the Montebello rehabilitation factor score (MRFS efficacy), and patients stratified in two groups according to their level of functional gain and their sociodemographic, clinical and functional characteristics were compared. Predictors of poor functional gain were evaluated using a multivariable logistic regression model adjusted for confounding factors. Result A total of 556 subjects were included in this study. Patients with poor functional gain at discharge demonstrated lower participation during physical therapy sessions were significantly older, more cognitively and functionally impaired on admission, more depressed, more comorbid, and more frequently admitted for cardiac disease or immobility syndrome than their counterparts. There was a significant linear association between PRPS scores and MRFS efficacy. In a multivariable logistic regression model, participation was independently associated with functional gain at discharge (odds ratio 1.51, 95 % confidence interval 1.19–1.91). Conclusion This study showed that participation during physical therapy affects the extent of functional gain at discharge in a large population of older patients with multiple diseases receiving in-hospital rehabilitation.