http://journals.lww.com/intjrehabilres/Abstract/publishahead/Predictors_of_physical_independence_at_discharge.99586.aspx
Ten Brink, Antonia F.; Hajos, Tibor R.S.; van Bennekom, Coen; Nachtegaal, Janneke; Meulenbelt, Henk E.J.; Fleuren, Judith F.M.; Kouwenhoven, Mirjam; Luijkx, Marscha M.; Wijffels, Markus P.; Post, Marcel W.M.
Published Ahead-of-Print
Abstract
The aim of this study was to identify predictors,
available at admission, of physical independence at discharge from
inpatient rehabilitation. Secondary aims were to identify predictors of
functional gain and length of stay (LOS). We included 1310 adult stroke
patients who were admitted for inpatient rehabilitation in five Dutch
rehabilitation centres. Data on the Utrecht Scale for Evaluation of
Clinical Rehabilitation at admission and discharge (physical and
cognitive independence, mood, pain and fatigue), age, sex and in a
subsample stroke characteristics as well were collected. A prediction
model was created using random coefficient analysis. None of the stroke
characteristics were independently associated with physical independence
or functional gain at discharge, or LOS. Higher physical and cognitive
independence scores and severe pain at admission were predictors of
higher physical independence scores at discharge. Furthermore, lower
physical independence scores, higher cognitive independence scores, less
pain at admission and younger age predicted more functional gain.
Finally, lower physical and cognitive independence scores at admission
and younger age predicted longer LOS. Physical independence at admission
was the most robust predictor for rehabilitation outcome in a Dutch
rehabilitation setting. To a lesser extent, age, cognitive independence
and pain predicted rehabilitation outcome after stroke. Treatment of
cognition and pain should be taken into account during rehabilitation.
Further work needs to be carried out to establish whether focusing on
these factors improves outcome after rehabilitation.
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