Original articleBeyond Function: Predicting Participation in a Rehabilitation Cohort
Section snippets
Participants
Participants were 435 adults aged 18 years and older from the Rehabilitation Outcomes Study who were recruited at discharge from a large acute care hospital or on admission to 1 of 2 rehabilitation hospitals in the greater Boston, MA, region. All subjects had a primary diagnosis of neurologic disorder, lower-extremity orthopedic trauma, or medically complex conditions. Specific inclusion criteria were that the person was currently receiving and/or about to be referred to skilled rehabilitation
Results
Table 1 displays the characteristics of the study sample. The mean age of the sample was 67.4 years, 50.8% of the patients were women, and 90.5% were white. The most prevalent impairment group was patients with complex medical conditions (42.3%) followed by lower-extremity orthopedic (33.6%), and, finally, major neurologic (24.1%). Of the 435 patients enrolled in this study, 417 (81%) completed the 1-month follow-up, 370 (72%) completed the 6-month follow-up, and 336 (65%) completed the
Discussion
This study revealed a distinct pattern of change in participation after hospitalization in the cohort of patients who received rehabilitation care. On average, patients with complex medical, lower-extremity orthopedic, and major neurologic impairments who received rehabilitation care achieved modest improvements in their levels of community participation during the first 6 months after their hospitalization. In contrast, on average, these same patients displayed a modest loss in social and home
Conclusions
The clinical implications of our findings are clear and significant. The focus of rehabilitation intervention to improve long-term participation requires careful consideration of the domain of participation of specific clinical interest. A rehabilitation intervention aimed at improving activity performance is more likely to have an effect on improving a patient’s subsequent performance of community participation roles, but not on social and home participation as measured by the PM-PAC. If the
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Supported by the National Institute of Disability and Rehabilitation Research, U.S. Department of Education (grant no. H133B990005).
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