Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Feb 2014
Multicenter Study Comparative StudyComparison of discharge functional status after rehabilitation in skilled nursing, home health, and medical rehabilitation settings for patients after hip fracture repair.
To examine differences in rehabilitation outcomes across 3 post-acute care (PAC) rehabilitation settings for patients after hip fracture repair. ⋯ Setting-specific effects varied depending on whether self-care or mobility was the outcome of focus. It remains unclear to what extent rehabilitation intensity or natural recovery effects changes in functional status for patients with hip fracture. This study points to important directions for PAC setting comparative effectiveness studies in the future, including uniform measurement, limited consensus on factors affecting recovery, accounting for selection bias, and using end-point data collection that is at the same follow-up time periods for all settings.
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Arch Phys Med Rehabil · Feb 2014
Multicenter StudyNegative affect and sleep disturbance may be associated with response to epidural steroid injections for spine-related pain.
To describe whether negative affect and sleep impairment are associated with the clinical effect of epidural steroid injections (ESIs) for low back pain. ⋯ Negative affect and sleep disturbance are associated with worse outcomes after ESI. Further research is needed to determine if treatment of negative affect and sleep disturbance prior to or concurrently with ESI will improve outcomes.
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Arch Phys Med Rehabil · Jan 2014
Multicenter StudyRegional variation in stroke rehabilitation outcomes.
To examine and describe regional variation in outcomes for persons with stroke receiving inpatient medical rehabilitation. ⋯ Rehabilitation outcomes for persons with stroke varied across CMS regions. Substantial variation in discharge destination and LOS remained after adjusting for demographic and clinical characteristics.
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Arch Phys Med Rehabil · Jan 2014
Multicenter StudySymptom burden and comorbidities impact the consistency of responses on patient-reported functional outcomes.
To assess the influence of symptom intensity, mood, and comorbidities on patient-clinician agreement and the consistency of responses to functional patient-reported outcomes (PROs). ⋯ Pain intensity is associated with disagreement between patients and clinicians about the patient's level of functioning. Moreover, physical symptoms (pain, dyspnea, fatigue) as well as specific medical comorbidities (musculoskeletal disorders, coronary artery disease), but not mood, are associated with inconsistency in patients' assessment of their functional abilities.
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Arch Phys Med Rehabil · Dec 2013
Multicenter StudyLongitudinal description of the glasgow outcome scale-extended for individuals in the traumatic brain injury model systems national database: a National Institute on Disability and Rehabilitation Research traumatic brain injury model systems study.
To comprehensively describe the temporal patterns of global outcome after traumatic brain injury (TBI) in the Traumatic Brain Injury Model Systems National Database (TBIMS NDB). ⋯ Individual growth curve analysis is a statistically rigorous approach to describe temporal change with respect to the GOS-E at the individual level for participants within the TBIMS NDB. Results indicated that, for individuals in the TBIMS NDB as a group, functional status as measured by the GOS-E initially improves, plateaus, and then begins to decline. Factors such as age at first GOS-E assessment, race, FIM score at rehabilitation admission, and rehabilitation length of stay were found to influence baseline GOS-E scores, as well as the rate and extent of both improvement and decline over time. Additional research may be required to determine the generalizability of these findings and the usefulness of this tool for clinical applications.