Rehabilitation Outcomes in Frail Older Patients

Factors Affecting Outpatient Rehabilitation Outcomes in Elders

“…Elders with lower levels of admission function showed significantly poorer functional gain and rehabilitation efficiency, consistent with previous findings from inpatient rehabilitation studies (Baztán et al, 2003;Bode & Heinemann, 2002;Landi et al, 2002;Musicco et al, 2003;Sahadevan et al, 1999). Admission function was the most potent factor affecting outpatient rehabilitation outcomes in the current study.…”

“…Such difficulties might be partially attributable to the observed association of cognitive impairment with poor admission and discharge function in older adults admitted to inpatient rehabilitation services (Fitz & Teri, 1994;Musicco, Emberti, Nappi, & Caltagirone, 2003;Resnick & Daly, 1998;Sahadevan, Lim, & Choo, 1999). However, the meaning of such an association has been increasingly challenged because of an observed lack of association between cognitive impairment and functional gain, that is, the change in function from admission to discharge as an outcome of rehabilitation services (Barnes, 1984;Baztán, Forcano, González, & Ruipérrez, 2003;Diamond, Felsenthal, Macciocchi, Butler, & Lally-Cassady, 1996;Goldstein, Strasser, Woodard, & Roberts, 1997;Jackson, 1984;Morris et al, 1999;Ruchinskas, Singer, & Repetz, 2000;Sahadevan et al, 1999;Tappen, 1994). Other than functional gain, the effect of cognitive impairment on other rehabilitation outcomes (e.g., rehabilitation efficiency, length of stay (LOS), and discharge location) is largely inconclusive because of the scarcity of studies and variation in measurements.…”

Functional and self‐efficacy changes of patients admitted to a Geriatric Rehabilitation Unit

“…Geriatric Rehabilitation Units (GRUs) have been recognized as an effective strategy to restore older, hospitalized patients’ functional abilities (Rubenstein et al. 1984, Baztan et al. 2003).…”

“…In fact, functional decline on admission to hospital has previously been shown to be a predictor of adverse hospital outcomes (Inouye et al 2000, Fleury 2002, Huckstadt 2002. Geriatric Rehabilitation Units (GRUs) have been recognized as an effective strategy to restore older, hospitalized patients' functional abilities (Rubenstein et al 1984, Baztan et al 2003. However, studies reporting this have been mainly conducted in the United States.…”

How can we improve targeting of frail elderly patients to a geriatric day-hospital rehabilitation program?

“…ceiling effect) and perhaps in part by a regression to the mean. Conversely, patients with very low functional measure scores on admission may have poor rehabilitation potential [28]. Another confounder is that even though the psychometric properties of each of the functional measures have well-defined thresholds detecting significant change, we have no way of determining if improvement in one of the tests is easier to attain than in another.…”