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A Journal on Physical Medicine and Rehabilitation after Pathological Events

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Europa Medicophysica 1999 December;35(4):185-93

language: English

Functional out­comes fol­low­ing the reha­bil­i­ta­tion of hos­pi­tal­ized ­patients ­with immo­bil­iza­tion syn­dromes

Boccignone A. 2, Abelli S. 1, Ortolani L. 1, Ortolani M. 1

1 Independent Orthopedic Rehabilitation Unit, Padova University Hospital;
2 Rehabilitation Unit, ­USSL 16, Padova, Italy


BACKGROUND: The so-­called immo­bil­iza­tion syn­drome is not­ed for its par­tic­u­lar­ly fre­quent occur­rence and sever­ity in ­terms of ­increased mor­bil­ity and mor­tal­ity, par­tic­u­lar­ly ­among eld­er­ly ­patients. This ­study inves­ti­gat­ed func­tion­al out­comes ­after the reha­bil­i­ta­tion of affect­ed ­patients in ­order to deter­mine the ­effect of treat­ment of ­this ­kind on the nat­u­ral evo­lu­tion of the syn­drome.
METHODS: The effec­tive­ness of reha­bil­i­ta­tion treat­ment was eval­u­at­ed ­using the FIM ­scale (Functional Indepen-­dence Measure) to meas­ure func­tion­al inde­pen­dence ­before and ­after treat­ment in ­patients who ­required phy­siat­ric con­sul­ta­tion as a ­result of the immo­bil­iza­tion syn­drome dur­ing ­their ­stay in Padova Geriatric Hospital
RESULTS: In the gen­er­al pop­u­la­tion, the ­mean FIM ­score ­increased ­from 46.4±15.9 on admis­sion to 73.6±27.3 at dis­charge. In the 6 sub­pop­u­la­tions stud­ied, ­there was a ­mean FIM ­score of 44±12.2 at admis­sion and 67.8±20.5 at dis­charge in bed­rid­den cereb­ro­vas­cu­lar ­patients; a ­mean ­initial FIM ­score of 33.8±10.1 and ­final ­score of 50.7±10.8 in ­patients ­with cere­bral invo­lu­tion­al syn­dromes; a ­mean FIM ­score of 52±21.2 at admis­sion and 81.6±22.8 at dis­charge in ­patients ­with ortho­paed­ic-rheu­mat­o­log­i­cal con­di­tions; an ­initial ­mean FIM ­score of 55.5±13.3 and a ­final ­score of 92.5±15.1 in bed­rid­den ­post-sur­gi­cal ­patients; a ­mean FIM rat­ing of 45.7±14.2 at admis­sion and 79.3±14.9 at dis­charge in bed­rid­den ­patients ­with med­i­cal con­di­tions; in the sub­pop­u­la­tion of ­patients ­with can­cer ­there was a ­mean ­initial ­score of 43.8±7.1 and a ­final ­score of 61.8±10.1.
DISCUSSION: Overall, ­there was a ­good recov­ery of func­tion­al inde­pen­dence. On aver­age, the lev­el of assis­tance ­required was ­reduced ­from ­intense-mod­er­ate to min­i­mal (p<0.001). In par­tic­u­lar, ­there was a ­good recov­ery of ­gait, ­with or with­out walk­ing ­aids, and of pos­tu­ral chang­es, where­as poor­er ­results ­were ­obtained for ­more com­plex ­tasks (bath­ing, ­stairs, tub/show­er trans­fers). Multiple regres­sion anal­y­sis dem­on­strat­ed the sta­tis­ti­cal­ly sig­nif­i­cant neg­a­tive ­effect of: bed ­rest for cere­bral invo­lu­tion­al syn­dromes, can­cer and cereb­ro­vas­cu­lar pathol­o­gies, age, and the dura­tion of bed ­rest on func­tion­al recov­ery.
CONCLUSIONS: Rehabilitation rep­re­sents an ­ideal instru­ment for improv­ing inde­pen­cence in dai­ly liv­ing ­skills in per­sons ­with immobilization syndrome.

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