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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
A Journal on Physical Medicine and Rehabilitation after Pathological Events
Official Journal of the , , , ,
In association with
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
Europa Medicophysica 1999 December;35(4):185-93
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.