Home > Journals > European Journal of Physical and Rehabilitation Medicine > Past Issues > Europa Medicophysica 1999 December;35(4) > Europa Medicophysica 1999 December;35(4):185-93



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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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