Rehabilitative Services Clinical Trial
Official title:
Evaluation of Subacute Rehabilitative Care
Prior rehabilitation outcome studies had many weaknesses. They had: a) evaluated rehabilitation effects only in isolated subgroups, b) focused on functional ability rather than on quality of life, c) not used randomized control groups, and d) had inadequate sample sizes. Differences in methodological approaches have resulted in inconsistent findings. The lack of long-term benefits suggests that services may need to be continued at home or in subacute care settings to optimize their effectiveness. Unfortunately, prior research did not include behavioral outcomes. The potential benefits of rehabilitative care could thus not be evaluated by these studies in more meaningful detail, and they did not accurately reflect the psychosocial objectives of rehabilitation.
Background:
Prior rehabilitation outcome studies had many weaknesses. They had: a) evaluated
rehabilitation effects only in isolated subgroups, b) focused on functional ability rather
than on quality of life, c) not used randomized control groups, and d) had inadequate sample
sizes. Differences in methodological approaches have resulted in inconsistent findings. The
lack of long-term benefits suggests that services may need to be continued at home or in
subacute care settings to optimize their effectiveness. Unfortunately, prior research did
not include behavioral outcomes. The potential benefits of rehabilitative care could thus
not be evaluated by these studies in more meaningful detail, and they did not accurately
reflect the psychosocial objectives of rehabilitation.
Objectives:
The goal of this study was to measure the additive effect of outpatient, subacute
rehabilitation as follow-up services to acute, inpatient rehabilitation on adults diagnosed
with a disabling disorder in four major diagnostic groups (nervous, circulatory,
musculoskeletal, and injury).
Methods:
A randomized clinical trial was conducted to determine the effects of subacute
rehabilitative care on: 1) physical function, 2) health and mental health, 3) mortality, 4)
family function, 5) personal adjustment, and 6) use of health care resources. Patients
hospitalized for the first time with a disabling condition [n=180] were provided inpatient
rehabilitation and then randomly assigned to either subacute rehabilitation at home [n=90]
or to usual outpatient follow-up [n=90] in which only medical services were provided but no
scheduled rehabilitative therapies were offered. To compare the two groups, analysis of
covariance was conducted for the outcome variables. The between subjects factor was subacute
rehabilitative care versus usual medical services as an outpatient.
Status:
Complete.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment