One-year trajectories of mental and physical functioning during and after rehabilitation among individuals with disabilities

Abstract

PurposeFirst, to evaluate the trajectories of physical and mental functioning in individuals with chronic disabilities receiving adapted physical activity-based rehabilitation. Second, to determine whether demographic factors, disability group, pain, fatigue and self-efficacy at baseline influenced these trajectories.Research designA prospective intervention study.MethodsThe study included 214 subjects with chronic disabilities who were admitted to a four-week adapted physical activity-based rehabilitation stay at Beitostølen Healthsports Centre. The subjects completed written questionnaires eight and four weeks before the rehabilitation, at admission to and discharge from the rehabilitation centre and again four weeks and 12 months after discharge. Multilevel models were performed to examine the trajectories of SF-12 physical and mental functioning with possible predictors.ResultsTime yielded a statistically significant effect on physical and mental functioning (p < 0.001). Low age (p = 0.002), no more than 2 h of personal assistance per week (p = 0.023), non-nervous system disability (p = 0.019), low pain level (p < 0.001) and high chronic disease-efficacy (p = 0.007) were associated with higher physical functioning. There was a greater improvement in physical functioning for subjects with lower chronic disease-efficacy at baseline (p = 0.036) and with a disability not associated with the nervous system (p = 0.040). Low fatigue (p = 0.001) and high chronic disease-efficacy (p = 0.004) predicted higher mental functioning. There was also a greater improvement in mental functioning for subjects with high fatigue (p =0.003) and low chronic disease efficacy at baseline (p = 0.032).ConclusionIndividuals with chronic disabilities who participated in an adapted physical activity-based intervention showed statistically significant increases in both physical and mental functioning across the 12 months after the intervention. The greatest improvement was among subjects with a high level of fatigue and low chronic disease-efficacy, as well as disabilities not associated with the nervous system, which has implications for the target groups in future rehabilitation.

Factors Predicting Falls and Mobility Outcomes in Patients With Stroke Returning Home After Rehabilitation Who Are at Risk of Falling

“…For these reasons, 12 months is considered an important time point for predicting falls and mobility levels in people with stroke. 36,37 To date there has been a paucity of research looking at the factors predicting both falls and mobility levels in people with stroke in the first 12 months after rehabilitation, using the same comprehensive baseline predictor dataset. The aim of this study was to identify factors predicting falls and mobility outcomes in people with stroke in the first 12 months after returning home from rehabilitation.…”

One-year trajectories of motivation and physical activity in persons with disabilities

“…Nor did we succeed in increasing physical activity from a 1-year perspective. This is in contrast to the results of Preede et al, who found success in improving mental and physical functioning over a longer timeframe after rehabilitation (23). However, increasing physical activity over time is challenging in the context of disability, and van der Ploeg et al (39) also reported a failure to enhance physical activity over time.…”

“…The study has a prospective interventional design (ClinicalTrials.gov NCT01788397) and was approved by the Regional Medical Committee for Research Ethics in Norway (S-08837c 2008/21144). The trajectory of physical and mental functioning over one year is reported by Preede et al (23).…”

Physical Functioning Among Older Adults New to Long-Term Services and Supports

“…(Ware et al, 1996;Ware et al, 2002). The SF12PCS has been used to describe self-reported PF in adults with diverse chronic conditions (Jakobsson, Westergren, Lindskov, & Hagell, 2012;Preede et al, 2015;Resnick & Nahm, 2001;Soley-Bori et al, 2015).…”