Gialanella B, Altieri G, Clemente M
Operative Unit for Recovery and Functional Rehabilitation Scientific Institute of Lumezzane, Salvatore Maugeri Foundation, Lumezzane, Brescia, Italy -
Eur J Phys Rehabil Med. 2014 Jun;50(3):247-54. Epub 2013 Oct 9.
Duration of rehabilitation is an important rehabilitation clinical outcome both from a clinical and administrative point of view. Very few studies have looked at predictors oftreatment duration in out-patient rehabilitation setting especially in patients with orthopedic-traumatologic conditions.
We undertook a prospective study to assess treatment duration and identify variables predicting this outcome measure (primary outcome) and efficiency in range of motion and activities of daily living (secondary outcome).
Prospective and observational study.
Out-patient Service for Rehabilitation.
Two hundred and ten patients admitted to Out-patient Service for Rehabilitation of orthopedic disorders were enrolled: 94 patients had limb fracture (35 wrist fracture, 28 ankle fracture, 27 shoulder fracture), and 120 and undergone elective orthopedic surgery (27 cruciate reconstruction, 93 rotator cuff repair).
Univariate Regression analysis was applied to analyze relationships among variables and length of rehabilitation while backward stepwise regression analysis was used to predict treatment duration. The independent variables were age, gender, work, type of physical therapy, comorbidity, pain, onset to admission interval, initial disability, initial range of motion percentage (ROM), and diagnosis group.
Mean treatment duration was 29.7±15 days. Treatment duration following rotator cuff repair was significantly longer than that of cruciate reconstruction (P=0.005), wrist fracture (P<0.001), and ankle fracture (P=0.002). Treatment duration was related to working status, admission disability, onset to admission interval, diagnosis group, admission pain, and admission range of motion. In multivariate regression analysis, admission range of motion and onset to admission interval were the only independent predictors of treatment duration and efficiency in range of motion, while admission range of motion and admission Health Assessment Questionnaire were predictors of efficiency in Health Assessment Questionnaire score.
The study highlights that rehabilitative treatment duration has strong relationship with admission range of motion and onset admission interval. CLINICAL REHABILITATION IMPACT. These findings should be useful for physicians for planning therapeutic measures in patients with orthopedic-traumatologic conditions and for managing the usual activities of an Out-patient Rehabilitative Service.
从临床和管理角度来看，康复疗程都是一项重要的康复临床结果。很少有研究关注门诊康复环境下治疗时长的预测因素，尤其是在患有骨创伤疾病的患者中。
我们开展了一项前瞻性研究，以评估治疗时长，并确定预测这一结果指标（主要结果）以及运动范围和日常生活活动效率（次要结果）的变量。
前瞻性观察研究。
门诊康复服务部。
纳入了210名因骨科疾病入住门诊康复服务部的患者：94例肢体骨折患者（35例腕部骨折、28例踝部骨折、27例肩部骨折），以及120例接受择期骨科手术的患者（27例交叉韧带重建、93例肩袖修复）。
采用单因素回归分析来分析变量与康复时长之间的关系，同时采用向后逐步回归分析来预测治疗时长。自变量包括年龄、性别、工作、物理治疗类型、合并症、疼痛、入院间隔时间、初始残疾程度、初始运动范围百分比（ROM）以及诊断组。
平均治疗时长为29.7±15天。肩袖修复后的治疗时长显著长于交叉韧带重建（P=0.005）、腕部骨折（P<0.001）和踝部骨折（P=0.002）。治疗时长与工作状态、入院时的残疾程度、入院间隔时间、诊断组、入院时的疼痛以及入院时的运动范围有关。在多因素回归分析中，入院时的运动范围和入院间隔时间是治疗时长和运动范围效率的唯一独立预测因素，而入院时的运动范围和入院时的健康评估问卷是健康评估问卷评分效率的预测因素。
该研究强调康复治疗时长与入院时的运动范围和入院间隔时间密切相关。临床康复影响。这些发现对于医生为骨创伤疾病患者制定治疗措施以及管理门诊康复服务的日常活动应是有用的。
