A prospective observational study of outcomes from rehabilitation of elderly patients with moderate to severe cognitive impairment.
Michael Vassallo, Lynn Poynter, Joseph Kwan and 2 others
PMID 27496699WHAT IT FOUND
64 of 116 elderly patients with moderate to severe cognitive impairment improved daily living scores after rehabilitation.
The moderate and severe groups did not differ in how many improved.
Key findings
0164 of 116 patients showed an improvement in Barthel score after rehabilitation.
02There was no significant difference between the moderate and severe cognitive impairment groups in the number of patients showing improvement.
03A discharge home required improvement in at least three Barthel items.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study had no control group and was not randomised. It cannot prove rehabilitation improved function. Patients were selected by a multidisciplinary team as having potential to benefit. This may have inflated the observed improvement. The rehabilitation was not quantified per patient. Each person received physiotherapy, physiotherapy assistants, occupational therapy and nursing support together, so the contribution of any single component cannot be separated. The severe cognitive impairment group had only 27 patients. Confidence in that subgroup is limited. Patients with hip fracture and stroke were not admitted to the wards. Results may not apply to those groups. Deaths and medical retransfers were excluded when reporting the 72% improvement. This changes the denominator and may make the result look better.
Declared interests
The authors declared no potential conflicts of interest. The research received no specific grant from any funding agency.
The easy way to misread this
Do not conclude that rehabilitation caused the Barthel score improvements. The study had no control group, patients were selected as likely to benefit, and each patient received physiotherapy, physiotherapy assistants, occupational therapy and nursing support together.