Changes in social participation and life-space mobility in newly enrolled home-based rehabilitation users over 6 months.
Yumiko Kamioka, Yuji Miura, Tomoyuki Matsuda and 5 others
PMID 32581429WHAT IT FOUND
Over 6 months, 47 newly enrolled home-based rehabilitation users had better social participation and wider life-space mobility.
Motor independence improved at 3 months. No control group, so changes cannot be attributed to the service.
Key findings
01The ICF community, social, and civic life score improved significantly from baseline to 3 months and to 6 months.
02The Life-Space Assessment score improved significantly from baseline to 6 months, with more frequent travel outside the home and to the neighborhood.
03FIM motor and FIM total scores improved significantly at 3 months, but the multiple comparisons did not show a significant difference from baseline at 6 months.
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
This was a prospective cohort with no control group, so it cannot show how effective home-based rehabilitation was. Twenty-three of 70 participants did not complete the 6-month survey: 8 entered hospital or care facility, 5 completed home rehabilitation after reaching its goal, 2 moved to ambulatory care, 2 died, and 6 dropped out for other reasons. Only 17 of 49 invited facilities agreed to take part, so the sample may not represent all home-based rehabilitation users. The ICF performance qualifier has reported low test-retest reliability, although the researchers added definitions, examples, and a remark column. Participants received many home-based rehabilitation services together, so the contribution of any single service cannot be separated. 72.4% of participants already made farthest trips to town or outside town at baseline, so that part of life space may have had less room to change. Many participants used ambulatory medical care or day services, which may have supported travel independently of home-based rehabilitation.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the improved social participation, life-space, or FIM scores as proof that home-based rehabilitation caused them. The study had no control group, and participants received evaluation and explanation; range-of-motion, muscle-strengthening, relaxation, respiratory, dysphagia, aphasia/dysarthria, and endurance/cognitive work; sitting/transfer, standing/balance, walking, stair climbing, eating, toileting, bathing, dressing/grooming, communication, household tasks, moving outside, recreation/leisure, and interpersonal interactions; orthosis/devices, living environment adjustment, instruction on how to assist, and other environmental work; and conference, coordination with other organizations, and caregiver support together, so the contribution of any single component cannot be separated.