The Community Rehabilitation Assessment: patient and clinician-reported outcomes in ambulatory rehabilitation.
Luke Andrew Turcotte, Caitlin McArthur, Charissa Levy and 3 others
PMID 37284338WHAT IT FOUND
Patients in ambulatory rehab showed large improvements in daily activities and walking speed.
The new assessment captured these changes, but without a control group, it is unclear how much was due to treatment versus natural recovery.
Key findings
01Patients improved significantly in instrumental activities of daily living, with a mean score change of 2.8 points on a 14-point scale.
02Walking speed improved by an average of 3.2 seconds on a 4-meter test, representing a medium effect size.
03Nearly 80% of patients reported achieving their rehabilitation goals or making progress in most areas.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This was a pilot study with no control group, so improvements cannot be definitively attributed to the rehabilitation intervention rather than natural recovery or other factors. The sample was not representative of the entire Ontario ambulatory rehabilitation population, as clinics volunteered for the study. Discharge assessments were missing for some patients, particularly those who were less healthy or had depressive symptoms at admission, which may bias the results. The CRA has not yet been validated for reliability and validity in this specific broad ambulatory rehabilitation population. Clinic treatment protocols varied widely, making it difficult to standardize the 'dose' of rehabilitation received.
Declared interests
The study was conducted by the Rehabilitative Care Alliance (RCA), a provincially funded secretariat. The authors did not declare any specific commercial conflicts of interest, but the RCA's role in promoting standardized data collection is central to the study's objective.
The easy way to misread this
Do not assume the observed improvements were caused solely by the rehabilitation intervention. Without a control group, natural recovery and other unmeasured factors could account for the changes.