Vincent Grote1, Alexandra Unger2, Elke Böttcher3, Michael Muntean4, Henry Puff4, Wolfgang Marktl5, Erich Mur6, Werner Kullich7, Sandra Holasek8, Peter Hofmann9, Helmut K Lackner10, Nandu Goswami10, Maximilian Moser11. 1. Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria; Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria. Electronic address: vincent.grote@rehabilitationresearch.eu. 2. University College of Teacher Education Carinthia, Viktor Frankl University College, Klagenfurt, Austria. 3. Humanomed Center, Althofen, Austria. Electronic address: elke.boettcher@humanomed.at. 4. Humanomed Center, Althofen, Austria. 5. GAMED & Karl Landsteiner Institut für Traditionelle Medizin, Vienna, Austria. 6. Univ.-Klinik Innsbruck & Research Unit f. Orthopädische Physiotherapie (UMIT), Hall in Tirol, Austria. 7. Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Department for Rehabilitation, Saalfelden, Austria. 8. Otto Loewi Research Center, Immunology and Pathophysiology, Medical University of Graz, Graz, Austria. 9. Institute of Sports Sciences, Exercise Physiology, Training & Training Therapy Research Group, University of Graz, Graz, Austria. 10. Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria. 11. Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria; Human Research Institute, Weiz, Austria.
Abstract
OBJECTIVES: Rehabilitation plays a vital role in the mitigation and improvement of functional limitations associated with aging and chronic conditions. Moderating factors such as sex, age, the medical diagnosis, and rehabilitation timing for admission status, as well as the expected change related to inpatient rehabilitation, are examined to provide a valid basis for the routine assessment of the quality of medical outcomes. DESIGN: An observational study was carried out, placing a focus on general and disease-specific health measurements, to assess representative results of multidisciplinary inpatient rehabilitation. Aspects that were possibly confounding and introduced bias were controlled based on data from a quasi-experimental (waiting) control group. MEASURES: Existing data or general health indicators were extracted from medical records. The indicators included blood pressure, resting heart rate, self-assessed health, and pain, as well as more disease-specific indicators of physical function and performance (eg, activities of daily living, walking tests, blood lipids). These are used to identify moderating factors related to health outcomes. SETTING AND PARTICIPANTS: A standardized collection of routine data from 16,966 patients [61.5 ± 12.5 years; 7871 (46%) women, 9095 (54%) men] with different medical diagnoses before and after rehabilitation were summarized using a descriptive evaluation in terms of a content and factor analysis. RESULTS: Without rehabilitation, general health indicators did not improve independently and remained stable at best [odds ratio (OR) = 0.74], whereas disease-specific indicators improved noticeably after surgery (OR = 3.20). Inpatient rehabilitation was shown to reduce the risk factors associated with certain lifestyles, optimize organ function, and improve well-being in most patients (>70%; cutoff: z-difference >0.20), with a standardized mean difference (SMD) seen in overall medical quality outcome of -0.48 ± 0.37 [pre- vs post-rehabilitation: ηp2 = 0.622; dCohen = -1.22; 95% confidence interval (95% CI) -1.24 to -1.19]. The baseline medical values obtained at the beginning of rehabilitation were influenced by indication, age, and sex (all P < .001); however, these factors have less significant effects on improvements in general health indicators (ηp2 < 0.01). According to the disease-specific results, the greatest improvements were found in older patients (SMD for patients >60 vs ≤60 years: 95% CI 0.08-0.11) and during the early rehabilitation stage (ηp2 = 0.063). CONCLUSIONS AND IMPLICATIONS: Compared with those who received no inpatient rehabilitation, patients who received rehabilitation showed greater improvements in 2 independent areas, general and disease-specific health measures, regardless of their diagnosis, age, and sex. Due to the study design and the use of a nonrandomized waiting group, causal conclusions must be drawn with caution. However, the comparability and stability of the presented results strongly support the validity of the observed improvements associated with inpatient rehabilitation.
OBJECTIVES: Rehabilitation plays a vital role in the mitigation and improvement of functional limitations associated with aging and chronic conditions. Moderating factors such as sex, age, the medical diagnosis, and rehabilitation timing for admission status, as well as the expected change related to inpatient rehabilitation, are examined to provide a valid basis for the routine assessment of the quality of medical outcomes. DESIGN: An observational study was carried out, placing a focus on general and disease-specific health measurements, to assess representative results of multidisciplinary inpatient rehabilitation. Aspects that were possibly confounding and introduced bias were controlled based on data from a quasi-experimental (waiting) control group. MEASURES: Existing data or general health indicators were extracted from medical records. The indicators included blood pressure, resting heart rate, self-assessed health, and pain, as well as more disease-specific indicators of physical function and performance (eg, activities of daily living, walking tests, blood lipids). These are used to identify moderating factors related to health outcomes. SETTING AND PARTICIPANTS: A standardized collection of routine data from 16,966 patients [61.5 ± 12.5 years; 7871 (46%) women, 9095 (54%) men] with different medical diagnoses before and after rehabilitation were summarized using a descriptive evaluation in terms of a content and factor analysis. RESULTS: Without rehabilitation, general health indicators did not improve independently and remained stable at best [odds ratio (OR) = 0.74], whereas disease-specific indicators improved noticeably after surgery (OR = 3.20). Inpatient rehabilitation was shown to reduce the risk factors associated with certain lifestyles, optimize organ function, and improve well-being in most patients (>70%; cutoff: z-difference >0.20), with a standardized mean difference (SMD) seen in overall medical quality outcome of -0.48 ± 0.37 [pre- vs post-rehabilitation: ηp2 = 0.622; dCohen = -1.22; 95% confidence interval (95% CI) -1.24 to -1.19]. The baseline medical values obtained at the beginning of rehabilitation were influenced by indication, age, and sex (all P < .001); however, these factors have less significant effects on improvements in general health indicators (ηp2 < 0.01). According to the disease-specific results, the greatest improvements were found in older patients (SMD for patients >60 vs ≤60 years: 95% CI 0.08-0.11) and during the early rehabilitation stage (ηp2 = 0.063). CONCLUSIONS AND IMPLICATIONS: Compared with those who received no inpatient rehabilitation, patients who received rehabilitation showed greater improvements in 2 independent areas, general and disease-specific health measures, regardless of their diagnosis, age, and sex. Due to the study design and the use of a nonrandomized waiting group, causal conclusions must be drawn with caution. However, the comparability and stability of the presented results strongly support the validity of the observed improvements associated with inpatient rehabilitation.
Authors: Jens Lehmann; Maria Rothmund; David Riedl; Gerhard Rumpold; Vincent Grote; Michael J Fischer; Bernhard Holzner Journal: Cancers (Basel) Date: 2021-12-24 Impact factor: 6.639
Authors: David Riedl; Thomas Licht; Alain Nickels; Maria Rothmund; Gerhard Rumpold; Bernhard Holzner; Vincent Grote; Michael J Fischer; Gustav Fischmeister Journal: Cancers (Basel) Date: 2022-10-04 Impact factor: 6.575
Authors: Walter Bily; Jakob Jauker; Helena Nics; Vincent Grote; Michael Pirchl; Michael J Fischer Journal: Int J Environ Res Public Health Date: 2022-03-07 Impact factor: 3.390
Authors: Andrej Zdravkovic; Vincent Grote; Michael Pirchl; Martin Stockinger; Richard Crevenna; Michael J Fischer Journal: Qual Life Res Date: 2021-06-15 Impact factor: 4.147