Gain in functional ability during medical rehabilitation as related to rehabilitation process indices and neurologic measures

Objective: To determine the incremental value of neurologic and rehabilitation process indices in predicting gain in functional abilities during rehabilitation after spinal cord injury (SCI) and to describe a model for program evaluation that provides unbiased comparisons of rehabilitation process and normative comparison of individual patient gains in functional ability. Study Design: Multiple regression including variables in a prespecified hierarchical fashion. Linear models are formulated to gauge the incremental value of neurologic measures and rehabilitation process indices when investigating the rehabilitation process and the outcome of medical rehabilitation. Results: All measures and indices vary in predictable and expected manners across individual centers and injury groups; moreover, each has demonstrated the capacity to provide unique information to the investigation of the rehabilitation process. The comprehensive set of variables accounts for 52.8% of the variance in self-care gain and 53.3% of the variance in mobility gain. The rehabilitation process indices together contribute 15% of the variance of self-care gain and over 18% of the explained variance in mobility gain, Conclusion: Forecasting gain in functional ability of patients in the domains of self-care and mobility may be enhanced when measures of neurologic impairment are supplemented with rehabilitation process indices. In addition, technical enhancements in measurement of rehabilitation process indices and gain in functional ability provide objective comparison of individual center differences and individual patient gains, (C) 1999 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.