Does change in functional performance affect quality of life in persons with orthopaedic impairment?

Background and Purpose: Examine the association between change in functional status and quality of life for individuals with orthopaedic impairments approximately 90 days after discharge from in-patient medical rehabilitation. Methods: A retrospective study from 2001 to 2002 using information from the IT HealthTrack database. The study included 3751 individuals with orthopaedic impairments aged 40 or older discharged from in-patient medical rehabilitation. Primary measures included motor and cognition functional status and quality of life. Data analyses included descriptive statistics, χ² analysis, and cumulative logit models. Results: The sample was 49.4% female and 81.1% non-Hispanic white. Most patients reported high levels of quality of life after hospital discharge. Change in functional status showed a significant association with quality of life with and without adjustment for possible confounding factors. Each one-point increase in total Functional Independence Measure (FIM) score was associated with an 8% increased odds ratio (OR 1.08, 95% CI: 1.07-1.09) of higher quality of life. Each one-point increase in motor and cognition FIM score was associated with an 8% (OR 1.08, 95% CI: 1.071.09) and 29% (OR 1.29, 95% CI: 1.24-1.35) increased odds ratio of higher quality of life, respectively. Of the 6 FIM domains, self care (OR 1.05, 95% CI: 1.03-1.06) and locomotion (OR 1.07, 95% CI: 1.03-1.11) were significantly associated with higher quality of life. Conclusions: Among individuals with orthopaedic impairments, a positive change in functional status was significantly associated with higher quality of life. The findings suggest the potential value of rehabilitation programs that focus on improving functional status.