Orthopedic impairment after medical rehabilitation: Functional performance and satisfaction with community participation

Objective: To determine the prevalence of satisfaction with community participation and to examine associations between change in functional status and satisfaction with community participation for persons with orthopedic impairments. Design: Retrospective study of 3832 patients discharged from medical rehabilitation facilities in 2001 using information from the IT Health Track database. Results: Primary measures were the FIM™ instrument and satisfaction with community participation. The majority of patients (86.9%) were satisfied (very or somewhat) with their level of community participation. Positive-change scores in FIM total from admission to the 80- to 180-day follow-up were associated with an 8% increased odds of being in a higher satisfaction with community participation level (odds ratio, 1.08; 95% confidence interval: 1.07, 1.09) after controlling for age, gender, marital status, race/ethnicity, insurance source, length of stay and functional status. Similarly, positive-change score in motor (odds ratio, 1.09; 95% confidence interval: 1.08, 1.10) and cognition (odds ratio, 1.26; 95% confidence interval: 1.19, 1.32) FIM measures from admission to follow-up were associated with greater satisfaction with community participation. Conclusion: Gains in functional status were significantly associated with greater satisfaction with community participation. Satisfaction with community participation provides information useful to evaluate patient recovery after discharge from inpatient medical rehabilitation.