Predicting follow-up functional outcomes in outpatient rehabilitation

John G. Baker, Roger C. Fiedler, Kenneth Ottenbacher, James J. Czyrny, Allen W. Heinemann

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Functional outcomes at an average of six months after outpatient rehabilitation were investigated in a pilot study with a sample of 42 patients receiving physical therapy for low back, neck, and other musculoskeletal problems. Logistic regression analyses were used to study variables related to the achievement of a predetermined level of physical functioning or to whether improvement occurred from initial to follow-up assessment. Scales used in the analyses were obtained from two measures of functioning, the Medical Outcomes Trust Short Form 36 (SF-36) and the Medical Rehabilitation Follow Along (MRFA(TM) instrument). Demographic and program characteristics variables obtained from clinic records were also included in the analyses. The independent variables entered into two groups of regression equations included age, gender, presenting problem, workers' compensation coverage, functioning at initial assessment, number of visits, length of program, and intensity of program. For the SF-36, the General Health scale and presenting problem predicted above or below a level greater than one standard deviation less than the mean on the Physical Functioning scale at follow-up. The combination of the Role Physical and Role Emotional scales predicted follow-up level on the Physical Component Summary (PCS) scale. The interaction of age and intensity of treatment was predictive for both the Physical Functioning and PCS scales. For predicting improvement or no improvement using the SF-36 scales, General Health and the interaction between age and intensity were predictive of change on the PhysiCal Functioning scale, whereas age and the interaction between age and number of visits were predictive of change on the PCS scale. For the MRFA(TM) instrument, the interactions between age and the intensity of treatment was predictive for both a predetermined level of physical functioning and amount of improvement in physical functioning at follow-up. An intensity rating of pain and a measure of affective distress at initial assessment both improved the identification of patients at risk for not reaching a given level of functioning whereas treatment intensity improved the identification of those patients at risk for not showing improvement at follow-up. Length of time between the end of outpatient therapy and follow-up assessment was generally not related to follow-up physical functioning. Interpretation and implications of these findings, as well as applications of this analytic approach to outcomes assessment, are discussed.

Original languageEnglish (US)
Pages (from-to)202-212
Number of pages11
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume77
Issue number3
DOIs
StatePublished - May 1998
Externally publishedYes

Fingerprint

Outpatients
Rehabilitation
Therapeutics
Workers' Compensation
Health
Neck
Logistic Models
Regression Analysis
Demography
Outcome Assessment (Health Care)
Pain

Keywords

  • Follow-Up
  • Functional Outcomes
  • Musculoskeletal
  • Outpatient

ASJC Scopus subject areas

  • Rehabilitation
  • Health Professions(all)
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Predicting follow-up functional outcomes in outpatient rehabilitation. / Baker, John G.; Fiedler, Roger C.; Ottenbacher, Kenneth; Czyrny, James J.; Heinemann, Allen W.

In: American Journal of Physical Medicine and Rehabilitation, Vol. 77, No. 3, 05.1998, p. 202-212.

Research output: Contribution to journalArticle

Baker, John G. ; Fiedler, Roger C. ; Ottenbacher, Kenneth ; Czyrny, James J. ; Heinemann, Allen W. / Predicting follow-up functional outcomes in outpatient rehabilitation. In: American Journal of Physical Medicine and Rehabilitation. 1998 ; Vol. 77, No. 3. pp. 202-212.
@article{548900e3de17472991e8b5a5c17dcbbb,
title = "Predicting follow-up functional outcomes in outpatient rehabilitation",
abstract = "Functional outcomes at an average of six months after outpatient rehabilitation were investigated in a pilot study with a sample of 42 patients receiving physical therapy for low back, neck, and other musculoskeletal problems. Logistic regression analyses were used to study variables related to the achievement of a predetermined level of physical functioning or to whether improvement occurred from initial to follow-up assessment. Scales used in the analyses were obtained from two measures of functioning, the Medical Outcomes Trust Short Form 36 (SF-36) and the Medical Rehabilitation Follow Along (MRFA(TM) instrument). Demographic and program characteristics variables obtained from clinic records were also included in the analyses. The independent variables entered into two groups of regression equations included age, gender, presenting problem, workers' compensation coverage, functioning at initial assessment, number of visits, length of program, and intensity of program. For the SF-36, the General Health scale and presenting problem predicted above or below a level greater than one standard deviation less than the mean on the Physical Functioning scale at follow-up. The combination of the Role Physical and Role Emotional scales predicted follow-up level on the Physical Component Summary (PCS) scale. The interaction of age and intensity of treatment was predictive for both the Physical Functioning and PCS scales. For predicting improvement or no improvement using the SF-36 scales, General Health and the interaction between age and intensity were predictive of change on the PhysiCal Functioning scale, whereas age and the interaction between age and number of visits were predictive of change on the PCS scale. For the MRFA(TM) instrument, the interactions between age and the intensity of treatment was predictive for both a predetermined level of physical functioning and amount of improvement in physical functioning at follow-up. An intensity rating of pain and a measure of affective distress at initial assessment both improved the identification of patients at risk for not reaching a given level of functioning whereas treatment intensity improved the identification of those patients at risk for not showing improvement at follow-up. Length of time between the end of outpatient therapy and follow-up assessment was generally not related to follow-up physical functioning. Interpretation and implications of these findings, as well as applications of this analytic approach to outcomes assessment, are discussed.",
keywords = "Follow-Up, Functional Outcomes, Musculoskeletal, Outpatient",
author = "Baker, {John G.} and Fiedler, {Roger C.} and Kenneth Ottenbacher and Czyrny, {James J.} and Heinemann, {Allen W.}",
year = "1998",
month = "5",
doi = "10.1097/00002060-199805000-00004",
language = "English (US)",
volume = "77",
pages = "202--212",
journal = "American Journal of Physical Medicine and Rehabilitation",
issn = "0894-9115",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Predicting follow-up functional outcomes in outpatient rehabilitation

AU - Baker, John G.

AU - Fiedler, Roger C.

AU - Ottenbacher, Kenneth

AU - Czyrny, James J.

AU - Heinemann, Allen W.

PY - 1998/5

Y1 - 1998/5

N2 - Functional outcomes at an average of six months after outpatient rehabilitation were investigated in a pilot study with a sample of 42 patients receiving physical therapy for low back, neck, and other musculoskeletal problems. Logistic regression analyses were used to study variables related to the achievement of a predetermined level of physical functioning or to whether improvement occurred from initial to follow-up assessment. Scales used in the analyses were obtained from two measures of functioning, the Medical Outcomes Trust Short Form 36 (SF-36) and the Medical Rehabilitation Follow Along (MRFA(TM) instrument). Demographic and program characteristics variables obtained from clinic records were also included in the analyses. The independent variables entered into two groups of regression equations included age, gender, presenting problem, workers' compensation coverage, functioning at initial assessment, number of visits, length of program, and intensity of program. For the SF-36, the General Health scale and presenting problem predicted above or below a level greater than one standard deviation less than the mean on the Physical Functioning scale at follow-up. The combination of the Role Physical and Role Emotional scales predicted follow-up level on the Physical Component Summary (PCS) scale. The interaction of age and intensity of treatment was predictive for both the Physical Functioning and PCS scales. For predicting improvement or no improvement using the SF-36 scales, General Health and the interaction between age and intensity were predictive of change on the PhysiCal Functioning scale, whereas age and the interaction between age and number of visits were predictive of change on the PCS scale. For the MRFA(TM) instrument, the interactions between age and the intensity of treatment was predictive for both a predetermined level of physical functioning and amount of improvement in physical functioning at follow-up. An intensity rating of pain and a measure of affective distress at initial assessment both improved the identification of patients at risk for not reaching a given level of functioning whereas treatment intensity improved the identification of those patients at risk for not showing improvement at follow-up. Length of time between the end of outpatient therapy and follow-up assessment was generally not related to follow-up physical functioning. Interpretation and implications of these findings, as well as applications of this analytic approach to outcomes assessment, are discussed.

AB - Functional outcomes at an average of six months after outpatient rehabilitation were investigated in a pilot study with a sample of 42 patients receiving physical therapy for low back, neck, and other musculoskeletal problems. Logistic regression analyses were used to study variables related to the achievement of a predetermined level of physical functioning or to whether improvement occurred from initial to follow-up assessment. Scales used in the analyses were obtained from two measures of functioning, the Medical Outcomes Trust Short Form 36 (SF-36) and the Medical Rehabilitation Follow Along (MRFA(TM) instrument). Demographic and program characteristics variables obtained from clinic records were also included in the analyses. The independent variables entered into two groups of regression equations included age, gender, presenting problem, workers' compensation coverage, functioning at initial assessment, number of visits, length of program, and intensity of program. For the SF-36, the General Health scale and presenting problem predicted above or below a level greater than one standard deviation less than the mean on the Physical Functioning scale at follow-up. The combination of the Role Physical and Role Emotional scales predicted follow-up level on the Physical Component Summary (PCS) scale. The interaction of age and intensity of treatment was predictive for both the Physical Functioning and PCS scales. For predicting improvement or no improvement using the SF-36 scales, General Health and the interaction between age and intensity were predictive of change on the PhysiCal Functioning scale, whereas age and the interaction between age and number of visits were predictive of change on the PCS scale. For the MRFA(TM) instrument, the interactions between age and the intensity of treatment was predictive for both a predetermined level of physical functioning and amount of improvement in physical functioning at follow-up. An intensity rating of pain and a measure of affective distress at initial assessment both improved the identification of patients at risk for not reaching a given level of functioning whereas treatment intensity improved the identification of those patients at risk for not showing improvement at follow-up. Length of time between the end of outpatient therapy and follow-up assessment was generally not related to follow-up physical functioning. Interpretation and implications of these findings, as well as applications of this analytic approach to outcomes assessment, are discussed.

KW - Follow-Up

KW - Functional Outcomes

KW - Musculoskeletal

KW - Outpatient

UR - http://www.scopus.com/inward/record.url?scp=0032078112&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032078112&partnerID=8YFLogxK

U2 - 10.1097/00002060-199805000-00004

DO - 10.1097/00002060-199805000-00004

M3 - Article

VL - 77

SP - 202

EP - 212

JO - American Journal of Physical Medicine and Rehabilitation

JF - American Journal of Physical Medicine and Rehabilitation

SN - 0894-9115

IS - 3

ER -