Criterion validity and sensitivity to change of the Early Rehabilitation Index (ERI): results from a German multi-center study.

Jens D Rollnik,Jens D Rollnik,B Leineweber,M Bertram,M Mertl-Rötzer,G Ketter,J Mehrholz,K Scheidtmann,C Bucka,M Hartwich,F Von Rosen,T Platz,P Peschel,H Woldag,M Pohl,R Thomas,C W Wallesch,D A Nowak,M Jöbges

doi:10.1186/s13104-016-2154-8

Abstract

BackgroundEvaluation of functional status is difficult in neurological and neurosurgical early rehabilitation patients. The Early Rehabilitation Index (ERI) was introduced in Germany over 20 years ago, but since then validation studies are lacking. The ERI (range −325 to 0 points) includes highly relevant items including the necessity of intermittent mechanical ventilation or tracheostomy.MethodsThe present paper analyzed data from a German multi-center study, enrolling 754 neurological early rehabilitation patients. Together with ERI, Barthel Index (BI), Glasgow Coma Scale (GCS), Glasgow Outcome Score Extended, Coma Remission Scale (CRS), Functional Ambulation Categories and length of stay were obtained.ResultsERI showed significant improvements from admission to discharge (p < 0.001). In addition, there were significant correlations of the ERI upon admission and at discharge with BI, CRS and GCS.ConclusionsEvaluation of our study data suggest that the ERI may be used as a valid assessment instrument for neurological and neurosurgical early rehabilitation patients.

Highlights

Evaluation of functional status is difficult in neurological and neurosurgical early rehabilitation patients
Rehabilitation patients are characterized by high morbidity and frequent colonization with multidrug resistant (MDR) bacteria [4, 5]
A floor effect is commonly seen with the Barthel Index (BI) since most of the early rehabilitation patients are completely dependent on nursing throughout the whole rehabilitation process

Summary

Introduction

Evaluation of functional status is difficult in neurological and neurosurgical early rehabilitation patients. Treatment facilities for neurological and neurosurgical early rehabilitation in Germany focus on severely impaired patients, immediately after acute-care hospital treatment [1, 2]. A floor effect is commonly seen with the BI since most of the early rehabilitation patients are completely dependent on nursing throughout the whole rehabilitation process. Another scale, called early functional abilities (EFA) [10] is common among early rehabilitation facilities, but there exists only scant data on its validation

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Conclusion