One-year trajectories of mental and physical functioning during and after rehabilitation among individuals with disabilities

Cecilie Røe,Astrid Nyquist,Paul B Perrin,Line Preede,Martin Saebu,Haakon Dalen,Erik Bautz-Holter

doi:10.1186/s12955-015-0328-z

Abstract

PurposeFirst, to evaluate the trajectories of physical and mental functioning in individuals with chronic disabilities receiving adapted physical activity-based rehabilitation. Second, to determine whether demographic factors, disability group, pain, fatigue and self-efficacy at baseline influenced these trajectories.Research designA prospective intervention study.MethodsThe study included 214 subjects with chronic disabilities who were admitted to a four-week adapted physical activity-based rehabilitation stay at Beitostølen Healthsports Centre. The subjects completed written questionnaires eight and four weeks before the rehabilitation, at admission to and discharge from the rehabilitation centre and again four weeks and 12 months after discharge. Multilevel models were performed to examine the trajectories of SF-12 physical and mental functioning with possible predictors.ResultsTime yielded a statistically significant effect on physical and mental functioning (p < 0.001). Low age (p = 0.002), no more than 2 h of personal assistance per week (p = 0.023), non-nervous system disability (p = 0.019), low pain level (p < 0.001) and high chronic disease-efficacy (p = 0.007) were associated with higher physical functioning. There was a greater improvement in physical functioning for subjects with lower chronic disease-efficacy at baseline (p = 0.036) and with a disability not associated with the nervous system (p = 0.040). Low fatigue (p = 0.001) and high chronic disease-efficacy (p = 0.004) predicted higher mental functioning. There was also a greater improvement in mental functioning for subjects with high fatigue (p =0.003) and low chronic disease efficacy at baseline (p = 0.032).ConclusionIndividuals with chronic disabilities who participated in an adapted physical activity-based intervention showed statistically significant increases in both physical and mental functioning across the 12 months after the intervention. The greatest improvement was among subjects with a high level of fatigue and low chronic disease-efficacy, as well as disabilities not associated with the nervous system, which has implications for the target groups in future rehabilitation.

Highlights

Chronic disability is generally defined as the consequence of impairment and a difficulty in functioning at the body, personal, or societal levels in one or more life domains, as experienced by an individual with a health condition in interaction with contextual factors [1]
The greatest improvement was among subjects with a high level of fatigue and low chronic disease-efficacy, as well as disabilities not associated with the nervous system, which has implications for the target groups in future rehabilitation
There were no significant differences in the distribution of disability groups between the 32 subjects who dropped out

Summary

Introduction

Chronic disability is generally defined as the consequence of impairment and a difficulty in functioning at the body, personal, or societal levels in one or more life domains, as experienced by an individual with a health condition in interaction with contextual factors [1]. It may be caused by congenital or acquired diseases or by trauma and other environmental factors [2]. Pain is a major factor in neurological conditions [7], but fatigue may contribute to disability in some conditions [8]

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Results