Improvement During Inpatient Rehabilitation Among Older Adults with Guillain-Barré Syndrome, Multiple Sclerosis, Parkinson Disease, and Stroke

Objective To quantify the improvement in independence experienced by patients with the following diagnoses: Guillain-Barré Syndrome (GBS), Multiple Sclerosis (MS), Parkinson Disease (PD), and stroke following inpatient rehabilitation. Design Subjects who were admitted to inpatient rehabilitation hospitals in 2012-2013 with an incident diagnosis of: GBS (n = 1079), MS (n = 1438), PD (n = 11,834), or stroke (n = 131,313) were included. The main outcome measure was improvement in Functional Independence Measure® (FIM) scores on self-care, mobility, and cognition during inpatient rehabilitation. We estimated percent improvement from a linear mixed-effects model adjusted for patients' age, sex, race/ethnicity, comorbidity count, diagnostic group (GBS, MS, PD, and stroke), and admission score. Results All patient diagnostic groups receiving inpatient rehabilitation improved across all three domains. The largest adjusted percent improvements were observed in the mobility domain and the smallest in the cognition domain for all groups. Percent improvement in mobility ranged from 84.9% (MS) to 144.0% (GBS), self-care from 49.5% (MS) to 84.1% (GBS), and cognition from 34.0% (PD) to 51.7% (GBS). Patients with GBS demonstrated the greatest percent improvement across all three domains. Conclusions Patients with GBS, MS, PD, and stroke should improve during inpatient rehabilitation but anticipated outcomes for patients with GBS should be even higher. Author Disclosures: The study was supported by funding secured by Kenneth J. Ottenbacher, PhD, OTR through the National Institutes of Health (grant numbers R01 HD069443, P2C HD065702, and K12 HD055929) and the National Institute on Disability, Independent Living, and Rehabilitation Research (grant number 90AR5009). This work was also supported by the National Institute on Aging (grant number P30 AG024832) and the Foundation for Physical Therapy's Center of Excellence in Physical Therapy Health Services and Health Policy Research and Training Grant. We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated and we certify that all financial and material support for this research (eg, NIH or NIA grants) and work are clearly identified here in the title page of the manuscript. Neither author has financially benefitted from this research project or its dissemination. The results of this study are accepted as an abstract for the 2018 Combined Sections Meeting of the American Physical Therapy Association. To date, the results of this study have not been presented or published elsewhere. Corresponding author: A. Williams Andrews, Campus Box 2085, Elon, NC 27244. 336-278-6351. andrewsb@elon.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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