Comparison of Rehabilitation Outcomes for Long Term Neurological Conditions: A Cohort Analysis of the Australian Rehabilitation Outcomes Centre Dataset for Adults of Working Age

PLoS ONE, 2015 · DOI: 10.1371/journal.pone.0132275 · Published: July 13, 2015

Simple Explanation

This study looks at how well adults with long-term neurological conditions do in inpatient rehabilitation. It uses a large set of data from Australia to compare different groups of conditions. The conditions were grouped into 'Sudden-onset' (like stroke or brain injury) and 'Progressive/stable' (like multiple sclerosis or cerebral palsy). The study found that all groups improved during their rehabilitation, but the type of improvement varied between conditions.

Study Duration

2003-2012

Participants

28,596 adults (16–65 years) with neurological impairment

Evidence Level

Cohort Analysis

Key Findings

1
All six groups (Stroke, ABI, SCI, GBS, Progressive, CP) showed statistically significant change (p<0.001) between admission and discharge in both motor and cognitive subscales as well as total scores.
2
SCI and GBS patients were generally at the ceiling of the cognitive subscale, indicating limited room for improvement in cognitive function as measured by the FIM.
3
The ‘Progressive/stable’ conditions made smaller improvements in FIM score than the ‘Sudden-onset conditions’, but also had shorter LOS.

Research Summary

This study analyzed a large Australian dataset to compare outcomes from in-patient rehabilitation (IPR) in working-aged adults across different groups of long-term neurological conditions. The analysis showed that all groups made gains in independence during admission, although the pattern of change varied between conditions. The study highlights the need for further development of datasets to capture the complexity of rehabilitation needs and to enable more comprehensive evaluation of outcomes and cost-efficiency.

Practical Implications

Clinical Practice

The findings can help clinicians compare their own practice and gauge their outcomes in treating not only common conditions but also rarer ones.

Dataset Development

The study informs the identification of additional information or approaches that should be included in future versions of the Australasian and UK datasets to align them more closely.

Service Planning

The analysis of length of stay and functional gains can help providers and purchasers of rehabilitation services with service planning and resource allocation.

Study Limitations

1
Significant attrition due to incomplete data.
2
AROC dataset records de-identified episodic data, resulting in the potential for more than one episode being reported against the one patient.
3
The AROC dataset was not designed to separate episodes according to the NSF categories, and the division between groups is not entirely clean.

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