Gain in functional ability during medical rehabilitation as related to rehabilitation process indices and neurologic measures

Objective: To determine the incremental value of neurologic and rehabilitat ion process indices in predicting gain in functional abilities during rehab ilitation after spinal cord injury (SCI) and to describe a model for progra m evaluation that provides unbiased comparisons of rehabilitation process a nd normative comparison of individual patient gains in functional ability. Study Design: Multiple regression including variables in a prespecified hie rarchical fashion. Linear models are formulated to gauge the incremental va lue of neurologic measures and rehabilitation process indices when investig ating the rehabilitation process and the outcome of medical rehabilitation. Results: All measures and indices vary in predictable and expected manners across individual centers and injury groups; moreover, each has demonstrate d the capacity to provide unique information to the investigation of the re habilitation process. The comprehensive set of variables accounts for 52.8% of the variance in self-care gain and 53.3% of the variance in mobility ga in. The rehabilitation process indices together contribute 15% of the varia nce of self-care gain and over 18% of the explained variance in mobility ga in, Conclusion: Forecasting gain in functional ability of patients in the domai ns of self-care and mobility may be enhanced when measures of neurologic im pairment are supplemented with rehabilitation process indices. In addition, technical enhancements in measurement of rehabilitation process indices an d gain in functional ability provide objective comparison of individual cen ter differences and individual patient gains, (C) 1999 by the American Cong ress of Rehabilitation Medicine and the American Academy of Physical Medici ne and Rehabilitation.