Objective: To compare day hospital to day centre rehabilitation using scale
s to measure mobility, activities of daily living and quality of life.
Design: Single blind randomized controlled trial with home assessments at b
aseline (twice), six weeks and three months.
Setting: Mainly rural health district. Day hospital and social services day
centres in market towns.
Interventions: Day hospital treatment or day centre rehabilitation by a phy
siotherapist and two health support workers.
Main outcome measures: World Health Organization mobility scale scored with
and without aid, Nottingham Extended Activities of Daily Living Scale and
Nottingham Health Profile,
Subjects: One hundred and five physically disabled older patients living at
home referred for day hospital rehabilitation or maintenance before discha
rge from hospital (66) or referred as outpatients (39).
Results: At three months there were no statistically significant difference
s between rehabilitation at day hospital and day centre for any of the outc
ome measurements. However, there were significant improvements between base
line and three months for the following subscales [mean change per six-week
period (95% confidence interval) ]: WHO mobility subscale (with aid) -0.67
(-0.99,-0.35); Nottingham Health Profile mobility subscale -10 (-15.5,-4.5
) Nottingham extended ADL mobility subscale +3.08 (1.78,4.37); Nottingham e
xtended ADL leisure subscale +1.66 (0.96,2.36).
Conclusion: There were no differences between day hospital and day centre i
n the outcomes measured. Day rehabilitation appeared to improve functional
ability and mobility and scales reflecting these domains deserve further ev
aluation as outcome measures in this patient group. However, no improvement
in quality of life was observed.