Long-Term Change and Predictors of Change in Physical and Mental Function after Rehabilitation: A Multi-Centre Study

Abstract

Objective: To investigate changes and predictors of change in physical and mental function over a 3-year period after rehabilitation.
Design: Prospective cohort.
Participants: Patients, across diseases, living in western Norway, accepted for somatic specialized interprofessional rehabilitation (n = 984).
Methods: Physical and mental function were assessed at admittance (baseline), and after 1 and 3 years using the Medical Outcome Study Short Form 36 (SF-36). Associations between changes in SF-36 component summary scores and sense of coherence, pain, disease group (musculoskeletal, neoplasm, cardiovascular, neurological, other), exercise habits and demographic variables were analysed using linear mixed modelling.
Results: In the total group, mean (standard deviation) physical component summary scores improved by 2.9 (8.4) and 3.4 (9.3) points at 1 and 3 years, respectively. Mental component summary scores improved by 2.1 (9.7) and 1.6 (10.8) points. Improvement in physical component summary was significantly greater for patients with higher sense of coherence (b = 0.09, p = 0.001) and for the neoplasm disease group (b = 2.13, p = 0.046). Improvement in mental component summary was significantly greater for patients with low sense of coherence (b = –0.13, p = < 0.001) and higher level of education (b = 3.02, p = 0.0302). Interaction with age (physical component summary: b = 0.22, p = 0.039/mental component summary b = 0.51, p = 0.006) indicated larger effect at 1 year than at 3 years.
Conclusion: Physical and mental function improved in the total study group over the 3-year period. Sense of coherence at baseline was associated with improved physical and mental function, suggesting that coping resources are important in rehabilitation.

LAY ABSTRACT
Rehabilitation aims to improve function among people with disabilities. This study investigated how physical and mental function change in a 3-year period after rehabilitation, and the factors related to these changes. In a cohort of 984 rehabilitation patients, physical and mental function were measured before rehabilitation (baseline) and at 1 and 3 years after rehabilitation. Both physical and mental function improved over a period of 3 years, with the greatest improvement from baseline to 1 year. Improved function at 1 year remained relatively stable over time. Participants with higher coping resources at baseline, measured by sense of coherence, had the greatest improvement in physical function, and less improvement in mental function. Participants’ disease group influenced change in physical function. Participants with a higher level of education demonstrated greater improvement in mental function. These results imply that coping resources should be addressed as an important part of rehabilitation.