Analysis of home-based rehabilitation in patients with motor impairment in primary care: a prospective observational study

Francisco Antonio Vega-Ramírez, Remedios López-Liria, Genoveva Granados-Gámez, Jose Manuel Aguilar-Parra, David Padilla-Góngora, Francisco Antonio Vega-Ramírez, Remedios López-Liria, Genoveva Granados-Gámez, Jose Manuel Aguilar-Parra, David Padilla-Góngora

Abstract

Background: The purpose of health and social policies is to encourage older people more longevity, remain free of disability and experience quality of life while living in their homes. The aim of this study was to describe the characteristics of 473 patients diagnosed with motor impairment in primary care, the objectives of home-based rehabilitation and its functional impact.

Methods: This prospective observational study was conducted in the Almería Health District. The analysed variables included age, gender, secondary diagnosis, Barthel Index (BI), physiotherapeutic objectives and techniques, and number of sessions.

Results: The sample had a mean age of 83 years, and 59% were women. The assessed conditions with a high prevalence included osteoarticular pathology (55%), Alzheimer's disease (15.1%), cardiovascular disease (13.7%) and stroke (6.5%). The techniques applied mainly consisted of functional exercises (57.1%), caregiver education (13.8%), and technical assistance (5.7%). There were statistically significant differences (t = -15.79; p < 0.001) between initial (X = 34.8) and final BI (X = 48.1), with an improvement of 13.4 points in patients' functional capacity (95% confidence interval [CI]: -15.0 to -11.7). An equation was constructed to predict patients' final BI as a function of the initial BI using a multiple linear regression model. The regression model explained 78% of the variance in patients with motor impairment.

Conclusions: Important improvements were obtained in terms of functional capacity with a mean of ten sessions of physiotherapy. Lower patient age was correlated with higher initial and final functional capacities in primary care. This study aimed to present a useful starting point for decision making among management and health administration regarding this population group by approaching the process from the reality of practice and in relation to the rehabilitation provided.

Trial registration: ClinicalTrials.gov identifier: NCT02715245 ; Date of registration: 18 January 2016.

Keywords: Geriatrics; Home based rehabilitation; Home care; Multimorbidity; Physiotherapy; Primary health care.

Conflict of interest statement

Ethics approval and consent to participate

All patients provided written informed consent before treatment in accordance with the Helsinki Declaration. The project was approved by the scientific ethics committee of the Torrecárdenas Hospital Complex (Almería) and the research commission of the Almería Health District (CEIC-AL 39/2012), adhered to guidelines of the International Committee of Medical Journal Editors. Associated health staff allocated eligible participants, provided information about the study, and gathered written consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow of the patients through the study

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