One-year trajectories of mental and physical functioning during and after rehabilitation among individuals with disabilities

Abstract

Purpose: First, to evaluate the trajectories of physical and mental functioning in individuals with chronic disabilities receiving adapted physical activity-based rehabilitation. Second, to determine whether demographic factors, disability group, pain, fatigue and self-efficacy at baseline influenced these trajectories.

Research design: A prospective intervention study.

Methods: The study included 214 subjects with chronic disabilities who were admitted to a four-week adapted physical activity-based rehabilitation stay at Beitostølen Healthsports Centre. The subjects completed written questionnaires eight and four weeks before the rehabilitation, at admission to and discharge from the rehabilitation centre and again four weeks and 12 months after discharge. Multilevel models were performed to examine the trajectories of SF-12 physical and mental functioning with possible predictors.

Results: Time yielded a statistically significant effect on physical and mental functioning (p < 0.001). Low age (p = 0.002), no more than 2 h of personal assistance per week (p = 0.023), non-nervous system disability (p = 0.019), low pain level (p < 0.001) and high chronic disease-efficacy (p = 0.007) were associated with higher physical functioning. There was a greater improvement in physical functioning for subjects with lower chronic disease-efficacy at baseline (p = 0.036) and with a disability not associated with the nervous system (p = 0.040). Low fatigue (p = 0.001) and high chronic disease-efficacy (p = 0.004) predicted higher mental functioning. There was also a greater improvement in mental functioning for subjects with high fatigue (p =0.003) and low chronic disease efficacy at baseline (p = 0.032).

Conclusion: Individuals with chronic disabilities who participated in an adapted physical activity-based intervention showed statistically significant increases in both physical and mental functioning across the 12 months after the intervention. The greatest improvement was among subjects with a high level of fatigue and low chronic disease-efficacy, as well as disabilities not associated with the nervous system, which has implications for the target groups in future rehabilitation.

Fig. 1

Change in Medical Outcomes Study 12-item Short Form Health Survey Physical Functioning Component Summary (PCS) for the high and low chronic disease-efficacy groups with standard error

Fig. 2

Change in Medical Outcomes Study 12-item Short Form Health Survey Physical Functioning Component Summary (PCS) for the disability groups with standard error

Fig. 3

Change in Medical Outcomes Study 12-item Short Form Health Survey Mental Functioning Component Summary (MCS) for subjects with high and low levels of fatigue with standard error

Fig. 4

Change in Medical Outcomes Study 12-item Short Form Health Survey Mental Functioning Component Summary (MCS) for the high and low chronic disease-efficacy groups with standard error