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.

Fig. 1

Flowchart of the inclusion process of the Rehabilitation Cohort West study (REKOVE) recruited at rehabilitation centres in western Norway, January–June 2015, aged 18 years or above. B: baseline; 1 y: 1 year; 3 y: 3 years.

Fig. 2

Physical (PCS) and mental (MCS) function of the Medical Outcome Study Short Form 36 (SF-36) as reported by participants, aged 18 years or above, included in the Rehabilitation Cohort West Study (REKOVE) in western Norway, January–June 2015. Scores at baseline, 1 year (1 y) and 3 years (3 y) for PCS (left) and MCS (right).

Fig. 3

Mean Physical Component Summary (scale 0 – 100) (PSC) scores and mean PCS scores on disease group at baseline, 1 year and 3 years. (left) Change scores of PCS on Sense of Coherence (scale 13 – 91) (SOC) (middle) and age (right) at 1 year and 3 years, (n = 666).

Fig. 4

Mean Mental Component Summary (scale 0 – 100) (MCS) scores and mean MCS scores on level of education at baseline, 1 year and 3 years. (left) Change scores of MCS on Sense of Coherence (scale 13 – 91) (SOC) (middle) and age (right) at 1 year and 3 years, (n = 666).