Neurological/Neurosurgical Early Rehabilitation – A Matched Pair Study

Objective: Neurological/neurosurgical early rehabilitation is indicated in patients with a Barthel-index of 30 points according to Schoenle. Apart from this indicator, further characteristics of patients who profit favour of such a program are still unknown. Therefore, we compared characteristics of patients in a neurological/neurosurgical early rehabilitation setting with inpatients in a multidisciplinary setting.

Methods: To determine patient characteristics for neurological/neurosurgical early rehabilitation in an acute hospital setting. A case-controlled comparison with matched pairs.

Data were collected throughout a clinical assessment of a cohort of patients undergoing inpatient comprehensive rehabilitation at Helios-Klinikum Berlin Buch. Descriptive statistics were used to compare patient characteristics. Patients were matched for age, gender and comorbidity.

Results: A total of 12 patients undergoing neurological/neurosurgical early rehabilitation were matched with 12 controls with musculoskeletal impairments. Compared to their controls, patients undergoing neurological/neurosurgical early rehabilitation showed lower levels in terms of functional status, cognitive functions, locomotor functions, hemoglobin as well as higher levels in terms of pain and depression. However, a more than two fold increase in adjusted Barthel-Index (delta Barthel-index divided by Barthel-index at beginning of rehabilitation) could be detected in patients with neurological/neurosurgical early rehabilitation (1.16; 95%-CI 0.32 to 2.01) compared to their matched pairs (0.50; 95%-CI 0.22 to 0.79).

Discussion: Compared to controls with musculoskeletal impairments, patients undergoing neurological/neurosurgical early rehabilitation start their rehabilitation on a lower functional level but their gain in adjusted-Barthel-index could be doubled throughout an early rehabilitation program.