Impact of a Long-Term Home-Based Rehabilitation Program on Quality of Life, Balance, and Autonomy in Adults with Disabilities

Overview

Journal J Funct Morphol Kinesiol

Date 2025 Jan 23

PMID 39846665

Authors

Patricio Barria

Asterio Andrade

Alejandro Yelincic

Bessie Cordova

Felipe Covarrubias-Escudero

Carlos Cifuentes

Juan Pablo Appelgren-Gonzalez

Affiliations

Soon will be listed here.

Abstract

Background: Rehabilitation is a critical process for enhancing functionality, independence, and quality of life in individuals with disabilities. Grounded in the biopsychosocial model, it addresses physical, emotional, and social dimensions through personalized, evidence-based interventions. By integrating standardized assessments and continuous evaluation, rehabilitation has the potential to promote recovery and support active participation in society.

Objectives: This study evaluated the impact of a long-term, multidisciplinary, home-based rehabilitation program on quality of life, balance, and functional autonomy in adults with neuromusculoskeletal disabilities.

Methods: A total of 559 participants received individualized interventions from a team of physical therapists, occupational therapists, psychologists, and other health professionals. Functional independence, balance, depressive symptoms, and quality of life were assessed using the Barthel Index, Berg Balance Scale, Beck Depression Inventory, and SF-36 questionnaire, respectively.

Results: A longitudinal analysis comparing pre- and post-intervention outcomes revealed statistically significant improvements ( < 0.001) across all metrics. The Barthel Index median increased from 85 to 90 points, indicating greater functional independence, while the Berg Balance Scale improved from 39 to 47 points, reflecting reduced fall risk. Depressive symptoms decreased, with Beck Depression Inventory scores dropping from 12 to 9, and both physical and mental health components of the SF-36 showed marked enhancements.

Conclusions: These findings demonstrate the program's effectiveness in addressing both physical and emotional needs, emphasizing the value of extended, personalized, home-based care in improving health, autonomy, and overall quality of life for individuals with disabilities. This study underscores the potential of multidisciplinary approaches to support long-term rehabilitation in diverse populations.

References

Covarrubias-Escudero F, Balbontin-Miranda F, Urzua-Soler B, Ciuffardi R, Munoz M, Hernandez V . Home-based functional electrical stimulation protocol for people with chronic stroke. Efficacy and usability of a single-center cohort. Artif Organs. 2024; . DOI: 10.1111/aor.14922. View

Horak F, Wrisley D, Frank J . The Balance Evaluation Systems Test (BESTest) to differentiate balance deficits. Phys Ther. 2009; 89(5):484-98. PMC: 2676433. DOI: 10.2522/ptj.20080071. View

McPherson A, Martin C . A review of the measurement properties of the 36-item short-form health survey (SF-36) to determine its suitability for use in an alcohol-dependent population. J Psychiatr Ment Health Nurs. 2012; 20(2):114-23. DOI: 10.1111/j.1365-2850.2012.01896.x. View

Turner J, Kelly B . Emotional dimensions of chronic disease. West J Med. 2000; 172(2):124-8. PMC: 1070773. DOI: 10.1136/ewjm.172.2.124. View

Ware Jr J, Sherbourne C . The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992; 30(6):473-83. View

Craft L, Perna F . The Benefits of Exercise for the Clinically Depressed. Prim Care Companion J Clin Psychiatry. 2004; 6(3):104-111. PMC: 474733. DOI: 10.4088/pcc.v06n0301. View

Melin J, Nordin A, Feldthusen C, Danielsson L . Goal-setting in physiotherapy: exploring a person-centered perspective. Physiother Theory Pract. 2019; 37(8):863-880. DOI: 10.1080/09593985.2019.1655822. View

Lee E, Sohn M, Lee J, Kim D, Shin Y, Oh G . Changes in Long-Term Functional Independence in Patients with Moderate and Severe Ischemic Stroke: Comparison of the Responsiveness of the Modified Barthel Index and the Functional Independence Measure. Int J Environ Res Public Health. 2022; 19(15). PMC: 9367998. DOI: 10.3390/ijerph19159612. View

Moschny A, Platen P, Klaassen-Mielke R, Trampisch U, Hinrichs T . Physical activity patterns in older men and women in Germany: a cross-sectional study. BMC Public Health. 2011; 11:559. PMC: 3154867. DOI: 10.1186/1471-2458-11-559. View

10.

Winstein C, Stein J, Arena R, Bates B, Cherney L, Cramer S . Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2016; 47(6):e98-e169. DOI: 10.1161/STR.0000000000000098. View

11.

Beck A, Ward C, Mendelson M, Mock J, ERBAUGH J . An inventory for measuring depression. Arch Gen Psychiatry. 1961; 4:561-71. DOI: 10.1001/archpsyc.1961.01710120031004. View

12.

MAHONEY F, BARTHEL D . FUNCTIONAL EVALUATION: THE BARTHEL INDEX. Md State Med J. 1965; 14:61-5. View

13.

Muir S, Berg K, Chesworth B, Klar N, Speechley M . Quantifying the magnitude of risk for balance impairment on falls in community-dwelling older adults: a systematic review and meta-analysis. J Clin Epidemiol. 2009; 63(4):389-406. DOI: 10.1016/j.jclinepi.2009.06.010. View

14.

Wang Y, Gorenstein C . Psychometric properties of the Beck Depression Inventory-II: a comprehensive review. Braz J Psychiatry. 2014; 35(4):416-31. DOI: 10.1590/1516-4446-2012-1048. View

15.

Chiu A, Au-Yeung S, Lo S . A comparison of four functional tests in discriminating fallers from non-fallers in older people. Disabil Rehabil. 2003; 25(1):45-50. View

16.

McLean S, Burton M, Bradley L, Littlewood C . Interventions for enhancing adherence with physiotherapy: a systematic review. Man Ther. 2010; 15(6):514-21. DOI: 10.1016/j.math.2010.05.012. View

17.

Sherrington C, Whitney J, Lord S, Herbert R, Cumming R, Close J . Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 2008; 56(12):2234-43. DOI: 10.1111/j.1532-5415.2008.02014.x. View

18.

Wade D . Outcome measurement and rehabilitation. Clin Rehabil. 1999; 13(2):93-5. DOI: 10.1191/026921599668611234. View

19.

BovendEerdt T, Botell R, Wade D . Writing SMART rehabilitation goals and achieving goal attainment scaling: a practical guide. Clin Rehabil. 2009; 23(4):352-61. DOI: 10.1177/0269215508101741. View

20.

Pournajaf S, Pellicciari L, Proietti S, Agostini F, Gabbani D, Goffredo M . Which items of the modified Barthel Index can predict functional independence at discharge from inpatient rehabilitation? A secondary analysis retrospective cohort study. Int J Rehabil Res. 2023; 46(3):230-237. PMC: 10396075. DOI: 10.1097/MRR.0000000000000584. View