Monitoring instruments for rehabilitation processes

Contact person: Bengt H. Sjölund

Monitoring the outcomes of rehabilitation programmes is a core activity for quality of the care provided, i e value for money.

The patient's function can be assessed with the Disability Rating Index (DRI), a self assessment questionnaire comprising 12 questions where the patient assesses his/her presumed ability to perform daily physical activities by putting a marking on a 0 - 100 mm line (VAS) on a paper.

In this project, we examine the effectiveness of various instruments to monitor patients disabled by chronic pain, utilizing data collected in a national quality registry Swedish Quality Registry for Pain rehabilitation (SQRP) from Sweden.

In a first study (1) 255 consecutive patients from a university hospital setting were included. The results showed that the rehab programme influenced pain intensity (sensory impairment) and life satisfaction (participation), but only to a small extent Disability Rating Index (DRI; activity).

A clinically relevant pain reduction and an increase of in life satisfaction were related. Patients' pre-treatment beliefs about recovery influenced the long-term decrease of pain intensity, indicating that more attention should be drawn to influencing patients' pre-treatment beliefs.

1. Brogårdh C, Persson AL, Sjölund BH. Intra- and inter-rater reliability of the Sollerman hand function test in patients with chronic stroke. Disability and Rehabilitation 2007;29:145-54.
2. Nyberg V, Novo M, Sjölund BH. MPI profiles among 15 000 persons disabled with chronic pain. Abstract. 12th World Congress on Pain, 2008, Glasgow.
3. Merrick D, Sjölund BH Patients' pre- treatment beliefs about recovery influence outcome of a pain rehabilitation programme. European Journal of Physical & Rehabilitation Medicine. 2009;45:391-401.