Title : Acute inpatient musculoskeletal rehabilitation: A service evaluation of patient characteristics and rehabilitation outcomes
Abstract:
Background: Patients with acute musculoskeletal and orthopaedic conditions frequently require specialist inpatient rehabilitation to optimise recovery and improve functional independence. However, service-level outcome data for this population remain limited. This service evaluation assessed functional and rehabilitation outcomes following inpatient musculoskeletal rehabilitation.
Methods: Baseline demographic and clinical characteristics were summarised descriptively. Functional outcomes were assessed using Functional Independence Measure and Functional Assessment Measure (FIM+FAM) and Rehabilitation Complexity Scale (RCS) at admission and discharge. Admission-discharge comparisons were analysed using the Wilcoxon signed-rank test, with standardised effect sizes (r) calculated.
Results: Fifteen patients were included (mean age 56.2±21.2 years, 53.3% female). Diagnoses included lower limb fractures (40%), limb salvage/reconstruction (26.7%), periprosthetic fracture/arthroplasty-related complications (20%), and polytrauma (13.3%). Mean length of stay was 22.8±17.9 days, with a mean baseline Patient Categorisation Assessment Tool (PCAT) score of 21.9±3.9. Significant improvement was observed in FIM+FAM scores (median change +37 [IQR 8.5], p=0.001, r=0.87). Rehabilitation complexity significantly decreased, with RCS median change -3 [IQR 1.5], p=0.001, r=0.88. FIM+FAM subdomain demonstrated significant improvement in motor function (+20, p=0.001, r=0.87), FAM (+8, p=0.002, r=0.85), and ADL score (+7, p=0.001, r=0.873). Cognitive scores showed minimal change (p=0.1).
Conclusions: Specialist acute inpatient musculoskeletal rehabilitation was associated with significant improvements in functional independence and reduced rehabilitation complexity. Improvements were primarily driven by physical function, functional adjustment, and ADL recovery, with limited cognitive change. These findings support the value of specialist musculoskeletal rehabilitation pathways, although larger evaluations are required.
