Improvement During Inpatient Rehabilitation Among Older Adults With Guillain-Barre Syndrome, Multiple Sclerosis, Parkinson Disease, and Stroke

Objective The aim of the study was to quantify the improvement in independence experienced by patients with the following diagnoses: Guillain-Barre syndrome, multiple sclerosis, Parkinson disease, and stroke after inpatient rehabilitation. Design Subjects who were admitted to inpatient rehabilitation hospitals in 2012-2013 with an incident diagnosis of the following: Guillain-Barre syndrome (n = 1079), multiple sclerosis (n = 1438), Parkinson disease (n = 11,834), or stroke (n = 131,313), were included. The main outcome measure was improvement in Functional Independence Measure scores on self-care, mobility, and cognition during inpatient rehabilitation. We estimated percent improvement from a linear mixed-effects model adjusted for patients' age, sex, race/ethnicity, comorbidity count, diagnostic group (Guillain-Barre syndrome, multiple sclerosis, Parkinson disease, and stroke), and admission score. Results All patient diagnostic groups receiving inpatient rehabilitation improved across all three domains. The largest adjusted percent improvements were observed in the mobility domain and the smallest in the cognition domain for all groups. Percent improvement in mobility ranged from 84.9% (multiple sclerosis) to 144.0% (Guillain-Barre syndrome), self-care from 49.5% (multiple sclerosis) to 84.1% (Guillain-Barre syndrome), and cognition from 34.0% (Parkinson disease) to 51.7% (Guillain-Barre syndrome). Patients with Guillain-Barre syndrome demonstrated the greatest percent improvement across all three domains. Conclusions Patients with Guillain-Barre syndrome, multiple sclerosis, Parkinson disease, and stroke should improve during inpatient rehabilitation but anticipated outcomes for patients with Guillain-Barre syndrome should be even higher.