The Applicability of the Patient-Specific Functional Scale (PSFS) in Rehabilitation for Patients with Acquired Brain Injury (ABI) – A Cohort Study

Janne Evensen,1 Helene Lundgaard Soberg,2,3 Unni Sveen,2,3 Knut A Hestad,4,5 Berit Arnesveen Bronken4 1Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, Gjøvik, Norway; 2Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway; 3Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; 4Department of Health and Nursing Sciences, Faculty of Health- and Social Sciences, The Inland Norway University of Applied Sciences, Elverum, Norway; 5Department of Research, Innlandet Hospital Trust, Brumunddal, NorwayCorrespondence: Janne EvensenDepartment of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, Gjøvik 2819, NorwayTel +47 61 11 75 00Email janne.evensen@sykehuset-innlandet.noAim: The primary aim of this study was to investigate the applicability of the Patient-Specific Functional Scale (PSFS) in patients with acquired brain injury (ABI) admitted to a specialized rehabilitation unit in a regional hospital. A secondary aim was to identify patient characteristics and functioning that predicted changes in the PSFS.Patients and Methods: In a cohort study, 59 patients with ABI were assessed for the ability to complete the PSFS. A trained multidisciplinary team applied the PSFS as part of a collaborative development of rehabilitation goals. The modified Rankin Scale (mRS), the Functional Ambulation Categories (FAC), the Rivermead Behavioural Memory Test (RBMT), the Norwegian Basic Aphasia Assessment (NBAA) and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) were used to identify characteristics of the sample. Multivariate regression analyses were performed to investigate associations between changes in the PSFS score from admission to discharge and a selected set of participant baseline characteristics and functioning.Results: Fifty-four patients (92%) of the patients with ABI were able to complete the PSFS. The five (8%) who were unable to complete the PSFS had severe cognitive or language impairment. The PSFS score improved by a mean of 2.6 (SD 2.0) points from admission to discharge. The LOTCA score made the strongest unique contribution to explain the change in the PSFS score (beta = 0.477, p= 0.020).Conclusion: In the present study, most patients with ABI (92%) were able to complete the PSFS. Cognitive function on admission was a predictor of improved functioning on the PSFS.Keywords: multidisciplinary rehabilitation, patient-specific outcome measure, patient-identified goals, shared decision making