Article

OBJECTIVE: To assess the effectiveness of an interdisciplinary ambulatory
rehabilitation programme for persons with spina bifida in an Australian community
cohort. METHODS: Fifty-four participants randomized to a treatment group (n = 27)
for a high-intensity rehabilitation programme (with cognitive behavioural
therapy) or a control group
(n = 27) comprising usual care. Outcome measures
include: Disability: Urogenital Distress Inventory (UDI6), Incontinence Impact
Questionnaire-7 (IIQ7), American Urological Association Symptom Index (AUA),
Wexner-Faecal Incontinence Score (WFIS), Neurological Disability Scale (NDS);
PARTICIPATION: Depression, Anxiety Stress Scale (DASS), McGill Quality of Life
(MQOL), Brief COPE Scale, Genera-lized Self-efficacy Scale (GSE). Assessments
were made at baseline and 3-months post-intervention. RESULTS: Adjusted for
baseline disease and demographic covariates, the intervention group improved
significantly at 3-month follow-up for primary and secondary outcomes, with
moderate to large effect sizes (r): urinary/bowel dysfunction
(AUA, UDI6, IIQ7,
WFIS) (p < 0.001 for all, r = 0.4-0.7); and cognitive function: NDS "cognitive"
and "mood" (p < 0.01, r = 0.6 for both); DASS "depression", "anxiety" and
"stress" (p < 0.001 for all, r = 0.5-0.7); MQOL total (p = 0.013, r = 0.5),
"psychological symptoms" (p < 0.001, r = 0.8); "active coping" (p = 0.035) and
"self-efficacy" scores (GSE p < 0.001). No difference between groups was noted in
other subscales. CONCLUSION: Targeted rehabilitation can improve clinical
outcomes in persons with spina bifida. Further research is needed for longer-term
outcomes related to "ageing" and participation restriction.

Langue : ANGLAIS