This study compared FIM motor score improvements between elderly and super-elderly patients with musculoskeletal disorders undergoing rehabilitation. It also evaluated the impact of BMI, cognitive function, length of hospital stay, and pre-injury functional status on rehabilitation outcomes.
A retrospective observational study was conducted on 319 patients aged 65 years and older who were admitted to the rehabilitation ward of Hospital A in Japan between 2019 and 2021 for musculoskeletal disorders. Patients were divided into elderly (n = 255, 65–89 years) and super-elderly (n = 64, ≥90 years) groups. Baseline data included age, sex, BMI, cohabitation status, family support level, hospital stay length, waiting period before admission, pre-injury modified Rankin Scale (mRS) scores, and discharge destination. FIM motor and cognitive scores were recorded at admission and discharge. A linear mixed model analyzed the impact of age group, time (admission vs. discharge), and covariates (BMI, cognitive function, hospital stay length, pre-injury functional status) on FIM motor score improvements, adjusting for repeated measures. Statistical significance was set at p 0.05.
Both groups significantly improved FIM motor scores from admission to discharge (elderly: 48.35 ± 17.60 to 73.47 ± 18.44; super-elderly: 39.72 ± 15.29 to 64.13 ± 20.03; p 0.0001). Although the super-elderly group had lower FIM motor scores at both admission and discharge (p 0.05), the magnitude of improvement was comparable between groups (p = 0.784). Cognitive function at admission significantly predicted greater motor score improvements (β = 0.85, F(1,312)=249.55, p 0.0001). Better pre-injury functional status was also a significant positive predictor (β = –3.08, F(1,312)=24.47, p 0.001). Longer hospital stay significantly enhanced recovery (β = 0.10, F(1,312)=8.20, p = 0.0045). BMI did not significantly affect improvements (F(1,312)=0.63, p=0.4269). The effect size for age group differences was small (Cohen's f² = 0.0108), indicating limited clinical significance.
Rehabilitation significantly improved motor function in both elderly and super-elderly patients. Despite lower initial scores, the super-elderly achieved improvements comparable to the elderly, suggesting age alone should not limit rehabilitation efforts. Cognitive function and pre-injury status were stronger predictors of outcomes than age, highlighting the importance of individualized programs based on patient-specific factors.
Rehabilitation programs for older patients should focus on assessing cognitive abilities and pre-injury functional status rather than imposing age-based restrictions. Tailoring interventions to these factors can enhance rehabilitation effectiveness and improve functional outcomes for the super-elderly population.
Musculoskeletal Disorders
Functional Independence Measure (FIM)
