Conclusion: Cognitive behavioral therapy combined with vestibular rehabilitation decreases dizziness in older people.
Minimal pain and an easy rehabilitation decreased the physical burden.
It is possible that, because of longer length of stay, the rehabilitation staff input reduces as the complexity of needs for rehabilitation decreases, and becomes limited to discharge planning by the end of the episode.
The percentage of older adults discharged home and to inpatient rehabilitation decreased from 59%to36%and13%to8% to 8% respectively with increasing age; the percentage of patients discharged to CCC and LTC increased from 5%to7%7% and from 4%to16%6% respectively.
Nineteen trials provided low quality evidence that multidisciplinary rehabilitation decreased pain (standardised mean difference 0.51, −0.01 to 1.04) and disability (0.68, 0.16 to 1.19) compared with physical treatments, but significant statistical heterogeneity across trials was present.
Studies have shown that the likelihood of returning to work after rehabilitation decreases with increasing age [ 2- 4] and that individuals with a higher level of education are more likely to return to work [ 5- 7].
56 58 62 63 On the basis of three trials, we found very low quality evidence that multidisciplinary rehabilitation decreased pain (standardised mean difference 0.73, 0.24 to 1.22) and low quality evidence that it reduced disability (0.49, 0.22 to 0.76) in the short term compared with waiting list.
Sixteen trials provided moderate quality evidence that multidisciplinary rehabilitation decreased pain (standardised mean difference 0.21, 95% confidence interval 0.04 to 0.37; equivalent to 0.5 points in a 10 point pain scale) and disability (0.23, 0.06 to 0.40; equivalent to 1.5 points in a 24 point Roland-Morris index) compared with usual care.
These include limitation of tissue injury to the discrete fistula site, avoidance of a skin incision, excellent haemostasis, the ability to perform a lacrimal bypass operation on an outpatient basis, quicker patient rehabilitation, decreased overall health care expense and patients' preference [ 8, 13].
Reducing the need for transfusion and delayed rehabilitation will decrease morbidity and medical and financial costs.
