Purpose：We aimed to build a predictive model for ADL, applicable to all patients admitted to a convalescent rehabilitation ward, that uses a simple index as explanatory variables, which is accessible early during hospitalization.

Methods：We included 1153 patients admitted to our convalescent rehabilitation ward. Stepwise multiple regression analysis was conducted using 18 Functional Independence Measure (FIM) sub-items at admission, with sex, age, and time since onset as explanatory variables. The total FIM motor score was calculated by summing 13 motor sub-items at discharge. Cross-validation was performed on 85 participants, independent of the analysis group, to confirm the model's clinical applicability.

Results：The multiple regression analysis results for the analysis group showed a significant equation with an R2 of 0.712. In the validation group with 85 patients, difference between the predicted and actual FIM scores at discharge was compared between the two groups, and a strong correlation of r=0.888 (p＜0.01) was observed, without any significant difference between the groups.

Conclusion：This model is less labor intensive when constructing a prediction equation because the objective variable is easily obtained. Our findings indicate that other convalescent rehabilitation wards can develop prognostic models using their data and implement them clinically.

We report the case of a 20-year-old woman with hypertrophic cardiomyopathy and severe brain dysfunction caused by post-resuscitation encephalopathy. Transferred to our hospital's convalescent rehabilitation ward, she aimed to regain independence in daily living and return to college. Upon admission, she was diagnosed with moderate attention impairment and intellectual disability. She underwent a 4-month intensive inpatient rehabilitation program, including occupational therapy (OT). Despite modest improvements in day-to-day activities and brain function by discharge, these were insufficient for her to resume university childcare classes. Further improvement in behavioral control, physical activity management, and exercise tolerance was necessary post-discharge.

OT is pivotal in supporting patient self-management of day-to-day activities, is included within the cardiac rehabilitation (CR) program covered by health insurance. Thus, we introduced her to the CR program for aerobic exercise training and OT. Counseling for physical activity based on the aerobic threshold was performed at each visit, using a chart to record daily activities and heart rate to prevent overactivity, which could lead to fatal arrhythmia.

Eventually, she resumed her classes and engaged in childcare training. For patients with brain and heart conditions, a combination of rehabilitation in the convalescent ward and outpatient CR seems to be beneficial for secondary prevention and long-term self-management.