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Open Access Commentary

Increasing the dose of acute rehabilitation: is there a benefit?

Ann M Parker12*, Robert K Lord23 and Dale M Needham124

Author Affiliations

1 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, 1830 East Monument St., 5th Floor, Baltimore, MD 21205, USA

2 Outcomes after Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, 1830 East Monument St., 5th Floor, Baltimore, MD 21205, USA

3 Johns Hopkins University School of Medicine, 1830 East Monument St., 5th Floor, Baltimore, MD 21205, USA

4 Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 1830 East Monument St., 5th Floor, Baltimore, MD 21205, USA

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BMC Medicine 2013, 11:199  doi:10.1186/1741-7015-11-199

Published: 10 September 2013

Abstract

Rehabilitation interventions, including physiotherapy and occupational therapy, can improve patient outcomes; however, the optimal duration and frequency of inpatient rehabilitation interventions is uncertain. In a recent randomized controlled trial published in BMC Medicine, 996 patients in two publicly-funded Australian metropolitan rehabilitation facilities were assigned to physiotherapy and occupational therapy delivered Monday through Friday (five days/week control group) versus Monday through Saturday (six days/week intervention group). This increased dose of rehabilitation in the intervention group resulted in greater functional independence and quality of life at discharge, with a trend towards significant improvement at six-month follow-up. Moreover, the length of stay for the intervention group was shorter by two days (95% CI 0 to 4, P = 0.10). Hence, in the acute inpatient rehabilitation setting, a larger dose of physiotherapy and occupational therapy, via six versus five days/week treatment, improves patient outcomes and potentially reduces overall length of stay and costs.

Please see related research: http://www.biomedcentral.com/1741-7015/11/198 webcite.

Keywords:
Occupational therapy; Physical therapy modalities; Rehabilitation; Quality of life; Activities of daily living; Mobility limitation; Length of stay