Article

Recommendations for health care redesign often advocate for
comparative effectiveness research that is patient-centered. For patients who
require rehabilitation services, a first step in this research process is to
understand current practices for specific patient groups. OBJECTIVE: To document
in detail the physical and occupational therapy treatment activities for
inpatient hip fracture rehabilitation among 3 patient subgroups distinguished by
their early rate of functional recovery between time of surgery to rehabilitation
admission. DESIGN: Multicenter prospective observational cohort, practice-based
evidence, study. SETTING: Seven skilled nursing facilities and 11 inpatient
rehabilitation facilities across the United States. PARTICIPANTS: A total of 226
patients with hip fractures treated with hip arthroplasty. METHODS: Comparisons
of physical and occupational therapy treatment activities among 3 groups with
different initial recovery trajectory (IRT) rates (slower, moderate, faster).
MAIN OUTCOME MEASURE(S): Percent of patients in each IRT group exposed to each
physical and occupational therapy activity (exposure), and mean minutes per week
for each activity (intensity). RESULTS: The number of patients exposed to
different physical or occupational therapy activities varied within the entire
sample. More specifically, among the 3 IRT groups, significant differences in
exposure occurred for 44% of physical therapy activities and 39% of occupational
therapy activities. More patients in the slower recovery group, IRT 1, received
basic activities of daily living treatments and more patients in the faster
recovery group, IRT 3, received advanced activities. The moderate recovery group,
IRT 2, had some treatments similar to IRT 1 group and others similar to IRT 3
group. CONCLUSIONS: Analyses of practice-based evidence on inpatient
rehabilitation of hip fracture patients treated with arthroplasty identified
differences in therapy activities among three patient groups classified by IRT
rates. These results may enhance physiatrists', other physicians', and
rehabilitation teams' understanding of inpatient rehabilitation for these
patients and help design future comparative effectiveness research.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS