Relationship Between Duration of Therapy Services in a Comprehensive Rehabilitation Program and Mobility at Discharge in Patients With Orthopedic Problems

Abstract

The purpose of this study was to examine the relationship between duration of physical therapy and occupational therapy and mobility at the time of discharge from a comprehensive rehabilitation program in a group of patients with orthopedic diagnoses. Subjects were 116 consecutive patients with orthopedic diagnoses (mean age=72.6 years, SD=12.0, range=21-99) who were admitted to a comprehensive inpatient rehabilitation program. This retrospective cohort study utilized the Uniform Data Set, social service records, and quality assurance records to provide demographic and medical information. The Functional Independence Measure (FIM) provided information regarding mobility at admission and discharge. The duration of physical therapy and occupational therapy was measured in hours. Subjects received an average of 40.8 hours of therapy and showed an average change in FIM mobility subscale scores of 24.5. Multiple linear regression was used to demonstrate that duration of therapy was a predictor of FIM score at the time of discharge (partial correlation=.069) after controlling for length of stay, number of diagnoses, FIM cognitive subscale score at admission, and FIM mobility subscale score at admission. Duration of therapy accounted for 6.9% of the variance in the model. This study indicates that the amount of physical therapy and occupational therapy that patients with orthopedic diagnoses receive during enrollment in an inpatient comprehensive rehabilitation program is related to the FIM mobility subscale score at the time of discharge. The authors suggest that increasing the hours of therapeutic intervention that a patient receives in inpatient rehabilitation could improve functional outcomes at discharge.