Category: Stroke; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Measurement
To investigate the impact of increasing participation in mobility-based therapy for an additional two days per week on length of stay in an inpatient rehabilitation facility (IRF).
A retrospective case control study of all patients admitted with a stroke diagnosis from May 2017 through April 2018 that were scheduled for additional physical and/or occupational therapy intervention(s) both weekend days. Scheduling and participation were tracked by a supervisor.
Participants (or Animals, Specimens, Cadavers) :
A total of 182 individuals admitted with a diagnosis of stroke between May 2017 and April 2018 were included. Patients were separated into those receiving therapy 7days a week (7-day group; 140) and those not able to receive therapy (less than 7 day group; 42).
Interventions : Mobility-based therapy provided by a physical or occupational therapist for an additional 2 days per week, above the standard of care. Scheduling and participation were tracked by a supervisor. In addition, each received a stroke-specific admissions letter and therapy team huddle on day of evaluation.
Main Outcome Measure(s) :
Length of stay, Functional Independent Measure (FIM) Total and Motor subset, Disposition
Significant difference (P=0.0001) in LOS between the 7-day group and the less than 7-day group (14.1 vs 19.6 days respectively). Although not statistically significant, Total FIM change, Motor FIM change and discharge to the community were higher in the 7-day group.
Individuals post stroke require individualized, intensive, task specific training for neurologic recovery. Our preliminary results support current evidence for improved function as well as a significant reduction in LOS. With the initiation of 7-day per week therapy, our program created an innovative way to increase intensity, while engaging patients and decreasing down time.