Rehabilitation Practices Table 5 Individual Studies – Intensity of Rehabilitation

Author Year
Country
Score
Research Design
Total Sample Size

Methods

Outcome

Heinemann et al. 1995
USA
Downs & Black score=18
Case Series
Initial N=264;
Final N=246

Population: SCI and ABI, SCI: Mean age = 38.9 yrs; Gender: males = 79%, females = 21%.
Treatment: Variation in therapy intensity (OT, PT, SLT, Psych). Also examined effect of various other factors including LOS, Interruptions, Onset days, Admission scores and age.
Outcome Measures: FIM (motor, cognitive, total), FIM Efficiency (motor or cognitive) all collected at Discharge.

  • (SCI findings only)

When analysed together, none of the individual therapy intensities were predictive of improved outcomes. When analysed individually, very little was significant in the prediction with only greater LOS associated with greater achievement of potential motor gains (p<.05) and interrupted rehab associated with less achievement of potential motor gains (p<.05).
Patients with > intervals between onset and admission had less motor function at discharge, achieved less of their potential motor gains and made less efficient motor gains (all p<.05).
Therapy intensity was predicted to a small degree by the various functional, demographic and medical variables (psychology intensity had highest explained variance with 26.3% ; SLT 17.2%, All therapies combined 16.6%, OT 7.3%, PT 6.5%).
People with lower cognitive and motor function at admission receive more intense therapy (psychology and all – p<.001, speech & OT – p<.01, PT – p<.05);

Note: FIM=Functional Independence Measure; LOS=Length of stay

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