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Is More Therapy Per Day Better?

Categories: Rehabilitation and Recovery

The Question

What affect does receiving more therapy each day have on the outcomes of individuals with traumatic brain injury?

Past Studies

Past Studies show that for many years, professionals have advocated for more rehabilitation services and sessions for individuals with traumatic brain injury. These professionals believed that if individuals received more therapy each day, they would achieve higher levels of functioning, spend less time in facilities, and have reduced hospital charges. Past researchers suggest that only a minor relationship exists between the amount of therapy received in a day and outcome. Research in this area is limited.

This Study

This study included 491 individuals from three inpatient Traumatic Brain Injury Model Systems’ sites. The participants received medical care; psychological services; and occupational, physical, and speech therapy. The researchers used rehabilitation tests to determine the participants’ progress, level of independent functioning and thinking skills. The researchers examined the records to find out how many hours per day the individuals spent in each therapy, how many days they stayed at the facilities, and what were their total charges.

The researchers found that the participants received about three to more than more4 hours of therapy per day. On average, the participants received the most occupational therapy per day, followed by physical therapy, speech therapy, and psychological services. Older individuals received less total therapy hours per day. Younger individuals appeared to receive more psychological sessions and total therapy hours per day. The individuals who spent fewer days in the facilities received more psychological service hours, were younger, and were functioning at higher levels when they were admitted to inpatient rehabilitation. The amount and frequency of therapies did not appear to influence the improvement of thinking skills, but did appear to be linked to greater gains with body movements and body mobility, such as walking. The number of days an individual spent in the inpatient rehabilitation unit was associated with greater charges. Overall, the researchers found that individuals who received more therapy per day appeared to have better outcomes. They suggest that therapy services be individually selected based on what the individual needs the most to potentially receive better outcomes.

Who May Be Affected By These Findings

Individuals with brain injuries and their loved ones, healthcare providers, insurers, and researchers.

Caveats

The researchers did not find that the number of days spent in inpatient rehabilitation or that charges were associated with the amount of therapy received per day. This was different than what a past study had found.

Bottom Line

Overall, the researchers found that individuals who received more therapy per day appeared to have better outcomes. The number of days an individual spent in the inpatient rehabilitation unit was associated with greater charges.

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Find This Study

Cifu, D.X., Kreutzer, J.S., Kolakowsky-Hayner, M.A., Marwitz, J.H., & Englander, J. (2003). The relationship between therapy intensity and rehabilitative outcomes after traumatic brain injury: A multicenter analysis. Archives of Physical Medicine and Rehabilitation, 84, 1441-1448.

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