Inpatient rehabilitation facilities

Abstract

The aim of this study was to determine whether patients whose treatment is consistent with the 3-hour rule have better outcomes than patients whose treatment is not consistent with the 3-hour rule.This is a retrospective review of the records of 581 patients. The authors compared the outcomes of 397 patients whose therapy was consistent with the 3-hour rule to the outcomes of 184 patients whose therapy was not consistent with the rule for at least one 7-day period during the stay on an inpatient rehabilitation facility.Patients whose care was consistent with the rule did not have more improvement in function or shorter length of stay than patients whose care was not consistent with the 3-hour rule.There is not good evidence to support the 3-hour rule as a determinant of the care that a patient at an IRF needs to achieve a good outcome.

Effective Delivery of Vagus Nerve Stimulation Requires Many Stimulations Per Session and Many Sessions Per Week Over Many Weeks to Improve Recovery of Somatosensation

“…There is no clear consensus on the optimal number of therapy sessions, yet our results show that more than 4 sessions are needed for there to be a significant VNS-driven improvement. 14,18,19 In these shortened VNS therapy schedules, the delivery of VNS itself does not seem to compensate for the reduced repetition of rehabilitation.…”

Inpatient rehabilitation patients are more active during rehabilitation times and days than non-rehabilitation times and days: An observational study

“…Participants were patients who were receiving OT, PT, and/or SLP in the 55-bed inpatient rehabilitation facility attached to the level-1 trauma medical center in Greenville, NC in the United States. Inclusion criteria were (1) being 18 years or older and (2) recovering from one or more of the following conditions, but not limited to: stroke, brain injury, specified neurologic conditions, major multiple trauma, congenital deformity, burns, amputation, systemic vasculitis with joint involvements, fracture of the hip, knee or hip replacement, active polyarthritis, and/or severe or advanced osteoarthritis (Forrest et al, 2019). Exclusion criteria were (1) admitting diagnosis and/or past medical history of spinal cord injuries; (2) having isolation precautions; (3) the presence of moderate-to-severe cognitive impairment according to the Six-Item Screener score of 3 or below (three or more errors) (Callahan et al, 2002); (4) inability to wear ActiGraph on their wrist 24-h per day for 9–11 days; and (5) being expected to stay in the facility less than three full rehabilitation days.…”

“…Participants were patients who were receiving OT, PT, and/ or SLP in the 55-bed inpatient rehabilitation facility attached to the level-1 trauma medical center in Greenville, NC in the United States. Inclusion criteria were (1) being 18 years or older and (2) recovering from one or more of the following conditions, but not limited to: stroke, brain injury, specified neurologic conditions, major multiple trauma, congenital deformity, burns, amputation, systemic vasculitis with joint involvements, fracture of the hip, knee or hip replacement, active polyarthritis, and/or severe or advanced osteoarthritis (Forrest et al, 2019). Exclusion criteria were (1) admitting diagnosis and/or past medical history of spinal cord injuries;…”

Hitting the Links for PubMed Golf

“…3 These antiquated policies have a substantial impact on IRF care, although both were implemented more than 40 yrs ago based solely on expert opinion, have had only minimal revision in the intervening decades (despite the pronounced changes in the US healthcare system), and remain without any significant scientific evidence base. [4][5][6] With respect to the "60%-rule" policy specifically, although medical diagnosis (and anticipated recovery) is one key factor in determining whether a particular patient is appropriate for IRF admission, physiatrists well know that several other factors must also be considered (e.g., premorbid, current, and anticipated function, planned discharge living setting, family/social support). 7,8 Based on an evaluation by the Institutes of Medicine, the US government has previously acknowledged that at least function, in addition to medical diagnosis, should be a key component of an IRF admission assessment.…”