Table 3.
Rehabilitation Treatments by Admission FIM Cognitive Score Subgroup
| Characteristics | Admission FIM Cognitive Score* | ||||||
|---|---|---|---|---|---|---|---|
| Overall (n=2130) | <=6 (n=339) | 7–10 (n=374) | 11–15 (n=495) | 16–20 (n=408) | >=21 (n=504) | P | |
| Selected non-therapy treatments | |||||||
| Restraints used (%) † | 56.7 | 85.0 | 76.5 | 64.2 | 44.9 | 25.0 | <.001 ‡ |
| Number of days of restraint use (mean, SD)§ | 23.8 (20.6) | 32.9 (29.1) | 27.6 (19.2) | 21.4 (15.0) | 16.6 (12.9) | 11.2 (8.7) | <.001 || |
| Sitter used (%) | 20.6 | 33.9 | 28.1 | 23.6 | 16.4 | 6.6 | <.001 ‡ |
| Number of days of sitter use (mean, SD)§ | 14.9 (14.9) | 22.2 (19.2) | 15.3 (13.9) | 11.2 (10.1) | 10.0 (8.4) | 11.0 (16.8) | <.001 || |
| Enteral nutrition (%) | 36.1 | 77.6 | 58.3 | 35.8 | 15.9 | 8.3 | <.001 ‡ |
| Number of days of enteral nutrition (mean, SD)§ | 20.3 (17.9) | 26.6 (20.1) | 19.5 (15.4) | 15.9 (17.6) | 12.9 (10.0) | 11.9 (12.4) | <.001 || |
| Parenteral nutrition adminstered (%) | 6.1 | 13.9 | 9.4 | 6.1 | 2.5 | 0.8 | <.001 ‡ |
| Medications | |||||||
| Medications administered (%) | |||||||
| Analgesic narcotic/opioid | 74.3 | 75.9 | 75.9 | 74.5 | 75.9 | 70.2 | 0.214 ‡ |
| Analgesic non-narcotic | 80.2 | 87.0 | 83.2 | 80.7 | 78.6 | 74.4 | <.001 ‡ |
| Anticholinergic | 52.4 | 76.5 | 61.0 | 48.1 | 46.3 | 38.7 | <.001 ‡ |
| Anticoagulant | 72.1 | 85.2 | 80.5 | 78.4 | 68.7 | 53.8 | <.001 ‡ |
| Anticonvulsant | 50.1 | 54.8 | 53.4 | 49.8 | 49.5 | 44.6 | 0.033 ‡ |
| Antidepressant | 69.2 | 81.3 | 77.8 | 69.3 | 69.9 | 53.8 | <.001 ‡ |
| Antiulcer | 73.9 | 83.4 | 80.8 | 77.4 | 73.9 | 58.8 | <.001 ‡ |
| Trazadone | 54.8 | 68.1 | 65.9 | 56.6 | 52.2 | 37.5 | <.001 ‡ |
| Therapy activities | |||||||
| % of study population receiving any PT | 99.3 | 100.0 | 99.7 | 99.0 | 99.5 | 98.8 | 0.172 ‡ |
| Total minutes/week (mean, SD)§ | 314.2 (109.5) | 343.8 (95.0) | 319.2 (98.8) | 308.7 (98.5) | 304.9 (115.0) | 303.3 (127.6) | <.001 || |
| % of study population receiving any OT | 99.2 | 99.7 | 99.5 | 99.2 | 99.5 | 98.4 | 0.212 ‡ |
| Total minutes/week (mean, SD)§ | 298.1 (101.3) | 321.8 (89.6) | 304.5 (88.4) | 299.3 (92.1) | 283.9 (107.9) | 287.5 (117.1) | <.001 || |
| % of study population receiving any speech language pathology | 96.7 | 100.0 | 98.9 | 98.4 | 97.3 | 90.7 | <.001 ‡ |
| Total minutes/week (mean, SD)§ | 253.6 (114.9) | 268 (108.1) | 290.5 (99.7) | 281.5 (109.4) | 239.9 (107.8) | 194.2 (118.8) | <.001 || |
| % of study population receiving any psychology | 75.2 | 71.4 | 82.1 | 84.0 | 77.7 | 61.7 | <.001 ‡ |
| Total minutes/week (mean, SD)§ | 85 (82.0) | 56.5 (62.0) | 71.7 (62.3) | 97.6 (75.8) | 92.2 (91.8) | 96.3 (101.9) | <.001 || |
| % of study population receiving any recreational therapy | 72.0 | 71.7 | 78.6 | 82.2 | 71.8 | 57.3 | <.001 ‡ |
| Total minutes/week (mean, SD)§ | 91.6 (71.2) | 66.4 (50.5) | 87.6 (62.4) | 105 (79.8) | 102.5 (71.8) | 87 (75.1) | <.001 || |
| % of study population receiving any social work/case management services | 84.1 | 89.1 | 82.1 | 83.6 | 84.3 | 82.3 | 0.069 ‡ |
| Total minutes/week (mean, SD)§ | 118.5 (74.7) | 101.3 (64.2) | 106.1 (73.3) | 117.6 (66.8) | 126.3 (72.5) | 133.7 (87.5) | <.001 || |
| PT activities (Three most frequently used) | |||||||
| Theraputic exercise | |||||||
| % patients receiving | 95.0 | 98.2 | 97.3 | 94.9 | 94.1 | 91.7 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 56 (41.9) | 50.7 (35.0) | 45 (33.0) | 49 (37.9) | 59.2 (40.3) | 73.5 (51.6) | <.001 || |
| Gait training | |||||||
| % patients receiving | 88.2 | 89.7 | 92.8 | 90.3 | 88.7 | 81.2 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 80.6 (70.3) | 92.4 (71.7) | 75.4 (61.4) | 75 (61.0) | 77 (68.4) | 86.1 (85.1) | 0.002 || |
| Standing | |||||||
| % patients receiving | 83.8 | 95.3 | 94.4 | 87.3 | 78.4 | 69.0 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 31.4 (23.2) | 33.5 (22.1) | 31.4 (20.7) | 31.3 (22.6) | 30.2 (25.8) | 30.5 (24.7) | 0.411 || |
| OT activities (Three most frequently used) | |||||||
| Cognitive activity | |||||||
| % patients receiving | 91.2 | 97.3 | 95.5 | 92.3 | 90.7 | 82.9 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 68.9 (61.4) | 83 (67.7) | 66.1 (57.5) | 66.2 (60.1) | 65.3 (58.3) | 67.1 (62.9) | <.001 || |
| Lower body dressing | |||||||
| % patients receiving | 82.0 | 92.9 | 95.7 | 86.7 | 79.7 | 61.5 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 16.5 (12.9) | 17.3 (11.7) | 16.1 (11.5) | 14.9 (11.3) | 16.7 (13.6) | 18 (16.4) | 0.014 || |
| Upper extremity activity | |||||||
| % patients receiving | 79.6 | 92.9 | 84.5 | 82.6 | 76.7 | 66.3 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 49.1 (42.4) | 46.2 (40.4) | 47.2 (36.9) | 43.8 (35.6) | 51.2 (40.4) | 57.7 (55.6) | <.001 || |
| Speech language pathology activities (Three most frequently used): | |||||||
| Education | |||||||
| % patients receiving | 72.4 | 79.4 | 79.9 | 79.0 | 70.8 | 56.7 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 17.9 (14.1) | 13.2 (12.3) | 15.5 (11.7) | 18.9 (13.7) | 20.2 (13.9) | 21.3 (17.1) | <.001 || |
| Verbal reasoning | |||||||
| % patients receiving | 62.6 | 63.7 | 65.5 | 74.9 | 66.7 | 44.8 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 19.8 (18.0) | 11.6 (10.9) | 18.4 (16.3) | 22.6 (19.4) | 21.1 (19.2) | 23 (19.1) | <.001 || |
| Verbal orientation review | |||||||
| % patients receiving | 59.6 | 87.6 | 84.0 | 70.7 | 45.1 | 22.8 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 19.6 (18.2) | 22.7 (19.9) | 23.3 (19.6) | 18.2 (17.2) | 14.6 (13.3) | 12.1 (11.8) | <.001 || |
| Psychology activities (Three most frequently used): | |||||||
| Neurobehavioral assessment | |||||||
| % patients receiving | 57.3 | 55.5 | 67.1 | 69.3 | 56.4 | 40.1 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 19.2 (16.9) | 18.3 (18.2) | 21.4 (16.2) | 20.3 (14.6) | 17.1 (20.7) | 17.8 (15.4) | 0.023|| |
| Psychotherapeutic and behavior intervention | |||||||
| % patients receiving | 44.6 | 37.8 | 50.5 | 55.4 | 46.6 | 31.9 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 22.6 (22.0) | 14.5 (14.0) | 18.7 (16.6) | 24.6 (20.0) | 24.8 (22.8) | 28 (31.1) | <.001 || |
| Neuropsychological testing | |||||||
| % patients receiving | 38.5 | 23.9 | 36.6 | 53.1 | 43.1 | 31.5 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 38.5 (36.9) | 19.5 (16.9) | 27.6 (21.3) | 40.8 (32.4) | 39.5 (34.1) | 52.7 (54.5) | <.001 || |
| Recreational therapy activities (Three most frequently used): | |||||||
| Board/table top games | |||||||
| % patients receiving | 31.8 | 32.7 | 34.0 | 38.4 | 34.3 | 21.2 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 25.3 (23.1) | 14.3 (12.9) | 21.1 (19.0) | 23.1 (21.4) | 31.5 (22.8) | 38.1 (30.4) | <.001 || |
| Card games | |||||||
| % patients receiving | 27.5 | 28.9 | 33.2 | 31.3 | 31.6 | 15.5 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 29 (28.3) | 15.7 (15.0) | 25.8 (27.7) | 30.3 (29.0) | 36.9 (31.7) | 35.8 (28.7) | <.001 || |
| Community reintegration | |||||||
| % patients receiving | 24.4 | 26.5 | 27.8 | 33.9 | 21.8 | 12.5 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 57.9 (47.2) | 29.9 (22.6) | 46.9 (32.2) | 63.5 (47.0) | 66.1 (43.0) | 92.2 (69.4) | <.001 || |
| Social work/case management activities (Three most frequently used): | |||||||
| Team meetings | |||||||
| % patients receiving | 80.3 | 87.9 | 79.9 | 82.6 | 79.2 | 74.0 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 10.4 (6.4) | 9.6 (5.3) | 10.6 (6.3) | 10.4 (5.8) | 10.2 (6.2) | 10.9 (7.9) | 0.158 || |
| Discharge planning for patient | |||||||
| % patients receiving | 68.0 | 76.4 | 69.0 | 67.5 | 67.6 | 62.5 | 0.001 ‡ |
| Minutes per week (mean, SD)§ | 21.3 (20.7) | 15 (17.8) | 18.7 (17.1) | 21.2 (19.1) | 22.7 (20.9) | 28 (25.0) | <.001 || |
| Education/support for family | |||||||
| % patients receiving | 54.5 | 75.8 | 58.3 | 56.2 | 51.2 | 38.1 | <.001 ‡ |
| Minutes per week (mean, SD)§ | 18 (16.9) | 16.1 (16.3) | 18.6 (17.8) | 19.2 (17.4) | 19.9 (18.9) | 15.6 (12.5) | 0.021 || |
| Therapist experience | |||||||
| Clinician Experience Index in years (mean, SD) | |||||||
| Overall | 4.8 (3.1) | 4.6 (3.3) | 4.3 (2.6) | 4.6 (2.8) | 5.2 (3.6) | 5.0 (3.0) | <.001 || |
| Physical therapy | 4.0 (4.4) | 3.8 (4.0) | 3.8 (4.7) | 3.7 (3.9) | 4.4 (4.7) | 4.2 (4.9) | 0.143 || |
| Occupational therapy | 3.1 (3.0) | 3.3 (2.9) | 2.8 (2.6) | 2.9 (2.9) | 2.9 (3.0) | 3.6 (3.5) | <.001 || |
| Speech language pathology | 5.1 (3.1) | 4.7 (2.9) | 4.8 (3.1) | 4.8 (3.1) | 5.4 (3.1) | 5.7 (3.3) | <.001 || |
| Recreational therapy | 1.9 (2.1) | 1.7 (2.0) | 1.8 (2.1) | 1.8 (2.2) | 1.8 (2.0) | 2.1 (2.3) | 0.380 || |
| Psychology | 4.5 (5.3) | 4.9 (5.6) | 4.3 (4.6) | 4.3 (4.6) | 5.1 (6.3) | 4.2 (5.6) | 0.326 || |
| Social work | 8.7 (9.0) | 8.9 (8.9) | 8.2 (8.4) | 9.1 (9.4) | 9.3 (9.9) | 8.3 (8.1) | 0.491 || |
NOTE:
*
n=10 patients missing admission FIM cognitive score.
†
Restraint types include: posey rolls and vests, posey Swedish locking belt-beds, abdominal binders, bed alarms, bed side rails, bed nets/enclosures, cameras, bed, lap and, seat belts, mitts, limb holders, and wander guards.
‡
Chi-Square analysis.
§
Data include only patients who had the specified treatment.
||
Analysis of variance test.