Inpatient Rehabilitation Services and Physical Activity Level

Abstract

Rationale: Patients in inpatient rehabilitation facilities are required to attend three hours of therapy on five of seven consecutive days. The members of the rehabilitation team including occupational and physical therapists, and speech-language pathologists use different approaches in therapy, yet have a similar aim in the wellbeing of the patient. The common ground between different types of therapy is that the therapy interventions may increase the patient's activity level through occupational participation and physical activity. However, despite the opportunity that therapy provides for physical activity, many patients are spending too much time sedentary during their inpatient stay. Research suggests that sedentary time is associated with chronic diseases and has been linked to poorer functional outcomes. The purpose of this research was to determine the physical activity levels during occupational therapy, physical therapy, and speech-language pathology services and during the time and day of receiving rehabilitation services and not receiving rehabilitation services in patients in inpatient rehabilitation. Method: Thirty-eight participants were recruited from Vidant Medical Center's inpatient rehabilitation facility for this prospective, repeated measures study. Participants were screened for moderate-to-severe cognitive impairments and wore an activity tracker to monitor physical activity for a duration of up to two weeks. Results: Significant differences were found in total activity counts between occupational therapy, physical therapy, and speech-language pathology services and in pairwise comparisons. Occupational therapy had the highest total activity counts among all therapies. A significant difference was found between times that participants were in therapy versus times that participants were not in therapy. A significant difference was found between days that participants received therapy versus days that participants did not receive therapy. Discussion: Significant physical activity differences among types of therapy could be attributed to the variations in therapy activities across therapy types, timing of therapy sessions, and/or level of patient impairment. Movement that is required to participate in inpatient rehabilitation such as bed and functional mobility and therapy activities contribute to the increased physical activity during the times that participants are participating in therapy. Non-therapy days most often occur on a weekend day, which is less structured than weekdays that require three hours of therapy. The increase in physical activity seen with therapy highlights a necessity of providing the patients with generalizability of therapy interventions, adaptations of therapy interventions, or individualized programs that can be implemented during non-rehabilitation times and post-discharge without a therapist present.