Abstract
Peiris CL, Taylor NF, Shields N. Extra physical therapy reduces patient length of
stay and improves functional outcomes and quality of life in people with acute or
subacute conditions: a systematic review.
Objectives
To investigate whether extra physical therapy intervention reduces length of stay
and improves patient outcomes in people with acute or subacute conditions.
Data Sources
Electronic databases CINAHL, MEDLINE, AMED, PEDro, PubMed, and EMBASE were searched
from the earliest date possible through May 2010. Additional trials were identified
by scanning reference lists and citation tracking.
Study Selection
Randomized controlled trials evaluating the effect of extra physical therapy on patient
outcomes were included for review. Two reviewers independently applied the inclusion
and exclusion criteria, and any disagreements were discussed until consensus could
be reached. Searching identified 2826 potentially relevant articles, of which 16 randomized
controlled trials with 1699 participants met inclusion criteria.
Data Extraction
Data were extracted using a predefined data extraction form by 1 reviewer and checked
for accuracy by another. Methodological quality of trials was assessed independently
by 2 reviewers using the PEDro scale.
Data Synthesis
Pooled analyses with random effects model to calculate standardized mean differences
(SMDs) and 95% confidence intervals (CIs) were used in meta-analyses. When compared
with standard physical therapy, extra physical therapy reduced length of stay (SMD=−.22;
95% CI, −.39 to −.05) (mean difference of 1d [95% CI, 0–1] in acute settings and mean
difference of 4d [95% CI, 0–7] in rehabilitation settings) and improved mobility (SMD=.37;
95% CI, .05–.69), activity (SMD=.22; 95% CI, .07–.37), and quality of life (SMD=.48;
95% CI, .29–.68). There were no significant changes in self-care (SMD=.35; 95% CI,
−.06–.77).
Conclusions
Extra physical therapy decreases length of stay and significantly improves mobility,
activity, and quality of life. Future research could address the possible benefits
of providing extra services from other allied health disciplines in addition to physical
therapy.
Key Words
List of Abbreviations:
ADLs (activities of daily living), CI (confidence interval), PT (physical therapy), SF-36 (Medical Outcomes Study 36-Item Short-Form Health Survey), SMD (standardized mean difference)To read this article in full you will need to make a payment
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Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
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© 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
