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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

  • Casey L. Peiris
    Correspondence
    Reprint requests to Casey L. Peiris, BPhys, Allied Health Clinical Research Office, Level 2, 5 Arnold St, Box Hill, Victoria, Australia 3128
    Affiliations
    Musculoskeletal Research Centre and School of Physiotherapy, La Trobe University, Victoria, Australia

    Allied Health Clinical Research Office, Eastern Health Level 2, Victoria, Australia
    Search for articles by this author
  • Nicholas F. Taylor
    Affiliations
    Musculoskeletal Research Centre and School of Physiotherapy, La Trobe University, Victoria, Australia

    Allied Health Clinical Research Office, Eastern Health Level 2, Victoria, Australia
    Search for articles by this author
  • Nora Shields
    Affiliations
    Musculoskeletal Research Centre and School of Physiotherapy, La Trobe University, Victoria, Australia
    Search for articles by this author

      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)
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