Flora M Hammond1, Ryan Barrett2, Marcel P Dijkers3, Jeanne M Zanca4, Susan D Horn2, Randall J Smout2, Tami Guerrier5, Elizabeth Hauser5, Megan R Dunning6. 1. Carolinas Rehabilitation, Charlotte, NC; Indiana University School of Medicine, Indianapolis, IN. Electronic address: flora.hammond@rhin.com. 2. Institute for Clinical Outcomes Research, Salt Lake City, UT. 3. Icahn School of Medicine at Mount Sinai, New York, NY. 4. Kessler Foundation, New York, NY. 5. Carolinas Rehabilitation, Charlotte, NC. 6. Rush University Medical Center, Chicago, IL.
Abstract
OBJECTIVES: To describe the amount and content of group therapies provided during inpatient rehabilitation for traumatic brain injury (TBI), and to assess the relations of group therapy with patient, injury, and treatment factors and outcomes. DESIGN: Prospective observational cohort. SETTING: Inpatient rehabilitation. PARTICIPANTS: Consecutive admissions (N=2130) for initial TBI rehabilitation at 10 inpatient rehabilitation facilities (9 in the United States, 1 in Canada) from October 2008 to September 2011. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Proportion of sessions that were group therapy (≥2 patients were treated simultaneously by ≥1 clinician); proportion of patients receiving group therapy; type of activity performed and amount of time spent in group therapy, by discipline; rehabilitation length of stay; discharge location; and FIM cognitive and motor scores at discharge. RESULTS: Of the patients, 79% received at least 1 session of group therapy, with group therapy accounting for 13.7% of all therapy sessions and 15.8% of therapy hours. On average, patients spent 2.9h/wk in group therapy. The greatest proportion of treatment time in group format was in therapeutic recreation (25.6%), followed by speech therapy (16.2%), occupational therapy (10.4%), psychology (8.1%), and physical therapy (7.9%). Group therapy time and type of treatment activities varied among admission FIM cognitive subgroups and treatment sites. Several factors appear to be predictive of receiving group therapy, with the treatment site being a major influence. However, group therapy as a whole offered little explanation of differences in the outcomes studied. CONCLUSIONS: Group therapy is commonly used in TBI rehabilitation, to varying degrees among disciplines, sites, and cognitive impairment subgroups. Various therapeutic activities take place in group therapy, indicating its perceived value in addressing many domains of functioning. Variation in outcomes is not explained well by overall percentage of therapy time delivered in groups.
OBJECTIVES: To describe the amount and content of group therapies provided during inpatient rehabilitation for traumatic brain injury (TBI), and to assess the relations of group therapy with patient, injury, and treatment factors and outcomes. DESIGN: Prospective observational cohort. SETTING: Inpatient rehabilitation. PARTICIPANTS: Consecutive admissions (N=2130) for initial TBI rehabilitation at 10 inpatient rehabilitation facilities (9 in the United States, 1 in Canada) from October 2008 to September 2011. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Proportion of sessions that were group therapy (≥2 patients were treated simultaneously by ≥1 clinician); proportion of patients receiving group therapy; type of activity performed and amount of time spent in group therapy, by discipline; rehabilitation length of stay; discharge location; and FIM cognitive and motor scores at discharge. RESULTS: Of the patients, 79% received at least 1 session of group therapy, with group therapy accounting for 13.7% of all therapy sessions and 15.8% of therapy hours. On average, patients spent 2.9h/wk in group therapy. The greatest proportion of treatment time in group format was in therapeutic recreation (25.6%), followed by speech therapy (16.2%), occupational therapy (10.4%), psychology (8.1%), and physical therapy (7.9%). Group therapy time and type of treatment activities varied among admission FIM cognitive subgroups and treatment sites. Several factors appear to be predictive of receiving group therapy, with the treatment site being a major influence. However, group therapy as a whole offered little explanation of differences in the outcomes studied. CONCLUSIONS: Group therapy is commonly used in TBI rehabilitation, to varying degrees among disciplines, sites, and cognitive impairment subgroups. Various therapeutic activities take place in group therapy, indicating its perceived value in addressing many domains of functioning. Variation in outcomes is not explained well by overall percentage of therapy time delivered in groups.
Authors: Samantha L Backhaus; Summer L Ibarra; Daniel Klyce; Lance E Trexler; James F Malec Journal: Arch Phys Med Rehabil Date: 2010-06 Impact factor: 3.966
Authors: Susan D Horn; John D Corrigan; Cynthia L Beaulieu; Jennifer Bogner; Ryan S Barrett; Clare G Giuffrida; David K Ryser; Kelli Cooper; Deborah M Carroll; Daniel Deutscher Journal: Arch Phys Med Rehabil Date: 2015-08 Impact factor: 3.966
Authors: Cynthia A Dahlberg; Christopher P Cusick; Lenore A Hawley; Jody K Newman; Clare E Morey; Cynthia L Harrison-Felix; Gale G Whiteneck Journal: Arch Phys Med Rehabil Date: 2007-12 Impact factor: 3.966