Trial reportJournal of the American Medical Directors Association2012
Enhanced medical rehabilitation increases therapy intensity and engagement and improves functional outcomes in postacute rehabilitation of older adults: a randomized-controlled trial.
Trial report in Journal of the American Medical Directors Association, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00951691 (Enhanced Acute Medical Rehabilitation for Disablement), which is not on this map. Cited by 28 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Enhanced Acute Medical Rehabilitation for Disablement
Who cites it
28 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Post-surgery interventions for hip fracture: a systematic review of randomized controlled trials.BMC musculoskeletal disorders · 2023Pooled it
- Multidisciplinary rehabilitation for older people with hip fractures.The Cochrane database of systematic reviews · 2021Pooled it
- Behaviour change techniques in personalised care planning for older people: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Pooled it
- Goal setting and strategies to enhance goal pursuit for adults with acquired disability participating in rehabilitation.The Cochrane database of systematic reviews · 2015Pooled it
- Executive Function Moderates Functional Outcomes of Engagement Strategies During Rehabilitation in Older Adults.American journal of physical medicine & rehabilitation · 2021Trial
- Effect of Enhanced Medical Rehabilitation on Functional Recovery in Older Adults Receiving Skilled Nursing Care After Acute Rehabilitation: A Randomized Clinical Trial.JAMA network open · 2019Trial
- Enhanced Medical Rehabilitation: Effectiveness of a clinical training model.NeuroRehabilitation · 2016Trial
- Short-term effects of goal-setting focusing on the life goal concept on subjective well-being and treatment engagement in subacute inpatients: a quasi-randomized controlled trial.Clinical rehabilitation · 2016Trial
- Trial
- Skilled Nursing Facility Rehabilitation Intensity and Successful Discharge in Persons with Dementia.Journal of the American Medical Directors Association · 2024Article
- Identifying characteristics of stroke patients benefiting from interprofessional collaboration.The British journal of occupational therapy · 2024Article
- Identifying profiles of stroke patients benefitting from additional training: a latent class analysis approach.Journal of rehabilitation medicine · 2024Observational
- Seizure prediction in stroke survivors who experienced an infection at skilled nursing facilities-a machine learning approach.Frontiers in physiology · 2024Article
- Admission Cognition and Function Predict Change in Physical Function Following Skilled Nursing Rehabilitation.Journal of the American Medical Directors Association · 2024Observational
- Advancing Rehabilitation Paradigms for Older Adults in Skilled Nursing Facilities: An Effectiveness-Implementation Hybrid Type 1 Clinical Trial Protocol.Physical therapy · 2023Article
- Using Implementation Science to Guide the Process of Adapting a Patient Engagement Intervention for Inpatient Spinal Cord Injury/Disorder Rehabilitation.Archives of physical medicine and rehabilitation · 2022Article
- Improvement in Activities of Daily Living during a Nursing Home Stay and One-Year Mortality among Older Adults with Sepsis.Journal of the American Geriatrics Society · 2021Article
- Is well-being prior to receiving rehabilitation services associated with postrehabilitation mental health and functioning?Aging & mental health · 2021Article
- Application of High-Intensity Functional Resistance Training in a Skilled Nursing Facility: An Implementation Study.Physical therapy · 2020Article
- Factors affecting the performance of activities of daily living in patients with advanced cancer undergoing inpatient rehabilitation: results from a retrospective observational study.Journal of physical therapy science · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
objectivesFor millions of disabled older adults each year, postacute care in skilled nursing facilities is a brief window of opportunity to regain enough function to return home and live independently. Too often this goal is not achieved, possibly because of therapy that is inadequately intense or engaging. This study tested Enhanced Medical Rehabilitation, an intervention designed to increase patient engagement in, and intensity of, daily physical and occupational therapy sessions in postacute-care rehabilitation.
designRandomized controlled trial of Enhanced Medical Rehabilitation versus standard-of-care rehabilitation.
settingPostacute care unit of a skilled nursing facility in St Louis, MO.
participantsTwenty-six older adults admitted from a hospital for postacute rehabilitation.
interventionBased on models of motivation and behavior change, Enhanced Medical Rehabilitation is a set of behavioral skills for physical and occupational therapists that increase patient engagement and intensity, with the goal of improving functional outcome, through (1) a patient-directed, interactive approach, (2) increased rehabilitation intensity, and (3) frequent feedback to patients on their effort and progress. MEASUREMENTS: Therapy intensity: assessment of patient active time in therapy sessions. Therapy engagement: Rehabilitation Participation Scale. Functional and performance outcomes: Barthel Index, gait speed, and 6-minute walk.
resultsParticipants randomized to Enhanced Medical Rehabilitation had higher intensity therapy and were more engaged in their rehabilitation sessions; they had more improvement in gait speed (improving from 0.08 to 0.38 m/s versus 0.08 to 0.22 in standard of care, P = .003) and 6-minute walk (from 73 to 266 feet versus 40 to 94 feet in standard of care, P = .026), with a trend for better improvement of Barthel Index (+43 points versus 26 points in standard of care, P = .087), compared with participants randomized to standard-of-care rehabilitation.
conclusionHigher intensity and patient engagement in the postacute rehabilitation setting is achievable, with resultant better functional outcomes for older adults. Findings should be confirmed in a larger randomized controlled trial.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.