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What the Research Says

Treatments developed from evidence-based research have changed the way healthcare professionals approach the healing process.

Gone are the days of prescribed bed rest and weeks off work after surgery or an injury. Today, patients are encouraged to start rehabilitation therapy as soon as possible, because research suggests it’s safe and leads to a speedier, better recovery.

Treatments have also changed. For example, while technologies such as electrical stimulation, ultrasound, or iontophoresis are still used in pain management, today’s therapists prefer manual therapy to get to the source of pain and correct the issue. Current research has shown that manual therapy, when combined with therapeutic exercise, provides a beneficial outcome for patients.

Research has also altered the exclusive use of assistive devices, because it’s now understood that keeping an injured area from moving actually increases muscle weakness. In addition, research has led therapists to focus on returning patients to regular activities by helping them learn to use their joints better, rather than on range of motion alone.

Learn what current research says about rehabilitation therapy.

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Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee  (The New England Journal of Medicine: April 9, 2020, abstract)

Research compares the treatment options for osteoarthritis of the knee, which has been treated successfully with both physical therapy and intraarticular injections of
glucocorticoids. Researchers sought to determine whether the short-term and long-term effectiveness for relieving pain and improving physical function differ between these two therapies. They concluded that patients with osteoarthritis of the knee who underwent physical therapy had less pain and functional disability at one year than patients who received an intraarticular glucocorticoid injection.

Assessment of Patient Outcomes of Rehabilitative Care Provided in Inpatient Rehabilitation Facilities (IRFs) and After Discharge (Study prepared for ARA Research Institute: July 10, 2014)

Study authors were commissioned by the ARA Research institute to conduct the most comprehensive national study to date comparing the clinical outcomes of patients treated in inpatient rehabilitation facilities (IRFs) to those treated in skilled nursing facilities (SNFs). Over a two-year period, IRF patients clinically and demographically similar to SNF patients returned home from their initial stay two weeks earlier and remained home nearly two months longer. They also remained alive nearly two months longer. Overall IRF patients experienced an eight percentage point lower mortality rate during the two-year study period than SNF patients and experienced five percent fewer emergency room visits per year. For five of the 13 conditions, IRF patients experienced significantly fewer re-admissions per year. The study found that significantly better clinical outcomes could be achieved by treating patients in an IRF with an additional cost to Medicare of $12.59 per day across all conditions.

Comparison of Functional Status Improvements Among Patients With Stroke Receiving Postacute Care in Inpatient Rehabilitation vs Skilled Nursing Facilities (JAMA Network: December 4, 2019)

This study sought to determine if there is a change in physical function associated with receiving postacute care after a stroke in inpatient rehabilitation vs. skilled nursing facilities. This cohort study included 99 ,185 patients who received postacute care in inpatient rehabilitation or skilled nursing facilities after a stroke. Care in an inpatient rehabilitation facility was associated with greater improvement in mobility and self-care compared with care in a skilled nursing facility, and a significant difference in functional improvement remained after accounting for patient, clinical, and facility characteristics at admission. These findings suggest that there is room for payment reform in postacute care and highlight the need to target decision-making regarding discharge to postacute facilities based on patient needs and potential for recovery.

Inpatient Medical Rehabilitation: An Integral Part of the Healthcare System (PowerPoint presentation based on above 7/10/14 and 12/4/19 studies)