Speech-language pathology treatment time during inpatient spinal cord injury rehabilitation: the SCIRehab project

Brougham, Rebecca; David, Dana Spivak; Adornato, Viki; Gordan, Wendy; Dale, Beverly; Georgeadis, Amy C.; Gassaway, Julie

doi:10.1179/107902611x12971826988174

Cited by 20 publications

(17 citation statements)

References 22 publications

(24 reference statements)

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“…51,52 All independent variables were checked for colinearity, and if any pair was highly correlated (r > 0.75), only one of the pair was allowed to enter the models. The discipline-specific articles that follow in this series describe the intensity of specific activities/interventions provided by each treating discipline; [28][29][30][31][32][33][34] this article only addresses time for all therapeutic activities combined.…”

Section: Discussionmentioning

confidence: 99%

Inpatient treatment time across disciplines in spinal cord injury rehabilitation

Whiteneck

Gassaway²,

Dijkers

et al. 2011

The Journal of Spinal Cord Medicine

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Background/objective: Length of stay (LOS) for rehabilitation treatment after spinal cord injury (SCI) has been documented extensively. However, there is almost no published research on the nature, extent, or intensity of the various treatments patients receive during their stay. This study aims at providing such information on a large sample of patients treated by specialty rehabilitation inpatient programs. Methods: Six hundred patients with traumatic SCI admitted to six rehabilitation centers were enrolled. Time spent on various therapeutic activities was documented by each rehabilitation clinician after each patient encounter. Patients were grouped by neurologic level and completeness of injury. Total time spent by each rehabilitation discipline over a patient's stay and total minutes of treatment per week were calculated. Ordinary least squares stepwise regression models were used to identify patient and injury characteristics associated with time spent in rehabilitation treatment overall and within each discipline. Results: Average LOS was 55 days (standard deviation 37), during which 180 (106) hours of treatment were received, or 24 (5) hours per week. Extensive variation was found in the amount of treatment received, between and within neurologic groups. Total hours of treatment provided throughout a patient's stay were primarily determined by LOS, which in turn was primarily predicted by medical acuity. Variation in minutes per week of treatment delivered by individual disciplines was predicted poorly by patient and injury characteristics. Conclusions: Variations between and within SCI rehabilitation patient groups in LOS, minutes of treatment per week overall, and for each rehabilitation discipline are large. Variation in treatment intensity was not well explained by patient and injury characteristics. In accordance with practice-based evidence methodology, the next step in the SCIRehab study will be to determine which treatment interventions are related with positive outcomes (at 1 year post injury), after controlling for patient and injury differences.

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Section: Discussionmentioning

confidence: 99%

Inpatient treatment time across disciplines in spinal cord injury rehabilitation

Whiteneck

Gassaway²,

Dijkers

et al. 2011

The Journal of Spinal Cord Medicine

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“…Speech-language pathologists often are consulted to evaluate and treat swallowing, motor speech-voicing, and cognitivecommunication functions. 14,15 It can be particularly challenging to differentiate the type and severity of CCLs and to identify and adapt appropriate cognitivecommunication interventions for individuals with SCI. Fig.…”

Section: Discussionmentioning

confidence: 99%

“…14 In the second stage of SCIRehab, analyses were conducted to better understand the type and amount of interventions that are provided in inpatient rehabilitation. Brougham et al 15 reported a significant difference in time spent in each SLP activity among different neurological groups. There is, however, a paucity of evidence regarding what specific SLP interventions are most important to patients with cognitive-communication needs in order to achieve the best outcomes.…”

Section: Introductionmentioning

confidence: 98%

Relationship of speech-language pathology inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: The SCIRehab Project

Gordan

Gerber

David

et al. 2012

The Journal of Spinal Cord Medicine

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Background/objective: Describe associations of patient characteristics and speech-language pathology (SLP) interventions provided during impatient rehabilitation for spinal cord injury (SCI) to outcomes at discharge and 1-year post-injury. Methods: Speech-language pathologists at six inpatient rehabilitation centers documented details of treatment provided. Least squares regression modeling was used to predict outcomes at discharge and 1-year injury anniversary. Cognitive, participation, and mood outcomes for a subsample of patients with traumatic brain injury (TBI) and cognitive-communication limitations (CCLs) were examined. Results: SLP treatment factors explain a small amount of variation in cognitive Functional Independence Measure (FIM), participation, and mood. Variation explained by treatment factors for cognitive outcomes at the time of discharge increased when the patient group was more homogeneous (patients with TBI and CCLs). More time in SLP cognitive-communication interventions had a negative relationship, while longer length of stay was positive. The added explanatory power was not seen for similar outcomes at 1-year post-injury. Conclusion: Patients with SCI who have the greatest need for interventions to address cognitive limitations due to TBI receive the most SLP cognitive-communication treatment and show the greatest amount of improvement during rehabilitation. Their cognitive functioning remained impaired at discharge; this likely accounts for the consistent finding that more hours of SLP cognitive-communication treatment is associated with lower cognitive FIM scores at discharge. Future research on individuals with dual SCI and TBI should include more comprehensive assessment of individual differences in cognitive performance in order to better examine the complex relationships between SLP treatments and outcomes. Note: This is the fifth of nine articles in this SCIRehab series.

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“…These treatment data were collected by means of the projectspecific electronic data capture system and supplemented by ongoing medical record abstraction and post-discharge patient interviews. The following series of manuscripts offer an overview of the multidisciplinary SCI rehabilitation process 11 and a detailed analysis of treatments provided by physical therapy, 12 occupational therapy, 13 therapeutic recreation, 14 speech language pathology, 15 psychology, 16 nursing, 17 and social work/case management. 18 The data presented cover interventions received by the 600 patients enrolled during the first year of the SCIRehab Project at six collaborating SCI rehabilitation facilities led by Craig Hospital, Englewood, CO and including Carolinas Rehabilitation, Charlotte, NC; The Mount Sinai Medical Center, New York, NY; National Rehabilitation Hospital, Washington, DC; Rehabilitation Institute of Chicago, Chicago, IL; and Shepherd Center, Atlanta, GA. A total of 141 938 treatment sessions are included in the 107 804 hours of therapy and education analyzed in this series of articles.…”

Section: Indiana University Indianapolis In Usamentioning

confidence: 99%

The SCIRehab project: analyzing multidisciplinary inpatient spinal cord injury rehabilitation treatment — second phase

Whiteneck

Gassaway²,

Dijkers

et al. 2011

The Journal of Spinal Cord Medicine

Self Cite

View full text Add to dashboard Cite

Speech-language pathology treatment time during inpatient spinal cord injury rehabilitation: the SCIRehab project

Cited by 20 publications

References 22 publications

Inpatient treatment time across disciplines in spinal cord injury rehabilitation

Inpatient treatment time across disciplines in spinal cord injury rehabilitation

Relationship of speech-language pathology inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: The SCIRehab Project

The SCIRehab project: analyzing multidisciplinary inpatient spinal cord injury rehabilitation treatment — second phase

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