The Impact of Physical Therapy on Nursing Home Patient Outcomes

Abstract

The objective of this retrospective study was to assess the intensity and outcome of individual components of interdisciplinary care, including physical therapy, in a teaching nursing home. Two independent reviewers abstracted records from 90 consecutive patients admitted to the nursing home. They rated intensity and outcome of each program component using a structured, standardized data-abstraction form. Program components were physical therapy, speech therapy, psychosocial therapy, medication adjustment, and other medical and nursing care. Physical therapy and medication adjustment were the most frequently received therapies. Eighty-eight percent of the patients receiving high-intensity physical therapy and 33% of the patients receiving moderate-intensity physical therapy improved. For medication adjustment, 93% and 72% of the high- and moderate-intensity groups, respectively, improved. In univariate analyses, physical therapy intensity and age were associated with improvement. Baseline function in activities of daily living and cognitive function were not associated with physical therapy outcome. A stepwise multiple logistic regression analysis revealed that only therapy intensity was associated with improved outcome. We conclude that physical therapy was efficacious for patients receiving high-intensity treatment. Advanced age, activities-of-daily-living status, and cognitive impairment were not associated with poor physical therapy outcome.

Power Mobility Driving Training for Seniors: A Pilot Study

“…A number of researchers studying different aspects of rehabilitation have demonstrated that a greater intensity of treatment results in better outcomes for the client compared with less intense treatment when other factors (e.g., diagnosis, age) are taken into account. For example, Chiodo, Gerety, Mulrow, Rhodes, and Tuley (1992) found that 88% of elderly nursing home residents who received highintensity physical therapy improved in physical function compared with 33% and 13% who received moderate and minimal intensity therapy, respectively. These changes could not be accounted for by age, cognitive status, level of independence in activities of daily living, or diagnoses.…”

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