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Top Rehabilitation Hospitals Spend Too Little on Rehabilitation

Author:

Clinical and Scientific Affairs

While a rehabilitation hospital is designed to help accident and stroke victims regain their physical autonomy, this rehabilitation process is stymied by the lack of time spent by patients in therapy. Top doctors, occupational and physical therapists, and other staff are recruited to help patients heal, but their time is stretched too thin. As a result, patients spend up to 72% of their time in hospital bedridden when they could be maximizing their time with rehabilitation experts. This lack of progress results in longer stays and poorer outcomes for patients, according to research.

Time Spent on Rehabilitation Lacking

A study in the journal Stroke found notable differences in the daily time devoted to rehabilitation activities in hospitals throughout the world. In each of the following countries, patients received therapy for a small portion of the day:

  • 21-31% of the working day in the US was dedicated to therapeutic activities
  • In the UK, less than 15% of the day was devoted to therapy
  • Swiss stroke patients spent 45% of the day in therapy
  • Belgian patients had 28% of their day dedicated to therapeutic activities

Unfortunately, not all inpatients even received the therapy they required. In the hospitals surveyed, between 0 and 65% of patients who required occupational therapy actually received such services.1

Longer Hospital Stays are Harmful

Slower rehabilitation progress can also cause additional problems for the patient. The longer a patient spends in the hospital, the higher chance of complications. According to a United States government report, 29 percent of patients in rehabilitation hospitals experience some setbacks in healing, such as infections or medication errors.2 More efficient and effective rehabilitation practices can get patients healing faster and home sooner.

The Solution? Robotic Rehabilitation Technologies

Inpatient rehabilitation can be made more effective with the addition of robotic rehabilitation technologies in a field with declining therapist numbers. Occupational therapy is greatly needed and hospitals are understaffed; as of 2015, scientists predict that demand for OT services will continue to exceed supply in all 50 US states should current trends continue.3 Furthermore, a 2018 study suggests that technology is underutilized by physical and occupational therapists, and patients report boredom and desire for greater autonomy during their rehabilitation.4 Considering the little time spent in active therapy, this boredom is of little surprise.

With Robotics, Increase Outcomes and Decrease Effort

The brain requires hundreds of repetitions to incorporate or re-learn a motor skill; robotic assistance appears to help patients complete the high volume of exercise required for optimal recovery. A meta-analysis of over 1700 patients shows that robotic training is at least as effective as conventional training for upper limb and mild lower limb impairment, but patients with severe lower limb impairment receive better rehabilitation outcomes with robotics.5

Robotic assistance can provide consistent, objective, engaging feedback to help get patients get better faster by increasing efficiency in their rehabilitation therapy. With robotic technology, not only can more time be devoted to rehabilitation, but human therapist effort is minimized/reduced, and the time spent is then optimized for faster healing. Click here to find more information on how robotic solutions can increase therapy outcomes.

References:

1 Putman K, de Wit L, Schupp W, Ilse B, Berman P, Connell L, Dejaeger E, de Meyer AM, de Weerdt W, Feys H, Walter J, Lincoln N, Louckx F, Anneleen M, Birgit S, Smith B, Leys M. Use of time by physiotherapists and occupational therapists in a stroke rehabilitation unit: a comparison between four European rehabilitation centres. Disabil Rehabilitationil. 2006 Nov 30;28(22):1417-24. doi: 10.1080/09638280600638216.

2 https://www.npr.org/sections/health-shots/2016/07/21/486756178/rehabilitation-hospitals-may-harm-a-third-of-patients-report-finds

3 Lin V, Zhang X, Dixon P. Occupational Therapy Workforce in the United States: Forecasting Nationwide Shortages. PM R. 2015 Sep;7(9):946-954. doi: 10.1016/j.pmrj.2015.02.012. Epub 2015 Feb 25. PubMed PMID: 25724851.

4 Langan J, Subryan H, Nwogu I, Cavuoto L. Reported use of technology in stroke rehabilitation by physical and occupational therapists. Disabil Rehabilitationil Assist Technol. 2018 Oct;13(7):641-647. doi: 10.1080/17483107.2017.1362043. Epub 2017 Aug 16. PubMed PMID: 28812386.

5 Lo K, Stephenson M, Lockwood C. Effectiveness of robotic assisted rehabilitation for mobility and functional ability in adult stroke patients: a systematic review. JBI Database System Rev Implement Rep. 2017 Dec;15(12):3049-3091. doi: 10.11124/JBISRIR-2017-003456. Review. PubMed PMID: 29219877.

Originally published on 24.1.2020

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