title: The SCIRehab project: treatment time spent in SCI rehabilitation. Occupational therapy treatment time during inpatient spinal cord injury rehabilitation.
abstract: BACKGROUND
  Occupational therapy (OT) is a critical component of the rehabilitation process after spinal cord injury (SCI), the constitution of which has not been studied or documented in full detail previously.
  
  
  OBJECTIVE
  To describe the type and distribution of SCI rehabilitation OT activities, including the amount of time spent on evaluation and treatment, and to discuss predictors (patient and injury characteristics) of the amount of time dedicated to OT treatment activities.
  
  
  METHODS
  Six inpatient rehabilitation centers enrolled 600 patients with traumatic SCI in the first year of the SCIRehab. Occupational therapists documented 32 512 therapy sessions including time spent and specifics of each therapeutic activity. Analysis of variance and contingency tables/chi-square tests were used to test differences across neurologic injury groups for continuous and categorical variables.
  
  
  RESULTS
  SCIRehab patients received a mean total of 52 hours of OT over the course of their rehabilitation stay. Statistically significant differences among four neurologic injury groups were seen in time spent on each OT activity. The activities that consumed the most OT time (individual and group sessions combined) were strengthening/endurance exercises, activities of daily living (ADLs), range of motion (ROM)/stretching, education, and a grouping of 'therapeutic activities' that included tenodesis training, fine motor activities, manual therapy, vestibular training, edema management, breathing exercise, cognitive retraining, visual/perceptual training desensitization, and don/doff adaptive equipment. Seventy-seven percent of OT work occurred in individual treatment sessions, with the most frequent OT activity involving ADLs. The variation in time (mean minutes per week) spent on OT ROM/stretching, ADLs, transfer training, assessment, and therapeutic activities can be explained in part by patient and injury characteristics, such as admission Functional Independence Measure (FIM) score, neurologic injury group, and the medical severity of illness score.
  
  
  CONCLUSIONS
  OT treatment patterns for patients with traumatic SCI show much variation in activity selection and time spent on activities, within and among neurologic level of injury groups. Some of the variation can be explained by patient and injury characteristics. Almost all patients with SCI participated in strengthening/ endurance and ROM/stretching exercises during OT treatment and these two activities are where the most time was spent when therapy provided in individual and group settings was combined. ADL work consumed the most time in individual therapy sessions.
authors.affiliation: Shepherd Center, Atlanta, Georgia, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: Foy
authors.forename: Ginger
authors.initials: G
authors.lastname: Perritt
authors.forename: Deepa
authors.initials: D
authors.lastname: Thimmaiah
authors.forename: Lauren
authors.initials: L
authors.lastname: Heisler
authors.forename: Jennifer Lookingbill
authors.initials: JL
authors.lastname: Offutt
authors.forename: Kara
authors.initials: K
authors.lastname: Cantoni
authors.forename: Ching-Hui
authors.initials: CH
authors.lastname: Hseih
authors.forename: Julie
authors.initials: J
authors.lastname: Gassaway
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ozelie
authors.forename: Deborah
authors.initials: D
authors.lastname: Backus
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D005260:Female; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D015337:Multicenter Studies as Topic; D009788:Occupational Therapy / Q000379:methods*; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000145:classification / Q000503:physiopathology / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult