title: Variation in Rehabilitation Treatment Patterns for Hip Fracture Treated With Arthroplasty.
abstract: BACKGROUND
  Recommendations for health care redesign often advocate for comparative effectiveness research that is patient-centered. For patients who require rehabilitation services, a first step in this research process is to understand current practices for specific patient groups.
  
  
  OBJECTIVE
  To document in detail the physical and occupational therapy treatment activities for inpatient hip fracture rehabilitation among 3 patient subgroups distinguished by their early rate of functional recovery between time of surgery to rehabilitation admission.
  
  
  METHODS
  Multicenter prospective observational cohort, practice-based evidence, study.
  
  
  METHODS
  Seven skilled nursing facilities and 11 inpatient rehabilitation facilities across the United States.
  
  
  METHODS
  A total of 226 patients with hip fractures treated with hip arthroplasty.
  
  
  METHODS
  Comparisons of physical and occupational therapy treatment activities among 3 groups with different initial recovery trajectory (IRT) rates (slower, moderate, faster).
  
  
  METHODS
  Percent of patients in each IRT group exposed to each physical and occupational therapy activity (exposure), and mean minutes per week for each activity (intensity).
  
  
  RESULTS
  The number of patients exposed to different physical or occupational therapy activities varied within the entire sample. More specifically, among the 3 IRT groups, significant differences in exposure occurred for 44% of physical therapy activities and 39% of occupational therapy activities. More patients in the slower recovery group, IRT 1, received basic activities of daily living treatments and more patients in the faster recovery group, IRT 3, received advanced activities. The moderate recovery group, IRT 2, had some treatments similar to IRT 1 group and others similar to IRT 3 group.
  
  
  CONCLUSIONS
  Analyses of practice-based evidence on inpatient rehabilitation of hip fracture patients treated with arthroplasty identified differences in therapy activities among three patient groups classified by IRT rates. These results may enhance physiatrists', other physicians', and rehabilitation teams' understanding of inpatient rehabilitation for these patients and help design future comparative effectiveness research.
authors.affiliation: Siebens Patient Care Communications, 13601 Del Monte Dr, Suite 47A, Seal Beach, CA 90740(∗). Electronic address: info@siebenspcc.com.
authors.forename: Hilary C
authors.initials: HC
authors.lastname: Siebens
authors.affiliation: Department of Information Systems and Operations Management, Loyola University Maryland, Baltimore, MD(†).
authors.forename: Phoebe
authors.initials: P
authors.lastname: Sharkey
authors.affiliation: Cedars-Sinai Medical Center, Los Angeles, CA(‡).
authors.forename: Harriet U
authors.initials: HU
authors.lastname: Aronow
authors.affiliation: Maccabi Healthcare Services, Tel Aviv, Israel(‖).
authors.forename: Daniel
authors.initials: D
authors.lastname: Deutscher
authors.affiliation: Cedars-Sinai Medical Center, Los Angeles, CA(¶).
authors.forename: Pamela
authors.initials: P
authors.lastname: Roberts
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA(#).
authors.forename: Michael C
authors.initials: MC
authors.lastname: Munin
authors.affiliation: Insall Scott Kelly Institute for Orthopaedics and Sports Medicine, New York, NY(∗∗).
authors.forename: Craig S
authors.initials: CS
authors.lastname: Radnay
authors.affiliation: Institute for Clinical Outcomes Research, Salt Lake City, UT(§).
authors.forename: Susan D
authors.initials: SD
authors.lastname: Horn
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D005260:Female; D006620:Hip Fractures / Q000451:nursing / Q000534:rehabilitation*; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D009788:Occupational Therapy; D015207:Osteoarthritis, Hip / Q000503:physiopathology / Q000601:surgery*; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function / Q000502:physiology*; D012047:Rehabilitation Centers; D012866:Skilled Nursing Facilities; D016896:Treatment Outcome; D014481:United States