title: Group Therapy Use and Its Impact on the Outcomes of Inpatient Rehabilitation After Traumatic Brain Injury: Data From Traumatic Brain Injury-Practice Based Evidence Project.
abstract: OBJECTIVE
  To describe the amount and content of group therapies provided during inpatient rehabilitation for traumatic brain injury (TBI), and to assess the relations of group therapy with patient, injury, and treatment factors and outcomes.
  
  
  METHODS
  Prospective observational cohort.
  
  
  METHODS
  Inpatient rehabilitation.
  
  
  METHODS
  Consecutive admissions (N=2130) for initial TBI rehabilitation at 10 inpatient rehabilitation facilities (9 in the United States, 1 in Canada) from October 2008 to September 2011.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Proportion of sessions that were group therapy (≥2 patients were treated simultaneously by ≥1 clinician); proportion of patients receiving group therapy; type of activity performed and amount of time spent in group therapy, by discipline; rehabilitation length of stay; discharge location; and FIM cognitive and motor scores at discharge.
  
  
  RESULTS
  Of the patients, 79% received at least 1 session of group therapy, with group therapy accounting for 13.7% of all therapy sessions and 15.8% of therapy hours. On average, patients spent 2.9h/wk in group therapy. The greatest proportion of treatment time in group format was in therapeutic recreation (25.6%), followed by speech therapy (16.2%), occupational therapy (10.4%), psychology (8.1%), and physical therapy (7.9%). Group therapy time and type of treatment activities varied among admission FIM cognitive subgroups and treatment sites. Several factors appear to be predictive of receiving group therapy, with the treatment site being a major influence. However, group therapy as a whole offered little explanation of differences in the outcomes studied.
  
  
  CONCLUSIONS
  Group therapy is commonly used in TBI rehabilitation, to varying degrees among disciplines, sites, and cognitive impairment subgroups. Various therapeutic activities take place in group therapy, indicating its perceived value in addressing many domains of functioning. Variation in outcomes is not explained well by overall percentage of therapy time delivered in groups.
authors.affiliation: Carolinas Rehabilitation, Charlotte, NC; Indiana University School of Medicine, Indianapolis, IN. Electronic address: flora.hammond@rhin.com.
authors.forename: Flora M
authors.initials: FM
authors.lastname: Hammond
authors.affiliation: Institute for Clinical Outcomes Research, Salt Lake City, UT.
authors.forename: Ryan
authors.initials: R
authors.lastname: Barrett
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Marcel P
authors.initials: MP
authors.lastname: Dijkers
authors.affiliation: Kessler Foundation, New York, NY.
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Zanca
authors.affiliation: Institute for Clinical Outcomes Research, Salt Lake City, UT.
authors.forename: Susan D
authors.initials: SD
authors.lastname: Horn
authors.affiliation: Institute for Clinical Outcomes Research, Salt Lake City, UT.
authors.forename: Randall J
authors.initials: RJ
authors.lastname: Smout
authors.affiliation: Carolinas Rehabilitation, Charlotte, NC.
authors.forename: Tami
authors.initials: T
authors.lastname: Guerrier
authors.affiliation: Carolinas Rehabilitation, Charlotte, NC.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hauser
authors.affiliation: Rush University Medical Center, Chicago, IL.
authors.forename: Megan R
authors.initials: MR
authors.lastname: Dunning
mesh_terms: D001930:Brain Injuries / Q000453:epidemiology / Q000534:rehabilitation*; D002170:Canada / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology / Q000534:rehabilitation; D015331:Cohort Studies; D015897:Comorbidity; D055317:Evidence-Based Practice / Q000706:statistics & numerical data; D005260:Female; D006302:Health Services Research; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data; D011446:Prospective Studies; D011615:Psychotherapy, Group / Q000706:statistics & numerical data; D057173:Recreation Therapy; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013070:Speech Therapy; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: Brain injuries; Health services; Health services research; Occupational therapy; Physical therapy specialty; Psychology; Recreation therapy; Rehabilitation; Speech therapy; Therapeutics