Patterns of therapy activities across length of stay and impairment levels: Peering inside the "black box" of inpatient stroke rehabilitation

Objectives: To classify therapy activities and to describe the type and pattern of activities provided during inpatient rehabilitation to persons with stroke. Design: Descriptive study. Setting: Eight acute and 5 subacute rehabilitation facilities across the United States. Participants: Persons with stroke (N = 177) who received rehabilitation services and had lengths of stay (LOSS) between 2 and 5 weeks. Interventions: Not applicable. Main Outcomes Measures: Weekly and total therapy units aggregated by discipline and activity type for each of 4 (2-wk, 3-wk, 4-wk, 5-wk) LOS groups. Results: Across LOS groups, significant differences in total therapy units were found by week of rehabilitation, discipline, and therapy activity type. Patterns in and significant interactions of time and activity type by discipline were also found. The amount of therapy provided by occupational and physical therapists was significantly more than that provided by speech-language pathologists. Conclusions: Patterns of time spent in therapy are similar for all LOS groups, but type of therapy received reflects a complex interaction of patient severity, rehabilitation discipline, and LOS.