Journal:Journal of Spinal Cord Medicine
Year, Volume, Issue, Page(s):11, 34, 2, 162-175
Study examined the type and distribution of occupational therapy (OT) activities provided during inpatient spinal cord injury (SCI) rehabilitation and identified predictors (patient and injury characteristics) of the amount of time dedicated to OT treatment activities. Data were collected from 600 patients with traumatic SCI admitted to six rehabilitation centers during the first year of enrollment in the SCIRehab project. 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 indicated that 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 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 score, neurologic injury group, and the medical severity of illness score.