Improved rehabilitation helps older patients better recover from their problems



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According to a new study conducted at the Washington University School of Medicine in St. Louis, goal-oriented and motivational physical and vocational therapy is helping older patients recover more easily from hip fractures, stroke and stroke. other diseases that lead them to specialized nursing facilities.

Improved medical rehabilitation – an approach in which physiotherapists and therapists work to involve patients more in therapy sessions – has enabled patients to recover more effectively than standard physical and occupational therapies offered to other qualified nursing homes , the researchers revealed.

Their conclusions are published on July 31 in the journal JAMA Network open now.

"We found that when you engage and motivate people, they do better," said the study's first author, Eric J. Lenze, MD, a professor of psychiatry.

Patients with improved rehabilitation did not receive longer or longer treatment sessions. Instead, the therapists focused on specific goals that were important to each patient and delivered, on average, 24 motivational messages about these goals during each treatment session. This approach resulted in a 25% improvement in functional recovery.

The research team studied 229 patients -; 114 of them were randomly selected to receive enhanced intervention and 115 of them received standard treatment. Each of them was in a qualified nursing facility while she was recovering from an injury or illness, such as a broken hip, an accident stroke or major surgery.

The improved rehabilitation of this study involved the use of motivation during therapy sessions, and the key was to focus the therapy on meaningful goals for the patient.

It's more than bringing people home; everyone wants to go home. In improved rehabilitation, therapists focus on concrete goals. For example, if a patient took care of their grandchildren on Wednesday before problems arise, therapists could then focus on the grandchildren to motivate them, a goal that the patient can visualize in his head. while doing exercises that would seem trivial. "

Now the question is whether these gains will last in the long run. We believe that the upcoming expansion of improved rehabilitation of skilled nursing home facilities will be the next crucial step. "

Emily Lenard, co-author and coordinator of the study

Lenze said that a challenge is that therapy can be expensive, and some insurers are reluctant to spend it. But with the aging of the population, he argues that an improved therapy could allow older patients to recover from an injury, particularly if this therapy made them more likely to return home and to get older. stay there.

"Avoiding rehospitalizations and long-term care in a retirement home is a huge economic benefit," he said. "We are already paying a lot for what is called post-acute rehabilitation, and we do not know if the health care system has the appetite to continue paying for more and more care." however, think that it is necessary to go beyond the idea of ​​providing more care and focus more on providing better, more cost-effective care.I think the improved medical rehabilitation is doing it. "

Source:

Washington University School of Medicine in St. Louis

Journal reference:

Lenze, E.J. et al. (2019) Effect of Enhanced Medical Rehabilitation on the Functional Recovery of Elderly People Benefiting from Post-Acute Rehabilitation in Skilled Nursing: Randomized Clinical Trial. JAMA Network open now. doi.org/10.1001/jamanetworkopen.2019.8199.

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