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The study to be summarized and critiqued was undertaken in 2011 by Dejong and colleagues, and is titled “Physical Therapy Activities in Stroke, Knee Arthroplasty, and Traumatic Brain Injury Rehabilitation: Their Variation, Similarities, and Association with Functional Outcomes.”
The prospective observational cohort study employed a sample of 433 stoke inpatients, 429 total knee arthroplasty inpatients and 207 traumatic brain injury inpatients for the purposes of not only examining the similarities and differences in the mix of physical activities used in rehabilitation among patients from diverse impairment groups as observed in the sample groups, but also to investigate whether the same physical therapy activities are in any way associated with functional improvement across impairment categories (Dejong et al., 2011).
The justification for conducting this particular research was premised on the fact that relatively few studies had attempted to evaluate and address the relationship between physical therapy treatments and outcomes by specifically investigating the individual and collective contributions of all treatment strategies; that is, the researchers felt the need to disaggregate the unique and discrete contribution of each physical therapy activity and intervention that can be provided to the patient as a constituent of a general program of rehabilitation (Dejong et al., 2011).
The authors have given a comprehensive account of how the research study was conducted, including expounding on issues of research design, sample selection, inclusion criteria, site locations, as well as measures and instruments. The sample size used in the study is large enough to enable generalization of findings across the populations of individuals undergoing physical therapy activities for stroke, knee arthroplasty, and traumatic brain injury.
However, a major limitation of the study is that it included only patients admitted to inpatient rehabilitation institutions in the United States but failed to include inpatients from skilled nursing institutions or inpatients from other countries (Dejong et al., 2011). This implies that it may be a little bit challenging to generalize the study findings to stroke, knee arthroplasty and traumatic brain injury patients receiving their rehabilitation care in skilled nursing facilities.
Although the study brought into the fore important findings for practice as witnessed in the following section, it was also constrained by the fact that it focused primarily on physical therapy without concomitantly taking into account other forms of therapy such as occupational therapy and speech-language rehabilitation. Lastly, the study was constrained by the fact that it failed to take into account the interventions that physical therapists employed when patients took part in discrete physical therapy activities (Dejong et al., 2011).
Summary of Important Findings for Practice
The researchers were successful in demonstrating “…how practice advances with one impairment group may or may not generalize to other patient groups and how we might learn from the experiences of working with other patient groups” (Dejong et al., 2011 p. 1833). The researchers also found that gait and community mobility are the 2 physical therapy interventions that could be employed on all patients across the sample group; that is the interventions worked well for people with stroke, knee arthroplasty and traumatic brain injury.
Lastly, the researchers found that 3 physical therapy interventions, namely assessment time, bed mobility and transfers, were negatively correlated with discharge functional independence measure (FIM) motor outcomes in the sampled participants, thus discouraging physical therapists from using these physical therapy interventions to rehabilitate patients with stroke, knee arthroplasty and traumatic brain injury. In conclusion, the researchers feel that additional research is required to examine whether higher-level or more-integrated physical therapy activities are positively correlated with superior patient results.
Dejong, G., Hsieh, C.N., Putman, K., Smout, R.J., Horn, S.D., & Tian, W. (2011). Physical therapy activities in stroke, knee arthroplasty, and traumatic brain injury rehabilitation: Their variation, similarities, and association with functional outcomes. Physical Therapy, 91(12), 1826-1837.