Improving Recovery During Rehab

Goal-oriented, motivational physical and occupational therapy helps older patients recover more fully from broken hips, strokes, and other ailments that land them in skilled nursing facilities for rehabilitation, according to research at Washington University School of Medicine in St. Louis.

Enhanced Medical Rehabilitation—an approach in which physical and occupational therapists work to engage patients more fully during therapy sessions—helped patients recover function better than standard physical and occupational therapy that was provided to others in the same skilled nursing facilities, the researchers found.

Their findings are published in JAMA Network Open.

“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 receiving enhanced rehab did not get more or longer therapy sessions. Instead, therapists focused on specific goals important to individual patients, and they delivered, on average, 24 motivational messages about those goals during every therapy session. That approach resulted in a 25 percent improvement in functional recovery.

“It’s more than just getting people home; everyone wants to go home,” said co-author and study coordinator Emily Lenard, MSW. “In enhanced rehab, therapists focus on concrete goals. For example, if a patient had taken care of grandchildren on Wednesdays before the problems began, then the therapists might focus on the grandchildren to motivate the patient, a goal that patient can visualize in his or her head while doing exercises that might otherwise seem mundane.”

Added Lenze: “Now the question is whether those gains will last over the long term. We believe extending enhanced rehab from skilled nursing facilities into the home setting will be the next critical step.”

This article was adapted from information provided by Washington University in St. Louis.

IMAGE: Robert Kneschke/

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