A systematic review to assess effect of Additional Physical Therapy on Length of Stay and Health Outcomes in ill People

Abstract

Objective: To revise an earlier analysis on whether more physical therapy services for patients with acute or subacute conditions shorten hospital stays, enhance health outcomes, and are safe and economical.
Data sources: Updates were made between 2010 and June 2023 using electronic database searches (AMED, CINAHL, EMBASE, MEDLINE, PEDro, and PubMed). Selection of the study: Eligible studies were randomized controlled trials assessing the effects of extra physical therapy treatments on patient health outcomes, duration of stay, or cost-effectiveness. Eleven additional publications from eight new randomized controlled trials with 1563 individuals were chosen from the 1524 potentially relevant articles found by the search. This review includes a total of 24 randomized controlled studies with 3262 participants. Data extraction: The form utilized in the initial systematic review was used to extract the data. The PEDro scale was used to evaluate the methodological quality,
Result: Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were computed by pooling post-intervention data using an inverse variance, random-effects model. Additional physical therapy services were found to shorten hospital stays by 3 days in sub-acute settings (MD -2.8, 95% CI -4.6 to -0.9, I² 0%) and by 0.6 days in acute situations (MD -0.6, 95% CI -1.1 to 0.0, I² 65%), according to moderately high quality evidence. Without causing an increase in adverse events, more physical therapy produced modest gains in self-care (SMD 0.11, 95% CI 0.03 to 0.19, I² 0%), activities of daily living (SMD 0.13, 95% CI 0.02 to 0.25, I² 15%), and health-related quality of life (SMD 0.12, 95% CI 0.03 to 0.21, I² 0%). Walking abilities did not much change. According to one study, extra physical therapy was probably more affordable for sub-acute rehabilitation.
Conclusions: More physical therapy services decrease the length of stay for people in hospitals while improving patient activity and participation results. Preliminary data indicates that these advantages might be cost-effective, and they are probably safe.