Feasibility of increasing the dosage of inpatient movement rehabilitation with additional self-directed independent exercise: “My Therapy”

Dr Tash Brusco1,2, Ms Louise Tilley1, Ms Brianna Walpole1, Ms Helen Kugler1, Mr Ran Li1, Ms Emma Kennedy1, Professor Meg Morris1,2

1Centre for Allied Health Research and Education (CAHRE), Cabrini, Melbourne, Australia, 2La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, La Trobe University, Melbourne, Australia

Abstract:

Aim:
To determine the feasibility of implementing My Therapy in addition to rehabilitation inpatient usual care, for musculoskeletal and frail older patients.

Methods:
A two-group quasi-experimental pre-post design examined the feasibility of delivering My Therapy in addition to usual care, compared to usual care. My Therapy comprised independent self-directed exercises prescribed by physiotherapists and occupational therapists. The primary outcome was My Therapy implementation feasibility, to achieve at least 70% adherence. Secondary outcomes were self-reported daily My Therapy participation (minutes), total daily movement rehabilitation participation (minutes), adverse events, length of stay, 10 metre walk speed, FIM scores and discharge home.

Results:
My Therapy participation was achieved by 72% (83/116) of the My Therapy group, averaging 14 minutes (SD 14) of extra practice per day. Total participation was 177 minutes (SD 47) for the My Therapy group (n=116) and 148 minutes (SD 88) for the usual care group (n=89), mean difference of 30 minutes (p=0.00). A minimal clinically important difference in FIM was achieved for significantly more My Therapy participants (22%, n=26) compared to usual care (10%, n=9; p=0.02). There were no safety concerns or group differences for other outcomes.

Significance of the findings to allied health:
My Therapy is a feasible and safe way to increase the amount of allied health therapy in hospitalised older people with musculoskeletal conditions or frailty to achieve an additional 14 minutes of daily practice alongside usual care rehabilitation.