Treatment strength in rehabilitation

Archives of Physical Medicine and Rehabilitation
R A Keith

Abstract

To propose treatment strength as central to an understanding of rehabilitation treatment, to delineate its features, to examine related research, and to suggest ways to improve the specification and conceptualization of treatment. Published literature. Definitions were proposed for treatment strength components: purity, specificity, dose, intensity, duration, timing, and treater characteristics and organization. Three measures of treatment exposure were selected as having the most research: length of inpatient stay, treatment intensity, and treatment specificity (using as example the stroke rehabilitation unit). Length of stay information was selected primarily from studies using multifacility data systems. All studies identified as using greater treatment intensity or augmented treatment were selected. Because of the large literature on stroke units, selected studies were chosen that used randomized controlled trials or community-based data. Greater treatment exposure, as measured by length of stay, generally results in greater benefit, although there are wide variations for a given condition over time and across countries. Research on treatment intensity uses various definitions for intensity with mixed results. Specializatio...Continue Reading

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