Association of Rate of Functional Recovery With Therapy Time and Content Among Adults With Acquired Brain Injuries in Inpatient Rehabilitation.

Observational design with no randomization; associations do not imply causation. Patients with slower recovery or greater impairment may have received more of certain therapies (confounding by indication). Single-center data from an academic medical center may not generalize to other settings. Therapy content was defined by billing codes (CPT), which may not accurately reflect the specific clinical activities performed or their intensity. Activities under 8 minutes were not billed and thus excluded from the therapy time calculation. Data on treating therapists and continuity of care were not available. The study could not account for medical complications or comorbidities that influence recovery rate. The inverse association between PT bed mobility training and mobility gain may reflect appropriate clinical decision-making for patients who are not yet ready for higher-level mobility, rather than a negative effect of the treatment itself.

The authors have no conflicts of interest to report.

Do not conclude that PT bed mobility training slows recovery or that SLP dysphagia treatment hinders function. These inverse associations likely reflect that patients with more severe impairments or slower expected recovery receive more of these specific treatments, not that the treatments cause the slower progress.