Early rehabilitation in trauma patients: an observational study from two Norwegian trauma centers.
Ingri G Olsen, Marianne Wesnes, Hanne Næss and 5 others
Of 317 severely injured trauma patients in two Norwegian hospitals, only 1 in 10 was seen by a rehabilitation specialist within the recommended 72 hours.
Physiotherapy reached 72%, but occupational therapy, speech therapy, and social work involvement was low, particularly for multitrauma patients.
Key findings
1Only 10% of 317 severely injured patients were assessed by a rehabilitation medicine specialist within the recommended 72 hours; 31% were seen at any point during their hospital stay.
2Physiotherapy was the most common intervention (72% of patients), while occupational therapy (27%), speech therapy (10%), and social work (29%) reached far fewer. Multitrauma patients received the least multidisciplinary involvement beyond physiotherapy.
3Patients with spinal cord injury received the most comprehensive multidisciplinary care (86% had two or more professions involved), while multitrauma patients had the least, with involvement beyond physiotherapy remaining limited.
Still to come
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
One year of data from two of Norway's four regional trauma centres; the authors note this may not reflect national practice or other countries. Retrospective data from hospital records. If a professional saw a patient but the encounter was not documented in the system, it does not appear in the results. HUS had a dedicated rehabilitation medicine specialist on a 40% position and St. Olav's did not. The between-hospital differences in PRM involvement reflect this staffing gap, not a difference in patient need or treatment effect. The study measures whether professionals were involved and when, not whether the involvement changed patient outcomes. There is no comparison group and no outcome measure. No dedicated early rehabilitation pathway existed for multitrauma patients at either centre at the time of the study, so the low involvement in that group partly reflects the absence of a structured referral route rather than a clinical judgement that the patients did not need it.
Declared interests
The authors declare no conflicts of interest. The study was funded by the Norwegian Air Ambulance Foundation, which had no involvement in planning or conducting the research.
The easy way to misread this
This study measures whether rehabilitation was delivered, not whether it helped. The large gap between HUS and St. Olav's reflects one hospital having a dedicated rehabilitation specialist and the other not, not a difference in patient outcomes. It cannot be read as evidence that early multidisciplinary rehabilitation is or is not effective.
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