High-intensity rehabilitation is a safe way to accelerate functional improvements in skilled nursing facility residents, according to a study from physical therapist-researchers.

Investigators tracked walking ability and discharge timing in 103 medically complex older residents. About half participated in the Intensive Therapeutic Rehabilitation for Older Skilled Nursing Home Residents (i-STRONGER) program. A control group received usual care.

Participants in the high-intensity program significantly increased their walking speed from evaluation to discharge by 0.13 m/s, exceeding clinically meaningful changes. In addition, their time to discharge was reduced by 3.5 days, reported first author Allison Gustavson, PT, DPT, Ph.D., from the University of Colorado Anschutz Medical Campus.

With less than 25% of skilled nursing home residents regaining pre-hospitalization levels of function, there is a need to fundamentally change the intensity of rehabilitation for medically complex conditions, Gustavson and colleagues contend. 

High-intensity rehabilitation therapy also may be a timely solution in response to recent policies aimed at raising the bar on quality and efficiency in post-acute care services, they concluded.

“Our study identified an impactful opportunity to improve the way we care for patients in skilled nursing facilities,” Gustavson said. “[H]igh-intensity resistance training is safe, effective, and preferable in caring for medically complex older adults [in these settings].”

The study was published in the journal Physical Therapy.