Extra physical therapy decreases length of stay and significantly improves mobility, activity, and quality of life, say authors of a systematic review published in the September issue of Archives of Physical Medicine and Rehabilitation. Future research could address the possible benefits of providing extra services from other allied health disciplines in addition to physical therapy, they add.

For this review, the authors searched electronic databases CINAHL, MEDLINE, AMED, PEDro, PubMed, and EMBASE from the earliest date possible through May 2010. Additional trials were identified by scanning reference lists and citation tracking. Randomized controlled trials evaluating the effect of extra physical therapy on patient outcomes were included for review. Two reviewers independently applied the inclusion and exclusion criteria, and any disagreements were discussed until consensus could be reached. Searching identified 2,826 potentially relevant articles, of which 16 randomized controlled trials with 1,699 participants met inclusion criteria. Data were extracted using a predefined data extraction form by 1 reviewer and checked for accuracy by another. Methodological quality of trials was assessed independently by 2 reviewers using the PEDro scale.

Pooled analyses with random effects model to calculate standardized mean differences (SMDs) and 95% confidence intervals were used in meta-analyses. When compared with standard physical therapy, extra physical therapy reduced length of stay (SMD=-.22; 95% CI, -.39 to -.05) (mean difference of 1 day [95% CI, 0-1] in acute settings and mean difference of 4 days [95% CI, 0-7] in rehabilitation settings) and improved mobility (SMD=.37; 95% CI, .05-.69), activity (SMD=.22; 95% CI, .07-.37), and quality of life (SMD=.48; 95% CI, .29-.68). There were no significant changes in self-care (SMD=.35; 95% CI, -.06-.77).