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<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>Traumatic brain injury (TBI) among older adults is increasing and can affect cognition. To effectively meet the rehabilitation needs of older adults, a clearer picture is needed of patient‐, clinical‐, and facility‐level characteristics that affect cognitive recovery during inpatient rehabilitation facility (IRF) stays.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To identify patient, clinical, and facility factors associated with cognitive recovery among older adults with TBI who received IRF care.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Secondary data analysis.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Uniform Data System for Medical Rehabilitation‐participating IRFs in the United States.</jats:p></jats:sec><jats:sec><jats:title>Patients</jats:title><jats:p>Patients were 65 to 99 years of age at IRF admission for TBI. Participants received IRF care between 2002 and 2018 (<jats:italic>N</jats:italic> = 137,583); 56.3% were male; 84.2% were white; mean age was 78.7 years.</jats:p></jats:sec><jats:sec><jats:title>Main Outcome Measure</jats:title><jats:p>Change in Functional Independence Measure Cognitive Score (FIM‐Cognitive) from IRF admission to discharge, categorized as favorable (FIM‐cognitive score gains ≥3 points) or poor (FIM‐cognitive score gains &lt;3 points) cognitive outcomes.</jats:p></jats:sec><jats:sec><jats:title>Interventions</jats:title><jats:p>Not applicable.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Patients had greater odds of favorable cognitive recovery if they were female (adjusted odds ratio [aOR] 1.05, 95% confidence interval [CI] 1.05–1.08), had higher motor functioning at IRF admission (aOR 1.03, 95% CI 1.03–1.04), longer length of stay (aOR 1.07, 95% CI 1.06–1.07), or received care at a freestanding IRF (vs. hospital rehab unit) (aOR 1.57, 95% CI 1.52–1.61). Patients who were older (aOR 0.99, 95% CI 0.98–0.99), Black (aOR 0.79, 95% CI 0.75–0.83), Hispanic or Latino (aOR 0.97, 95% CI 0.91–1.02), or were part of another racial or ethnic group (aOR 0.85, 95% CI 0.81–0.90) (vs. White), had high‐cost comorbid conditions (aOR 0.71, 95% CI 0.65–0.76), or who had higher cognitive functioning at IRF admission (aOR 0.90, 95% CI 0.90–0.91) had lower odds of favorable cognitive recovery.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Patient (age, sex, race, ethnicity), clinical (level of functioning at IRF admission, length of stay) and facility (e.g., freestanding IRF) factors contributed to the cognitive recoveries of older adults during IRF stays.</jats:p></jats:sec>

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Patients in the intensive care unit (ICU) often experience extended periods of immobility. Following hospital discharge, many face impaired mobility and never return to their baseline function. Although the benefits of physical and occupational rehabilitation are well established in non‐ICU patients, a paucity of work describes effective practices to alleviate ICU‐related declines in mobility.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To assess how rehabilitation with physical and occupational therapy (PT‐OT) during ICU stays affects patients' mobility, self‐care, and length of hospital stay.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Retrospective cohort study.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Inpatient ICU.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>A total of 6628 adult patients who received physical rehabilitation across multiple sites (Arizona, Florida, Minnesota, and Wisconsin) of a single institution between January 2018 and December 2021.</jats:p></jats:sec><jats:sec><jats:title>Interventions</jats:title><jats:p>Not applicable.</jats:p></jats:sec><jats:sec><jats:title>Main Outcome Measures</jats:title><jats:p>Descriptive statistics, linear regression models, and gradient boosting machine methods were used to determine the relationship between the amount of PT‐OT received and outcomes of hospital length of stay (LOS), Activity Measure for Post‐Acute Care Daily Activity and Basic Mobility scores.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The 6628 patients who met inclusion criteria received an average (median) of 23 (range: 1‐89) minutes of PT‐OT per day. Regression analyses showed each additional 10 minutes of PT‐OT per day was associated with a 1.0% (95% confidence interval [CI]: 0.41–1.66, <jats:italic>p</jats:italic> &lt; .001) higher final Basic Mobility score, a 1.8% (95% CI: 1.30%–2.34%, <jats:italic>p</jats:italic> &lt; .001) higher final Daily Activity score, and a 1.2‐day (95% CI: −1.28 to −1.09, <jats:italic>p</jats:italic> &lt; .001) lower hospital LOS. One‐dimensional partial dependence plots revealed an exponential decrease in predicted LOS as minutes of PT‐OT received increased.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Higher rehabilitation minutes provided to patients in the ICU may reduce the LOS and improve patients' functional outcomes at discharge. The benefits of rehabilitation increased with increasing amounts of time of therapy received.</jats:p></jats:sec>