Early rehabilitation in trauma patients: an observational study from two Norwegian trauma centers

OBJECTIVE: To examine the provision of consultation by a specialist in physical and rehabilitation medicine, and timing of early rehabilitation services for severely injured trauma patients as recommended in the Norwegian Trauma Plan. DESIGN: Observational cohort study. SUBJECTS/PATIENTS: Adults aged ≥ 18 years admitted with severe (New Injury Severity Score > 12) traumatic injuries. METHODS: Observational cohort study with data from the Norwegian Trauma Registry and medical records. Outcomes included consultation with a physical and rehabilitation medicine specialist, timing of assessment, and involvement of health professions. RESULTS: Among 317 patients, 10% received assessment by a physical and rehabilitation medicine specialist within 72 h. Early assessment occurred in 43% (n = 6) of patients with spinal cord injury, 12% (n = 8) with traumatic brain injury, and 7% (n = 17) with multitrauma. Overall, 31% (n = 99) of all patients were assessed by a physical and rehabilitation medicine specialist, including 93% (n = 13) of spinal cord injury patients, 57% (n = 39) with traumatic brain injury, and 19% (n = 43) with multitrauma. Physiotherapists assessed 72% of patients, while involvement from other rehabilitation professionals was limited. CONCLUSION: Despite recommendations, only one-third of patients were assessed by a physical and rehabilitation medicine specialist, and 10% within 72 h. Physiotherapy was common, but other rehabilitation input was limited. Patients with spinal cord injury received more comprehensive care than those with traumatic brain injury or multitrauma.