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What Is the Difference between Acute and Subacute Rehabilitation?

Acute rehabilitation requires daily therapy, and consists of helping a patient relearn skills, like walking.
Patients who do not possess enough strength for daily therapy will be enrolled in subacute rehabilitation.
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  • Written By: Mary McMahon
  • Edited By: Nancy Fann-Im
  • Last Modified Date: 08 April 2014
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Acute and subacute rehabilitation both provide patients with tools to help them regain skills they may have lost due to injury and to adapt to permanent disability. The primary difference between the two is the level of intensity. Patients in acute rehabilitation can expect daily therapy and may work with therapists for three or more hours every day, while subacute rehabilitation is less intense. Both programs offer inpatient and outpatient options, depending on the situation.

When a patient is very sick, subacute rehabilitation is a better choice because the patient does not have the energy and strength to handle daily rehabilitation sessions. This can be useful for patients just recovering from surgery and injuries who need some rehabilitation, but are not ready for hard work. On the other end of the scale, patients who have completed acute rehabilitation and no longer need such rigorous sessions can step down to a subacute program.

In acute rehabilitation, patients must go to rehabilitation sessions every day, and may stay in a rehabilitation facility for convenience. Nurses and therapists work with patients on physical therapy, occupational therapy, speech therapy, and any other services the patient may need. Patients usually have exercises they need to do on their own in addition to attending sessions where they work under the guidance of therapists.

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Acute rehabilitation can help patients relearn skills like walking, eating, and writing after an injury. The program is tailored to the needs of the patient, and usually a care provider coordinates therapy services to make sure the patient gets appropriate therapies without being overloaded. In a subacute program, patients can build up strength and dexterity, fine-tune their skills, and increase their levels of independence.

Costs for subacute and acute rehabilitation tend to be different. Acute programs are more expensive because of the increased numbers of sessions and the larger care team. Patients may qualify for financial assistance, depending on their income level and the nature of the injury. It can also be necessary to go to a specialty facility, such as a stroke rehabilitation center, to get the best possible care. In subacute rehabilitation, specialty services can be helpful, but are not always required.

Qualifications for working in rehabilitation facilities are the same, no matter what kinds of services the facility offers. Therapists need to be fully trained and licensed, as do nurses, doctors, and other personnel. Some facilities provide opportunities to medical and nursing students along with interns and trainees, and people with concerns about working with care providers in training can discuss them with their primary point of contact at the facility.

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Discuss this Article

anon335422
Post 5

The most important aspect when it comes to rehab, subacute vs acute is what are the goals, are they feasible? Rehab (amount of therapy/intensity) will not cause a patient to regain more speech/strength or promote neurological recovery. Example: stroke patient, spinal cord injury, multiple sclerosis, neuropathies.

Sicker or less activity tolerant patient go to SNF (subacute rehab), and sometimes the higher functioning patient (walking, etc) might end up in a SNF (subacute) because they are too well to go to acute rehab or not medically complex enough and do not have the necessary assistance at home.

healthy4life
Post 4

My aunt had a pretty bad stroke last year, and though she did receive a little bit of therapy during her stay in the hospital, she didn't get the continued therapy that she needed. Her husband refused to take her to the subacute rehabilitation facility that her doctor had recommended, and as a result, her speech is still highly impaired today.

No one knew why he refused to take her. It seems that he just checked out of the relationship after she had her stroke. I fully believe that if she had gone through rehab during that crucial first year, she could be talking normally today.

kylee07drg
Post 3

We normally think of acute inpatient rehab as being for people with injuries, but my friend's grandmother recently got admitted to a facility to help her deal with her Parkinson's disease. I had never heard of someone getting rehab for this condition before, but apparently, it helps.

While she was there, she got a lot of attention and assistance from various kinds of therapists and doctors. The therapy was so intense that it wouldn't have made since for her to live at home and drive up there, because she had different types of sessions every day.

Perdido
Post 2

@StarJo – My dad went through subacute outpatient rehab after injuring his rotator cuff. At first, he had to go to the clinic three times a week, but as he began to heal and regain use of his shoulder, the sessions tapered off.

The therapist would take his arm and move it for him at different angles. My dad said that the first few sessions were very painful, and he wanted to hit the therapist.

Eventually, he was able to do more intense exercises, like using a rubber band for resistance. He was only having to go to therapy once a week at that point.

It didn't seem to him that therapy was helping much for the first month or so, but as he began to regain his strength and range of motion, he started to see just how beneficial it had been. He had to go through twelve weeks of rehab, but he was so much better because of it.

StarJo
Post 1

It sounds like acute rehabilitation would be garnered more towards people who have had strokes. I would imagine an inpatient facility would be the most beneficial to them.

Subacute rehabilitation sounds like it's mostly for people who have injured muscles or broken bones. I think there is one of these facilities on my street. People with casts and crutches are always coming and going, so I guess they don't need to stay there around the clock for care.

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