We appreciate the opportunity to respond to Cooney's editorial "Hip Fracture Outcomes."1 Several points were made in the editorial about our investigation that were not consonant with the analysis or discussion in our article.2
We were most concerned about Cooney's suggestion that we used syllogistic logic to argue that use of physical and occupational therapy (PT/OT) affects outcomes other than ambulation. He states twice in his editorial that our strongest finding was the relationship between PT/OT and length of hospital stay. Actually, in our "Results" section we clearly indicate that we found no evidence of direct effects from PT/OT on length of stay or discharge destination. We emphasized use of PT/OT in our article because it is one of the few factors influencing ambulation that is under the provider's control. Our other analyses point to the potential importance of ambulation, with or without use of PT/OT, on short and intermediate outcomes after hip fracture.
Hoenig H, Sloane R, Horner R, Rubenstein LV, Kahn K. Hip Fracture Rehabilitation. Arch Intern Med. 1998;158(1):100–101. doi: