The impact of timing and dose of rehabilitation delivery on functional recovery of stroke patients.
BACKGROUND
To investigate the impact of both timing and dose of rehabilitation delivery on the functional recovery of stroke patients.


METHODS
From chart review, we included 76 patients who were admitted to a regional hospital for first-ever stroke, and who had received multidisciplinary rehabilitation programs including physical therapy (PT) and occupational therapy (OT) at the inpatient department, and continuous rehabilitation therapy at the outpatient department for at least 3 months. The collected data included age, sex, type of stroke (hemorrhage/infarction), onset of stroke, initial motor status by Brunnstrom's motor recovery stages, time to rehabilitation intervention (from onset of stroke), length of stay, existence of aphasia, craniotomy (yes/no), and total units of rehabilitation. Main outcome measures were serial Barthel Index (BI) at initial assessment, 1 month, 3 months, 6 months, and 1 year post-stroke.


RESULTS
Age was inversely correlated with BI and BI improvement at 3 months and 6 months post-stroke. Rehabilitation intervention time from onset was negatively correlated with BI improvement at 1 month and 1 year, and with BI at 1 month, 3 months, 6 months, and 1 year post-stroke. The total units of inpatient PT and/or OT were positively correlated with BI improvement at 1 month, 3 months, and 6 months post-stroke. The total units of PT and/or OT were positively correlated with BI improvement at 3 months and 6 months post-stroke. And the initial BI was positively correlated with BI at 1 month, 3 months, and 6 months post-stroke. The total units of OT can significantly predict BI improvement at 3 months and 6 months post-stroke, while the initial BI capacity can significantly predict BI status at 1 month, 3 months, and 6 months post-stroke.


CONCLUSIONS
There is a dose-dependent effect of rehabilitation on functional improvement of stroke patients for the first 6 months post-stroke, and earlier delivery of rehabilitation has lasting effects on the functional recovery of stroke patients up to 1 year.
Huang
Hsiu-Chen
HC
Department of Physical Medicine and Rehabilitation, Chiayi Christian Hospital, Taiwan, R.O.C. d281@cych.org.tw
Chung
Kao-Chi
KC
Lai
Der-Chung
DC
Sung
Sheng-Feng
SF
D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy; D026741:Physical Therapy Modalities; D000071939:Stroke Rehabilitation; D013997:Time Factors