Dose-response relationship between physiotherapy resource provision with function and balance improvements in patients following stroke: a multi-centre observational study.
OBJECTIVE
Inpatient rehabilitation of patients following stroke can be resource intensive, with optimal models of service delivery unclear. This study investigates the dose-response curves between physiotherapy service delivery variables and balance and function clinical outcomes.


METHODS
This was a multi-centre (15 sites), prospective, cohort study involving patients (n = 288) admitted for rehabilitation following stroke conducted across two states in Australia. Physiotherapy department resource provision variables were collected and examined for association with change in patient function and balance outcomes (Functional Independence Measure, step test, functional reach test) measured at admission and discharge from inpatient care.


RESULTS
A greater amount of log-transformed physiotherapy department resource provision was associated with greater improvement in the functional independence measure [Regression coefficient (95% CI): 4.05 (1.15, 6.95)] and functional reach test [46.43 (17.03, 75.84)], while physiotherapist time provided to patients was associated with greater improvement for the step test [0.15 (0.03, 0.28)], and functional reach [0.35 (0.19, 0.52)].


CONCLUSIONS
Receiving a higher rate of physiotherapist input is an important factor in attaining a greater amount of recovery in function and balance outcomes; however, the improvement by patients who received the greatest amount of input was highly variable.
Haines
Terry P
TP
Allied Health Clinical Research Unit, Southern Health, Cheltenham, Victoria, Australia. terrence.haines@med.monash.edu.au
Kuys
Suzanne
S
Clarke
Jane
J
Morrison
Greg
G
Bew
Paul
P
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006295:Health Resources / Q000600:supply & distribution*; D006748:Hospital Departments; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D004856:Postural Balance / Q000502:physiology*; D011446:Prospective Studies; D020521:Stroke / Q000628:therapy*