Effectiveness of 7-day versus weekday-only rehabilitation for stroke patients in an acute-care hospital: a retrospective cohort study

Abstract

Purpose: Early rehabilitation is widely recommended for acute-stroke patients. We tested the hypothesis that the functional prognosis of stroke patients receiving daily early rehabilitation in a clinical practice setting is generally better than that of patients receiving rehabilitation only on weekdays.

Materials and methods: We analyzed hospitalized patients who experienced either cerebral infarctions or cerebral hemorrhages and subsequently underwent rehabilitation at our hospital between October 2010 and September 2014. We examined the association between training frequency and activities of daily living improvements, as indicated by the Barthel Index (BI) effectiveness.

Results: In total, 661 patients with cerebral infarctions and 245 with intracerebral hemorrhages (ICHs) were analyzed. The BI effectiveness was highest for patients receiving high-frequency therapy following cerebral infarction. In addition, multiple linear regression analysis indicated that BI effectiveness was significantly and positively correlated with high-frequency therapy (coefficient, 0.072; 95% confidence interval, 0.019–0.126; p < 0.01) in patients with cerebral infarctions. There was no significant difference in BI effectiveness between therapeutic protocols for patients with ICHs.

Conclusion: This retrospective cohort study demonstrated that extensive therapy can result in functional recovery in patients with cerebral infarctions.

Implications for Rehabilitation

• Early intervention with intensive rehabilitation therapy is important for improving the functional recovery of patients during acute-care hospitalization.

• Few acute hospitals provide more than 2 h of daily rehabilitation for patients with acute stroke.

• In a daily clinical practice setting, this clinical study demonstrates a direct relationship between early intervention with intensive rehabilitation therapy and good functional recovery of stroke patients in an acute ward.

Keywords:

• Acute stroke
• early rehabilitation
• functional outcome
• dose
• daily

Disclosure statement

The authors report no conflicts of interest.