Dose and setting of rehabilitation received after stroke in Queensland, Australia: a prospective cohort study.
Clin Rehabil
; 34(6): 812-823, 2020 Jun.
Article
en En
| MEDLINE
| ID: mdl-32389061
ABSTRACT
OBJECTIVE:
The aims of this study were to describe patterns and dose of rehabilitation received following stroke and to investigate their relationship with outcomes.DESIGN:
This was a prospective observational cohort study.SETTING:
A total of seven public hospitals and all subsequent rehabilitation services in Queensland, Australia, participated in the study.SUBJECTS:
Participants were consecutive patients surviving acute stroke between July 2016 and January 2017.METHODS:
We tracked rehabilitation for six months following stroke and obtained 90- to 180-day outcomes from the Australian Stroke Clinical Registry.MEASURES:
Dose of rehabilitation - time in therapy by physiotherapy, occupational therapy and speech pathology; modified Rankin Scale (mRS)- premorbid, acute care discharge and 90- to 180-day follow-up.RESULTS:
We recruited 504 patients, of whom 337 (median age = 73 years, 41% female) received 643 episodes of rehabilitation in 83 different services. Initial rehabilitation was predominantly inpatient (260/337, 77%) versus community-based (77/337, 21%). Therapy time was greater within inpatient services (median = 29 hours) compared to community-based (6 hours) or transition care (16 hours). Median (Quartile 1, Quartile 3) six-month cumulative therapy time was 73 hours (40, 130) when rehabilitation commenced in stroke units and continued in inpatient rehabilitation units; 43 hours (23, 78) when commenced in inpatient rehabilitation units; and 5 hours (2, 9) with only community rehabilitation. In 317 of 504 (63%) with follow-up data, improvement in mRS was most likely with inpatient rehabilitation (OR = 3.6, 95% CI = 1.7-7.7), lower with community rehabilitation (OR = 1.6, 95% CI = 0.7-3.8) compared to no rehabilitation, after adjustment for baseline factors.CONCLUSION:
Amount of therapy varied widely between rehabilitation pathways. Amount of therapy and chance of improvement in function were highest with inpatient rehabilitation.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Accidente Cerebrovascular
/
Rehabilitación de Accidente Cerebrovascular
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Oceania
Idioma:
En
Revista:
Clin Rehabil
Asunto de la revista:
REABILITACAO
Año:
2020
Tipo del documento:
Article
País de afiliación:
Australia