Journal article
Dose and setting of rehabilitation received after stroke in Queensland, Australia: a prospective cohort study
Clinical Rehabilitation, Vol.34(6), pp.812-823
2020
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.
Details
- Title
- Dose and setting of rehabilitation received after stroke in Queensland, Australia: a prospective cohort study
- Authors
- Rohan S Grimley (Author) - Griffith UniversityIngrid C M Rosbergen (Author) - University of QueenslandLouise Gustafsson (Author) - University of QueenslandEleanor Horton (Author) - University of the Sunshine Coast - School of Nursing, Midwifery and ParamedicineTheresa Green (Author) - University of QueenslandGreg Cadigan (Author) - Queensland Department of HealthSuzanne Kuys (Author) - Australian Catholic UniversityNadine E Andrew (Author) - Monash UniversityDominique A Cadilhac (Author) - Monash University
- Publication details
- Clinical Rehabilitation, Vol.34(6), pp.812-823
- Publisher
- Sage Publications Ltd.
- Date published
- 2020
- DOI
- 10.1177/0269215520916899
- ISSN
- 0269-2155
- Organisation Unit
- University of the Sunshine Coast, Queensland; School of Nursing, Midwifery and Paramedicine - Legacy
- Language
- English
- Record Identifier
- 99450967202621
- Output Type
- Journal article
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- Domestic collaboration
- Web Of Science research areas
- Rehabilitation
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Source: InCites