Article

OBJECTIVE: To study the effects of daily treatment time on functional gain of
patients who have had a stroke. A retrospective cohort study. SETTING: An
inpatient rehabilitation hospital (IRH) in northern California. PARTICIPANTS:
Three hundred sixty patients who had a stroke and were discharged from the IRH in
2007. INTERVENTIONS: Average minutes of rehabilitation therapy per day, including
physical therapy, occupation therapy, speech and language therapy, and total
treatment. MAIN OUTCOME MEASURES: Functional gain measured by the Functional
Independence Measure, including activities of daily living, mobility, cognition,
and the total of the Functional Independence Measure (FIM) scores. RESULTS: The
study sample had a mean age of 64.8 years; 57.4% were men and 61.4% were white.
The mean total daily therapy time was 190.3 minutes, and the mean total
functional gain was 26.0. A longer daily therapeutic duration was significantly
associated with total functional gain (r = .23, P = .0094). Patients who received
a total therapy time of <3.0 hours per day had significantly lower total
functional gain than did those treated >/=3.0 hours. No significant difference in
total functional gain was found between patients treated >/=3.0 but <3.5 hours
and >/=3.5 hours per day. The daily treatment time of physical therapy,
occupational therapy, and speech and language therapy also was significantly
associated with corresponding subscale functional gains. In addition, hemorrhagic
stroke, left brain injury, earlier IRH admission, and a longer IRH stay were
associated with total functional improvement. CONCLUSIONS: The study demonstrated
a significant relationship between daily therapeutic duration and functional gain
during IRH stay and showed treatment time thresholds for optimal functional
outcomes for patients in inpatient rehabilitation who had a stroke.
CI - Copyright (c) 2013 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS