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  • Guideline recommendations for active therapy dose following acute stroke are not being met in any setting

    Author(s)
    Grimley, Rohan
    Kuys, Suzanne
    Gustafsson, Louise
    Horton, Eleanor
    Green, Theresa
    Cadigan, Greg
    Cadilhac, Dominique
    Rosbergen, Ingrid
    Griffith University Author(s)
    Gustafsson, Louise
    Kuys, Suzanne S.
    Year published
    2018
    Metadata
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    Abstract
    Background: National guidelines recommend a minimum of three hours scheduled active therapy (occupational therapy and physiotherapy) per weekday after acute stroke. Little is known about dose of rehabilitation received. Aims: To describe current dose of active rehabilitation therapy following acute stroke across different rehabilitation settings. Methods: Prospective observational cohort study of consecutive patients who received rehabilitation after acute stroke in seven sites. We collected data on therapy delivered by allied health professionals (duration, professional group, setting) through all types of rehabilitation ...
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    Background: National guidelines recommend a minimum of three hours scheduled active therapy (occupational therapy and physiotherapy) per weekday after acute stroke. Little is known about dose of rehabilitation received. Aims: To describe current dose of active rehabilitation therapy following acute stroke across different rehabilitation settings. Methods: Prospective observational cohort study of consecutive patients who received rehabilitation after acute stroke in seven sites. We collected data on therapy delivered by allied health professionals (duration, professional group, setting) through all types of rehabilitation episodes up to 6-months post stroke. Active therapy time was defined as face-to-face physiotherapy or occupational therapy in minutes/weekday. Descriptive analyses are presented. Results: 368 patients received rehabilitation (40% female, mean age 71). Median (IQR) active therapy dose was 42 minutes/weekday (IQR 15, 87). Active therapy dose in minutes/weekday (IQR) within different rehabilitation settings was: statistical rehabilitation episodes in acute stroke unit (ASU) 104 (48,168); inpatient rehabilitation units (IRU) 95 (63,135); centre and home-based community rehabilitation (CR)10 (4,22); and transition care (TC) 19 (9,31). Median total active therapy per patient across all episodes (mean 1.2 episodes / patient) was 22 hours (IQR 5.7, 54): ASU 9hours (3,26), IRU 30hours (12,60), CR 3hours (1, 7), and TC 11hours (5,19). Daily dose of active therapy exceeded 3 hours in 11% of all episodes: 24% in ASU, 10% in IRU, 3% in CR, and 5% in TC. Conclusion: Active therapy guideline recommendations are not being met for most stroke survivors across all settings.
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    Conference Title
    International Journal of Stroke
    Volume
    13
    Issue
    1_suppl
    Publisher URI
    https://journals.sagepub.com/doi/full/10.1177/1747493018778666
    Subject
    Clinical Sciences
    Neurosciences
    Science & Technology
    Life Sciences & Biomedicine
    Clinical Neurology
    Peripheral Vascular Disease
    Neurology
    Publication URI
    http://hdl.handle.net/10072/402613
    Collection
    • Conference outputs

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