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  • Rehabilitation after acute stroke varies widely in terms of setting and therapy dose

    Author(s)
    Grimley, Rohan
    Kuys, Suzanne
    Gustafsson, Louise
    Horton, Eleanor
    Green, Therese
    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 that stroke survivors should receive rehabilitation to maximize participation in the community. Aim: To describe patterns of rehabilitation received following acute stroke in terms of dose, length of stay (LOS) and settings. Methods: Prospective multi-centre observational study of consecutive patients surviving acute stroke. We collected minutes of rehabilitation received and LOS for all rehabilitation episodes up to 6-months post stroke in Inpatient Rehabilitation (IR), Community Rehabilitation (CR) and Transition Care (TC). IR included: Acute Stroke Units (ASU), specialized ...
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    Background: National Guidelines recommend that stroke survivors should receive rehabilitation to maximize participation in the community. Aim: To describe patterns of rehabilitation received following acute stroke in terms of dose, length of stay (LOS) and settings. Methods: Prospective multi-centre observational study of consecutive patients surviving acute stroke. We collected minutes of rehabilitation received and LOS for all rehabilitation episodes up to 6-months post stroke in Inpatient Rehabilitation (IR), Community Rehabilitation (CR) and Transition Care (TC). IR included: Acute Stroke Units (ASU), specialized rehabilitation units (IRU) and Geriatric Evaluation Management (GEM). CR included centre and home based teams and individual outpatient rehabilitation providers. TC included residential and home-based rehabilitation. Results: 368 patients (**% female, median age 71) received rehabilitation. A total of 721 rehabilitation episodes (mean 1.2/patient, range 1–6) were delivered at 83 services sites (29 IR, 31 CR, 9 TC, 14other). 73% of initial rehabilitation occurred in IR (70% in ASU, 24% in IRU and 6% GEM), 21% in CR and 5% through TC. Patients received a median total of 34 hours (IQR 9, 82) therapy (13 ASU, 45 IRU, 4 CR, 16 TC) over median 54 days (IQR 21, 108). Median LOS by site was ASU 9days, IRU 29days, CR 38days, TC 59days. Proportion of total episodes delivered were: ASU 27%, IRU 24%, CR 28%, TC 10%. Of **number initial ASU rehab episodes, 53% subsequently received IR in IRU, 17% CR, 15% TC. **% of rehab days and **% of rehab dose occurred in IRU, Initial ASU IR was associated with **total LOS, **total dose, **chance of subsequent OR/IR. **% of all patients (*% of those receiving rehab) received <14/30 days of rehab. Total % of episodes by service type Conclusion: The majority of patients commenced rehabilitation within an ASU, but received the greatest total dose in IRU. CR provides greatest number of episodes, but at extremely low dose.
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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/10072/402617
    Collection
    • Conference outputs

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