Factors Associated With Time to Achieve Physical Functional Recovery in Patients With Severe Stroke After Inpatient Rehabilitation: A Retrospective Nationwide Cohort Study in Japan.
Reiko Yamaura, Tetsuji Kaneko, Koichi Benjamin Ishikawa and 3 others
PMID 36545532WHAT IT FOUND
Only 40.4% of patients with severe stroke achieved physical independence by discharge.
Younger age and higher initial motor scores predicted faster recovery. Patients who reached this goal received 10 more minutes of therapy per day than those who did not.
Key findings
01FIM motor scores of 70 or higher, indicating self-care independence, were achieved by 40.4% of patients at discharge.
02Patients who achieved physical independence received a median of 6.94 units of rehabilitation per day, compared to 6.41 units for those who did not.
03Time to achieve physical independence was significantly shorter for patients who were younger, had higher initial motor scores, and had no pre-stroke disability.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study used administrative claims data, which lacks detailed clinical information such as specific comorbidities, exact onset times, and the content of rehabilitation sessions. Rehabilitation intensity was measured in units, assuming equal quality and patient effort across all sessions, which may not reflect the actual therapeutic value or patient engagement. The results apply only to inpatient rehabilitation in Japan under a specific insurance system and may not generalize to outpatient settings or other countries. Patients who transferred to other hospitals were handled as competing risks, which may obscure the true long-term outcomes for those who did not improve quickly enough to stay in the initial facility.
Declared interests
The authors declared no conflicts of interest. The study was approved by the Institutional Review Board of the International University of Healthcare and Welfare.
The easy way to misread this
Do not interpret the 10-minute difference in daily therapy time as the sole cause of improved outcomes. The study is observational, so patients who received slightly more therapy may have been those who were already recovering faster or had better baseline prognoses.