The effects of rehabilitation therapy duration on functional recovery of patients with subacute stroke stratified by individual's age: a retrospective multicenter study.
Yosuke Kimura, Yuhei Otobe, Mizue Suzuki and 8 others
PMID 36052892WHAT IT FOUND
Longer daily rehabilitation was linked to better functional recovery in stroke patients aged 70 and older, but not in those under 70.
This suggests older adults may benefit more from increased therapy duration, while younger patients might already be receiving enough.
Key findings
01In patients aged 70-79 and 80 or older, longer daily rehabilitation time was significantly associated with greater gains in functional independence.
02In patients aged 69 or younger, there was no significant association between the duration of daily rehabilitation and functional recovery.
03Functional recovery (FIM gain) decreased progressively with age, with the youngest group gaining an average of 38.6 points compared to 25.4 points in the oldest group.
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 was retrospective, so it could not control for important covariates like stroke severity (NIHSS), fatigue levels, or the specific content of therapy sessions. The timing of assessments (admission to discharge) varied among patients and did not align with fixed post-stroke time points, potentially affecting comparability. The population was selected for convalescent rehabilitation, excluding those too mild or too severe for this setting, limiting generalizability to all stroke patients. The FIM score may have a ceiling effect for younger patients, masking potential benefits of increased therapy duration on more complex functional tasks. The study design cannot prove causation; the association between longer therapy and better outcomes in older adults may be influenced by unmeasured factors such as motivation or tolerance.
Declared interests
No specific conflicts of interest or funding sources are declared in the provided text.
The easy way to misread this
Do not conclude that older patients require more therapy to get better, or that younger patients do not benefit from therapy. This is an observational study showing an association, not a randomized trial proving that increasing duration causes better outcomes. The lack of association in younger adults may reflect a ceiling effect on the FIM scale rather than a true lack of benefit.