Timing and Intensity of Rehabilitation Services During Acute Stroke Hospitalization: Impacts on Functional Recovery and Community Discharge.
Jessica Edelstein, Amanda Hoffman, Darcie M Luby and 2 others
Among stroke patients receiving OT, a shorter wait between evaluation and first treatment and higher daily therapy intensity were each linked to better discharge function and greater odds of community discharge.
PT showed only one significant link: earlier evaluation.
Key findings
1In the OT cohort, fewer days between evaluation and first treatment (B = -0.091, 95% CI [-0.16, -0.02], p = .013) and higher average daily therapy intensity (B = 0.482, 95% CI [0.04, 0.92], p = .031) were each associated with higher discharge function scores, and earlier treatment initiation (OR = 0.927, 95% CI [0.865, 0.993], p = .032) and higher intensity (OR = 1.396, 95% CI [1.026, 1.900], p = .034) increased odds of community discharge.
2In the PT cohort, earlier therapy evaluation (B = -0.129, 95% CI [-0.22, -0.04], p = .006) was associated with better discharge mobility, but therapy intensity and days to treatment were not statistically significant.
3No therapy-related variable (days to evaluation, days to treatment, or intensity) was significantly associated with community discharge in the PT model.
Still to come
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Retrospective EMR data collected for clinical purposes, so documentation variability and measurement error are possible for therapy dates, intensity, and AM-PAC scores. Single health system in Colorado; findings may not generalise to other regions or care models. OT and PT cohorts are not mutually exclusive (most patients received both), and joint OT-PT sessions were not accounted for, so the independent contribution of each discipline cannot be fully separated. Patients who received an evaluation only (521 OT, 283 PT) were excluded; many of these were likely higher-functioning and discharged home, which may understate the community discharge rate. Stroke severity (e.g., NIH Stroke Scale) was not available in the dataset, so only disease burden (ICD-10 code count) was used as a proxy. Unmeasured confounders such as social determinants of health, family support, and provider-level factors were not controlled.
The easy way to misread this
Do not read the OT findings as proof that more therapy minutes cause better outcomes. This is a retrospective observational study with no randomisation, and the OT and PT cohorts overlap. Patients who received more therapy may have been triaged differently, had different care-team workflows, or had different baseline trajectories. The associations are consistent with prior work but do not establish that changing your unit's scheduling will change patient outcomes.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →