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Effectiveness of Intensive Rehabilitation Therapy on Functional Outcomes After Stroke: A Propensity Score Analysis Based on Japan Rehabilitation Database

      Abstract

      Aim: To examine the association of the amount of rehabilitation with functional gains of elderly stroke patients at a convalescent rehabilitation ward using propensity score analysis methods and the Japan Rehabilitation Database.
      Methods: This study was a retrospective cohort study. From the database, 6875 patients who were admitted to the convalescent rehabilitation wards with stroke were identified. After excluding 4586 patients, 2325 were eligible for the study. Intensive rehabilitation therapy (IRT) was defined as rehabilitation therapy of more than 15 hours per week by a physical therapist, an occupational therapist, and/or a speech therapist. Functional Independence Measure (FIM) gain, discharge rate to home, and FIM efficiency were examined using student's t test and the χ2 test after inverse probability weighting (IPW).
      Results: IRT was provided to 862 patients (37.1%). The unadjusted data showed that patients in the IRT group had a longer hospital stay, more physical therapy, occupational therapy, and speech and language therapy. After adjustment for IPW, the baseline characteristics were found to be closely matched between the 2 groups. The IRT group showed significantly higher motor FIM gain, cognitive FIM gain, FIM gain, and discharge rate to home.
      Conclusions: The present study demonstrated that a longer rehabilitation time per week was associated with increased functional gain in elderly stroke patients at convalescent rehabilitation wards.

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