College of Science and Engineering, Health and Sports Technology Course, Kanto Gakuin University, Yokohama, Japan -
School of Medicine, Department of Rehabilitation Science, Physical Therapy Course, Osaka Metropolitan University, Osaka, Japan.
Eur J Phys Rehabil Med. 2022 Oct;58(5):675-682. doi: 10.23736/S1973-9087.22.07581-5. Epub 2022 Sep 1.
The duration of rehabilitation therapy is one of the key elements for promoting post-stroke functional recovery. However, whether an individual's age affects the effectiveness of the duration of rehabilitation therapy on post-stroke functional recovery remains unclear.
This study aimed to investigate whether age has an influence on the relationship between the duration of rehabilitation therapy and post-stroke functional recovery.
This is a retrospective observational study.
Six convalescent inpatient rehabilitation hospitals in Japan.
The population of the study was represented by a total of 1186 participants with subacute stroke.
Participants were stratified into four groups according to their age (≤59, 60-69, 70-79, and ≥80 years). The data of minutes involved in performing rehabilitation therapy for participants during hospitalization per day (extracted from the medical records of each hospital). The outcome measurement was the absolute change in the functional independence measure (FIM) score during hospitalization.
The mean FIM gains in the ≤59 years, 60-69 years, 70-79 years, and the ≥80 years groups were 38.7 (18.8), 32.8 (18.0), 29.7 (16.6), and 25.4 (17.2), respectively. The results of the multivariate regression analyses showed that there was a significant association between the duration of daily rehabilitation therapy and the FIM gain in the 70-79 years and the ≥80 years groups (-70-79 years group: B=1.289, β=0.290, 95% confidence intervals (CIs): 0.718-1.859, P<0.001; the ≥80 years group: B=2.375, β=0.371, 95% CIs: 1.644-3.107, P<0.001), but not in the other groups.
For patients with subacute stroke in rehabilitation hospitals, a higher duration of daily rehabilitation therapy was associated with better functional recovery in the 70-79 years group and ≥80 years groups. Understanding the responsiveness of patients with stroke to rehabilitation therapy by age group helps to better allocate medical resources and develop more effective approaches.
An increased duration of daily rehabilitation therapy may be helpful in older adults with stroke selected for intensive rehabilitation for improvement of basic daily functioning.
康复治疗的持续时间是促进卒中后功能恢复的关键因素之一。然而，个体的年龄是否会影响康复治疗持续时间对卒中后功能恢复的效果尚不清楚。
本研究旨在探讨年龄是否会影响康复治疗持续时间与卒中后功能恢复之间的关系。
这是一项回顾性观察研究。
日本六家康复住院医院。
研究人群由总共 1186 名亚急性卒中患者组成。
根据年龄（≤59 岁、60-69 岁、70-79 岁和≥80 岁）将参与者分为四组。每天在医院进行康复治疗的分钟数（从每个医院的病历中提取）。结局测量是住院期间功能独立性测量（FIM）评分的绝对变化。
≤59 岁、60-69 岁、70-79 岁和≥80 岁组的平均 FIM 增益分别为 38.7（18.8）、32.8（18.0）、29.7（16.6）和 25.4（17.2）。多变量回归分析结果表明，在 70-79 岁和≥80 岁组中，每日康复治疗的持续时间与 FIM 增益之间存在显著关联（70-79 岁组：B=1.289，β=0.290，95%置信区间（CI）：0.718-1.859，P<0.001；≥80 岁组：B=2.375，β=0.371，95%CI：1.644-3.107，P<0.001），但在其他组中没有。
对于康复医院的亚急性卒中患者，较高的每日康复治疗持续时间与 70-79 岁组和≥80 岁组的功能恢复更好相关。按年龄组了解卒中患者对康复治疗的反应性有助于更好地分配医疗资源并开发更有效的方法。
增加每日康复治疗的持续时间可能有助于选择强化康复治疗的老年卒中患者改善基本日常生活功能。
