Seki Masayoshi, Maeda Takuya, Mizushima Risa, Kasai Fumihito
Rehabilitation Center, Koto Toyosu Hospital, Showa University, Tokyo, JPN.
Physical Therapy, School of Nursing and Rehabilitation Sciences, Showa University, Tokyo, JPN.
Cureus. 2025 May 26;17(5):e84836. doi: 10.7759/cureus.84836. eCollection 2025 May.
Background Heatstroke is a life-threatening condition, the incidence of which has been exacerbated by climate change and urbanization. Despite its increasing prevalence, rehabilitation for managing heatstroke, particularly occupational therapy (OT), remains underexplored. Objective This study aimed to investigate the implementation, characteristics, and effects of OT in patients hospitalized with heatstroke who were admitted to the emergency department. Methods We conducted a retrospective analysis of 49 patients diagnosed with heatstroke who were admitted to an emergency critical care center between July and September from 2019 to 2022. The patients were classified according to severity using the Japanese Association for Acute Medicine Heatstroke (JAAM-HS) criteria. Data on demographics, clinical outcomes, and OT interventions were collected. Statistical analyses included t-tests, chi-square tests, logistic regressions, and linear regressions. Results Among the 49 patients (median age: 72 years), 20 were classified as Grade II and 29 as Grade III. OT was primarily implemented in severe (Grade III) cases and focused on training in activities of daily living, neurological rehabilitation for cerebellar ataxia, and mobility support. Patients with Grade III heatstroke had significantly worse discharge outcomes (p = 0.006) and were more likely to be transferred to another facility. OT participation was not significantly associated with discharge destination but was associated with longer hospital stays (p = 0.003), likely reflecting greater illness severity. Age and sex were not significant predictors of the outcome. Conclusion This study highlights the variable implementation of OT in patients hospitalized with heatstroke and underscores the need for standardized rehabilitation protocols. Considering the potential for long-term neurological sequelae in severe cases, early and structured OT may support functional recovery. Further prospective studies are warranted to investigate the potential effectiveness of OT interventions and to develop evidence-based strategies tailored to illness severity.
中暑是一种危及生命的疾病，气候变化和城市化加剧了其发病率。尽管中暑的患病率不断上升，但针对中暑的康复治疗，尤其是职业治疗（OT），仍未得到充分探索。目的：本研究旨在调查急诊科收治的中暑住院患者接受职业治疗的实施情况、特点及效果。方法：我们对2019年至2022年7月至9月期间收治于急诊重症监护中心的49例确诊为中暑的患者进行了回顾性分析。采用日本急性医学协会中暑（JAAM-HS）标准对患者的严重程度进行分类。收集了人口统计学、临床结局和职业治疗干预的数据。统计分析包括t检验、卡方检验、逻辑回归和线性回归。结果：在49例患者（中位年龄：72岁）中，20例被分类为二级，29例为三级。职业治疗主要在重症（三级）病例中实施，重点是日常生活活动训练、小脑共济失调的神经康复和行动支持。三级中暑患者的出院结局明显更差（p = 0.006），且更有可能被转至其他机构。参与职业治疗与出院目的地无显著关联，但与住院时间延长有关（p = 0.003），这可能反映了病情更严重。年龄和性别不是结局的显著预测因素。结论：本研究强调了中暑住院患者职业治疗实施的差异，并强调了标准化康复方案的必要性。考虑到重症病例存在长期神经后遗症的可能性，早期和结构化的职业治疗可能有助于功能恢复。有必要进行进一步的前瞻性研究，以调查职业治疗干预的潜在效果，并制定针对病情严重程度的循证策略。
