Additional weekend therapy may reduce length of rehabilitation stay after stroke: a meta-analysis of individual patient data

English, Coralie, Shields, Nora, Brusco, Natasha K., Taylor, Nicholas F., Watts, Jennifer J., Peiris, Casey, Bernhardt, Julie, Crotty, Maria, Esterman, Adrian, Segal, Leonie, and Hillier, Susan (2016) Additional weekend therapy may reduce length of rehabilitation stay after stroke: a meta-analysis of individual patient data. Australian Journal of Physiotherapy, 62 (3). pp. 124-129.

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Abstract

Questions: Among people receiving inpatient rehabilitation after stroke, does additional weekend physiotherapy and/or occupational therapy reduce the length of rehabilitation hospital stay compared to those who receive a weekday-only service, and does this change after controlling for individual factors? Does additional weekend therapy improve the ability to walk and perform activities of daily living, measured at discharge? Does additional weekend therapy improve health-related quality of life, measured 6 months after discharge from rehabilitation? Which individual, clinical and hospital characteristics are associated with shorter length of rehabilitation hospital stay? Design: This study pooled individual data from two randomised, controlled trials (n = 350) using an individual patient data meta-analysis and multivariate regression. Participants: People with stroke admitted to inpatient rehabilitation facilities. Intervention: Additional weekend therapy (physiotherapy and/or occupational therapy) compared to usual care (5 days/week therapy). Outcome measures: Length of rehabilitation hospital stay, independence in activities of daily living measured with the Functional Independence Measure, walking speed and health-related quality of life. Results: Participants who received weekend therapy had a shorter length of rehabilitation hospital stay. In the un-adjusted analysis, this was not statistically significant (MD -5.7 days, 95% CI -13.0 to 1.5). Controlling for hospital site, age, walking speed and Functional Independence Measure score on admission, receiving weekend therapy was significantly associated with a shorter length of rehabilitation hospital stay (beta = 7.5, 95% CI 1.7 to 13.4, p = 0.001). There were no significant between-group differences in Functional Independence Measure scores (MD 1.9 points, 95% CI -2.8 to 6.6), walking speed (MD 0.06 m/second, 95% CI -0.15 to 0.04) or health-related quality of life (SMD -0.04, 95% CI -0.26 to 0.19) at discharge. Discussion: Modest evidence indicates that additional weekend therapy might reduce rehabilitation hospital length of stay.

Item ID: 45564
Item Type: Article (Refereed Research - C1)
Keywords: physical therapy, occupational therapy, rehabilitation, stroke, weekend therapy
Additional Information:

Open Access funded by Australian Physiotherapy Association Under a Creative Commons license

ISSN: 1836-9553
Funders: National Health and Medical Research Council (NHMRC)
Projects and Grants: NHMRC 631905, NHMRC Council Partnership 541958
Date Deposited: 27 Jul 2016 07:49
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110317 Physiotherapy @ 100%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920201 Allied Health Therapies (excl. Mental Health Services) @ 100%
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