Gender and being born overseas influences the amount of acute stroke therapy

To identify patient factors that influence the amount, frequency and intensity of physical and occupational therapy received by patients each weekday within 14 days of stroke.

Exploration of data from studies conducted to monitor activity and therapy.

Stroke patients receiving active treatment (not for palliative care). Physiotherapists and occupational therapists.

Therapy data for 274 patients from 7 hospitals were included. Patients received a median of 40.0 min of therapy (physiotherapy plus occupational therapy) per weekday. Multivariable regression found that women had 22% less total therapy per weekday (factor change 0.78, 95% confidence interval (CI): 0.66-0.9, p = 0.001) and a decreased likelihood of receiving two or more sessions of therapy per weekday. Those born overseas had 23% less high intensity therapy per weekday (Factor change 0.77, 95% CI: 0.71-0.84, p < 0.001). Those with more severe stroke had a greater likelihood of receiving two or more sessions of therapy per weekday (OR = 1.05, 95% CI: 1.02-1.09, p = 0.006) but increasing severity increased the odds of receiving no high intensity therapy by 7% (factor change 1.07, 95% CI: 1.02-1.11, p = 0.002). Age did not exhibit a significant association.

There is some evidence that patient factors may influence the amount of therapy provided. Physiotherapists and occupational therapists should be aware of potential biases associated with therapy provision.