Rehabilitation Dose Contributes to Improvement in Transfer and Mobility Activities Among Patients With Ischemic...

To examine the association between rehabilitation dose (≤40min, 40-60min, 60-80min, 80-120min, and ≥120 min) during the first 14 days and recovery of transfer and mobility activities among inpatients with ischemic stroke who required assistance before acute hospitalization.

Nationwide Japanese retrospective observational database study.

Acute care and rehabilitation units.

Stroke patients admitted between April 1, 2016, and March 31, 2022, with modified Rankin scale scores of 4 and 5 before hospitalization. The study included 6531 patients (N=6531) (3869 men, 59.2%) with a mean age of 84.02 (±9.27) years.

Not applicable (observational study without intervention).

The Barthel Index at 30 days was used to assess seated position, transfer ability (with or without assistance), and wheelchair self-propulsion, with each item dichotomized into achievement or nonachievement to facilitate clinical interpretation.

Among 6531 patients, higher rehabilitation doses were associated with better outcomes in a dose-response manner. Compared with ≤40 min, ≥120 min/day was associated with improved seated position (relative risk [RR], 2.27; 95% CI, 2.06-2.51), transfer with assistance (RR, 2.18; 95% CI, 1.93-2.45), independent transfer (RR, 2.04; 95% CI, 1.58-2.65), and wheelchair self-propulsion (RR, 2.68; 95% CI, 1.90-3.87).

In patients with severe preischemic stroke disability, a higher daily rehabilitation dose was associated with improved transfer and mobility functions.