Additional weekend therapy may reduce length of rehabilitation stay after stroke: a meta-analysis of individual patient data
journal contributionposted on 09.05.2022, 01:36 by C English, Nora ShieldsNora Shields, Natasha BruscoNatasha Brusco, Nicholas TaylorNicholas Taylor, JJ Watts, Casey PeirisCasey Peiris, J Bernhardt, M Crotty, A Esterman, L Segal, S Hillier
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 (β = 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. Clinical Trial Registration: ACTRN12610000096055, ACTRN12609000973213. [English C, Shields N, Brusco NK, Taylor NF, Watts JJ, Peiris C, et al. (2016) Additional weekend therapy may reduce length of rehabilitation stay after stroke: a meta-analysis of individual patient data. Journal of Physiotherapy 62: 124-129].
The CIRCIT trial was funded by National Health and Medical Research Council Grant 631905. The Saturday trial was supported by National Health and Medical Research Council Partnership Grant 541958.
JournalJournal of Physiotherapy
Pagination6p. (p. 124-129)
Rights Statement© 2016 Australian Physiotherapy Association. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).
Science & TechnologyLife Sciences & BiomedicineOrthopedicsRehabilitationPhysical therapyOccupational therapyStrokeWeekend therapyRANDOMIZED CONTROLLED-TRIALALLIED HEALTH-SERVICESCIRCUIT CLASSINTENSITYSETTINGSPROTOCOLOUTCOMESCIRCITCOSTActivities of Daily LivingHumansInpatientsLength of StayOccupational TherapyPhysical Therapy ModalitiesQuality of LifeRehabilitation CentersStroke RehabilitationTreatment Outcome