Additional weekend therapy may reduce length of rehabilitation stay after stroke: a meta-analysis of individual patient data
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Date
2016
Authors
English, Coralie
Shields, Nora
Brusco, Natasha Kareem
Taylor, Nicholas F
Watts, Jennifer J
Peiris, Casey L
Bernhardt, Julie
Crotty, Maria
Esterman, Adrian Jeffrey
Segal, Leonie
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Rights
Copyright 2016 Australian Physiotherapy Association. Published by Elsevier B.V.
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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 (b = 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]
Description
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords
Citation
English C, Shields N, Brusco NK, Taylor NF, Watts JJ, Peiris C, Bernhardt J, Crotty M, Esterman A, Segal L, Hillier S. Additional weekend therapy may reduce length of rehabilitation stay after stroke: a meta-analysis of individual patient data. J Physiother. 2016 Jul;62(3):124-9. doi: 10.1016/j.jphys.2016.05.015.