Dose-Response Effect of Daily Rehabilitation Time on Functional Gain in Stroke Patients

OBJECTIVE: To demonstrate the effect of daily treatment time on recovery of functional outcomes and how each type of rehabilitation treatment influences the improvement of subgroups of functional outcomes in stroke patients. METHODS: We conducted a retrospective study in 168 patients who were admitted to the Department of Rehabilitation Medicine between 2015 and 2016. Patients who experienced their first-ever stroke and unilateral lesions were included. All patients underwent conventional rehabilitation treatment, and each treatment was administered one to two times a day depending on individual and treatment room schedules. Based on the mean daily treatment time, patients were divided into two groups: a high-amount group (n=54) and low-amount group (n=114). Outcomes were measured through the Korean version of Modified Barthel Index (MBI), FuglMeyer Assessment of the upper extremity, Trunk Impairment Scale (TIS), and Berg Balance Scale (BBS) scores on admission and at discharge. RESULTS: The functional change and scores at discharge of MBI, TIS, and BBS were greater in the high-amount group than in the low-amount group. Among various types of rehabilitation treatments, occupational therapy training showed significant correlation with MBI, TIS, and BBS gain from admission to discharge. CONCLUSION: The amount of daily mean treatment in post-stroke patients plays an important role in recovery. Mean daily rehabilitation treatment time seems to correlate with improved balance and basic activities of daily living after stroke.