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Too Many Patients Receiving Too Little Rehab After Stroke, Study Finds
Rates of physical, occupational, and speech rehabilitation therapy after stroke are low in the United States, according to study findings published in Stroke.
“In the initial weeks after a stroke, the brain is ready to undergo maximum rewiring to get people back on their feet. Rehab therapy helps maximize this recovery, with higher rehab therapy doses helping more, but what we found in this study is that most patients are getting rather small doses of rehab therapy,” said study lead author Steven Cramer, MD, stroke neurologist and professor of neurology, David Geffen School of Medicine at the University of California, Los Angeles, and the California Rehabilitation Institute, also in Los Angeles.
The study included 510 patients hospitalized with radiologically confirmed stroke across 28 acute care hospitals in the United States. Researchers followed patients to track doses of rehabilitation therapy over 1 year.
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Therapy counts were low on the whole, according to the study. Most therapy was delivered in 6 to 8 sessions over the first 3 months. Among patients, 35% received no physical therapy, 48.8% received no occupational therapy, and 61.7% received no speech therapy.
When researchers examined factors associated with therapy counts, they found that patients discharged home had the lowest levels of therapy, regardless of the severity of their stroke. Additionally, Hispanic patients received lower amounts of physical and occupational therapy than other patients.
The study also showed that more severe clinical and behavioral deficits after stroke predicted higher therapy doses, a finding that mostly pleased the research team.
“But in the bigger picture,” added Dr Cramer, “the findings reinforce that too many patients are missing out on a golden opportunity to maximize recovery during a critical period following a stroke.”
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