ArticleBMC neurology2016
Access, timing and frequency of very early stroke rehabilitation - insights from the Baden-Wuerttemberg stroke registry.
Article in BMC neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Beyond cardiac embolism and cryptogenic stroke: unveiling the mechanisms of cerebrovascular events in Chagas disease.Lancet regional health. Americas · 2025Review
- Operationalising routinely collected patient data in research to further the pursuit of social justice and health equity: a team-based scoping review.BMC medical research methodology · 2025Article
- Assessment of rehabilitation following acute ischaemic stroke in China: a registry-based retrospective observational study.BMJ open · 2024Observational
- Intelligent systems for sitting posture monitoring and anomaly detection: an overview.Journal of neuroengineering and rehabilitation · 2024Review
- The effect of post-acute rehabilitation setting on 90-day mobility after stroke: A difference-in-difference analysis.medRxiv : the preprint server for health sciences · 2024Article
- Association Between Neurological Outcomes and Timing of Physical Therapy Initiation Among Patients Treated for Aneurysmal Subarachnoid Hemorrhage: A Propensity-Adjusted Analysis.Neurosurgery practice · 2023Article
- Descriptive analysis of post-stroke patients in a neurological physical therapy unit.Frontiers in neurology · 2023Article
- Patients' and professionals' perspectives on the consideration of patients' convenient therapy periods as part of personalised rehabilitation: a focus group study with patients and therapists from inpatient neurological rehabilitation.BMC health services research · 2022Article
- Effectiveness of active occupational therapy in patients with acute stroke: A propensity score-weighted retrospective study.Frontiers in rehabilitation sciences · 2022Article
- The characteristics of stroke and its rehabilitation in Northern Tanzania.Global health action · 2021Article
- High Intensity Physical Rehabilitation Later Than 24 h Post Stroke Is Beneficial in Patients: A Pilot Randomized Controlled Trial (RCT) Study in Mild to Moderate Ischemic Stroke.Frontiers in neurology · 2019Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile the precise timing and intensity of very early rehabilitation (VER) after stroke onset is still under discussion, its beneficial effect on functional disability is generally accepted. The recently published randomized controlled AVERT trial indicated that patients with severe stroke might be more susceptible to harmful side effects of VER, which we hypothesized is contrary to current clinical practice. We analyzed the Baden-Wuerttemberg stroke registry to gain insight into the application of VER in acute ischemic stroke (IS) and intracerebral hemorrhage (ICH) in clinical practice.
methods99,753 IS patients and 8824 patients with ICH hospitalized from January 2008 to December 2012 were analyzed. Data on the access to physical therapy (PT), occupational therapy (OT), and speech therapy (ST), the time from admission to first contact with a therapist and the average number of therapy sessions during the first 7 days of admission are reported. Multiple logistic regression models adjusted for patient and treatment characteristics were carried out to investigate the influence of VER on clinical outcome.
resultsPT was applied in 90/87% (IS/ICH), OT in 63/57%, and ST in 70/65% of the study population. Therapy was mostly initiated within 24 h (PT 87/82%) or 48 h after admission (OT 91/89% and ST 93/90%). Percentages of patients under therapy and also the average number of therapy sessions were highest in those with a discharge modified Rankin Scale score of 2 to 5 and lowest in patients with complete recovery or death during hospitalization. The outcome analyses were fundamentally hindered due to biases by individual decision making regarding the application and frequency of VER.
conclusionsWhile most patients had access to PT we noticed an undersupply of OT and ST. Only little differences were observed between patients with IS and ICH. The staff decisions for treatment seem to reflect attempts to optimize resources. Patients with either excellent or very unfavorable prognosis were less frequently assigned to VER and, if treated, received a lower average number of therapy sessions. On the contrary, severely disabled patients received VER at high frequency, although potentially harmful according to recent indications from the randomized controlled AVERT trial.
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