Dose-response relationship between physiotherapy resource provision with function and balance improvements in patients following stroke: a multi-centre observational study

作者：Haines Terry P^*; Kuys Suzanne; Clarke Jane; Morrison Greg; Bew Paul

来源：Journal of Evaluation in Clinical Practice, 2011, 17(1): 136-142.

DOI：10.1111/j.1365-2753.2010.01380.x

• hospitals
• rehabilitation
• stroke

Rationale, aims and objectives
Inpatient rehabilitation of patients following stroke can be resource intensive, with optimal models of service delivery unclear. This study investigates the dose-response curves between physiotherapy service delivery variables and balance and function clinical outcomes.
Method
This was a multi-centre (15 sites), prospective, cohort study involving patients (n = 288) admitted for rehabilitation following stroke conducted across two states in Australia. Physiotherapy department resource provision variables were collected and examined for association with change in patient function and balance outcomes (Functional Independence Measure, step test, functional reach test) measured at admission and discharge from inpatient care.
Results
A greater amount of log-transformed physiotherapy department resource provision was associated with greater improvement in the functional independence measure [Regression coefficient (95% CI): 4.05 (1.15, 6.95)] and functional reach test [46.43 (17.03, 75.84)], while physiotherapist time provided to patients was associated with greater improvement for the step test [0.15 (0.03, 0.28)], and functional reach [0.35 (0.19, 0.52)].
Conclusion
Receiving a higher rate of physiotherapist input is an important factor in attaining a greater amount of recovery in function and balance outcomes; however, the improvement by patients who received the greatest amount of input was highly variable.

• 出版日期2011-2