Effectiveness of active occupational therapy in patients with acute stroke: A propensity score-weighted retrospective study
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Background and purpose: The effects of therapy and patient characteristics on rehabilitation outcomes in patients with acute stroke are unclear. We investigated the effects of intensive occupational therapy (OT) on patients with acute stroke. Methods: We performed a retrospective cohort study using the 2005–2016 Japan Rehabilitation Database, from which we identified patients with stroke ( n = 10,270) who were admitted to acute care hospitals ( n = 37). We defined active OT (AOT) and non-AOT as OT intervention times (total intervention time/length of hospital stay) longer or shorter than the daily physical therapy intervention time, respectively. The outcomes assessed were the Functional Independence Measure (FIM) and National Institutes of Health Stroke Scale (NIHSS) scores, duration of hospitalization, and rate of discharge. Propensity scores and inverse probability of treatment weighting analyses adjusted for patient characteristics were performed to investigate the effects of AOT on patient outcomes. Results: We enrolled 3,501 patients (1,938 and 1,563 patients in the AOT and non-AOT groups, respectively) in the study. After inverse probability of treatment weighting, the AOT group had a shorter length of hospitalization (95% confidence interval: −3.7, −1.3, p < 0.001), and the FIM (95% confidence interval: 2.0, 5.7, p < 0.001) and NIHSS (95% confidence interval; 0.3, 1.1, p < 0.001) scores improved significantly. Subgroup analysis showed that lower NHISS scores for aphasia, gaze, and neglect and lower overall NIHSS and FIM scores on admission led to a greater increase in FIM scores in the AOT group. Conclusions: AOT improved the limitations in performing activities of daily living (ADL) and physical function in patients with acute stroke and reduced the length of hospitalization. Additionally, subgroup analysis suggested that the increase in FIM score was greater in patients with severe limitations in performing ADLs and worse cognitive impairment, such as neglect, on admission.
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Yamakawa et al. reported that an active OT intervention on patients with acute stroke was effective in improving limitations in performing ADLs and reducing length of hospitalization.
“Yamakawa et al. [50], referred an active OT intervention on patients with acute stroke was effective in improving the limitations in performing ADLs and reducing the length of hospitalization.”
From Early Occupational Therapy Intervention post-stroke (EOTIPS): A randomized controlled trial (2024) · cites this paper as [50]
Yamakawa et al. also indicated that the intervention was more effective in patients with severe limitations in performing ADLs and cognitive impairment.
“They also indicated that it was more effective in patients with severe limitations in performing ADLs and cognitive impairment, such as neglect.”
From Early Occupational Therapy Intervention post-stroke (EOTIPS): A randomized controlled trial (2024) · cites this paper as [50]
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“Furthermore, this research exposed cohesion with other published articles significant results: improvements in functional independence [48–50], cognition skills [51] and symptoms of depression [5].”
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- Authors
- Yamakawa, S., Nagayama, H., Tomori, K., Ikeda, K., & Niimi, A.
- Affiliations
- Kanagawa University of Human Services (JP)
- Tokyo University of Technology (JP)
- Yokohama Brain and Spine Center (JP)
- Corresponding author
- Nagayama, Hirofumi
- Venue
- Frontiers in Rehabilitation Sciences
- Publisher
- Frontiers Media SA
- Published
- 2023-01-05
- Volume
- 3
- Pages
- 1045231-1045231
- ISSN
- 2673-6861 (ISSN-L)
- PMC
- PMC9849931
- OpenAlex
- W4313557087
- Cited by
- 10
- References
- 39
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 2
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Rehabilitation Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Japan Society for the Promotion of Science (20H03914)
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Health Professions › Occupational Therapy › Occupational Therapy Practice and Research
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- acute stroke, stroke rehabilitation, functional independence, activities of daily living, length of hospital stay, stroke severity, aphasia, hemispatial neglect, cognitive impairment
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