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Dose–response relationship between physiotherapy resource provision with function and balance improvements in patients following stroke: a multi‐centre observational study
Author(s) -
Haines Terry P.,
Kuys Suzanne,
Clarke Jane,
Morrison Greg,
Bew Paul
Publication year - 2011
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2010.01380.x
Subject(s) - medicine , functional independence measure , rehabilitation , physical therapy , observational study , balance (ability) , stroke (engine) , physical medicine and rehabilitation , test (biology) , prospective cohort study , surgery , mechanical engineering , engineering , paleontology , biology
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.