Early Post Stroke Rehabilitation Load Correlates With Greater Functional Improvement of Hemiparesis

Evidences show that generally stroke patients receiving greater amount of physiotherapy obtain better motor function over time, although this has not been investigated in the early post stroke population. The aim of the present observational retrospective study was to investigate the relationship between the amount of physiotherapy provided to early post acute stroke patients and their motor improvement. Overall, 846 early stroke patients with hemiparesis, treated with physiotherapy, were retrospectively analyzed. Clinical data at admission as well as functional scales at the first evaluation and at discharge were analyzed. For each patient, a rehabilitation load (resulting from the total number of the 30’ daily consecutive physiotherapy sessions they received) was used as the dose of physiotherapy. Pre and post rehabilitation scales were analyzed and their change (Δ) was correlated with the rehabilitation load. The mean rehabilitation load was ten sessions (range 2 to 56). The scores of Barthel index, Motor Assessment Score, Motricity index for both lower and upper limb, Functional Ambulation Classification, Berg Balance scale and Trunk control test significantly improved from pre to post rehabilitation, and a significant correlation was found between the rehabilitation load and the improvement in Barthel index (P < 0.05), Motor Assessment Score, Motricity Index for upper and lower limb (P < 0.001), Berg Balance scale (P < 0.05) and Trunk control test (P < 0.001). In this study, a significant correlation was found between early post stroke motor rehabilitation dose and greater improvement in functional scales, assessing patient’s independence, balance and paretic limb’s motricity.