Effect of the Timing of Occupational Therapy Initiation During the Acute Phase of Stroke on Recovery: A Retrospective Study with Propensity Score Matching

抄録

Objective: This study investigated the effect of the timing of occupational therapy initiation during the acute phase of stroke on patient recovery.

Methods: This retrospective study with a 2-week observation period included 216 patients who experienced stroke and underwent rehabilitation during hospitalization at our institution. Patients were classified as the early group (began occupational therapy 1 day after stroke onset) or the late group (began therapy 2 days or later after stroke onset). This classification was based on the limited number of occupational therapists at our institution, where therapy is initiated 1 day after stroke onset if that day is a weekday (Monday through Friday); however, therapy for new patients is suspended on weekends (Saturday and Sunday) and holidays. As a result, the classification of patients into early and late groups was influenced by the patients' admission dates, resulting in some degree of randomization. Baseline characteristics were balanced using propensity score matching, and outcomes were compared at 2 weeks using the Mann-Whitney U test. The primary outcome was the change in the activities of daily living (ADLs) performance. The secondary outcome was the ADLs performance at 2 weeks.

Results: The early group exhibited a significantly greater change in the ADLs performance compared to that of the late group (p = 0.036). Additionally, compared to the late group, the early group exhibited significantly better ADLs performance at 2 weeks (p = 0.049).

Conclusion: Earlier initiation of occupational therapy during the acute phase of stroke may positively influence patient recovery.