Current status of acute stroke rehabilitation at primary stroke centers in Japan: a nationwide cross-sectional web-based questionnaire survey

Abstract

Background: The current status of the system for providing acute stroke rehabilitation in Japan still remains unknown, since no fact-finding survey regarding this issue has been conducted in the past. Methods: During the period between February 7, 2022, and April 21, 2022, a nationwide, cross-sectional web-based questionnaire survey was administered to 959 primary stroke centers (PSCs) in Japan. In the survey, mainly the current provision status of acute stroke rehabilitation at PSCs was asked. In addition, we questioned providers about the influence of the pandemic of 2019 novel coronavirus (COVID-19) on the provision system and the contents of the rehabilitation. Results: Responses were obtained from 639 hospitals (66.6%). Board-certified rehabilitation doctors and certified nurses in stroke rehabilitation nursing were involved in acute stroke rehabilitation in 41% and 45% of the hospitals, respectively. Irrespective of the type of stroke, 40-minute rehabilitative training was provided as an initial session of acute rehabilitation for stroke patients at many hospitals in Japan. In 37% of the hospitals, the rehabilitative training was not provided on the closed days of the hospitals. In 61% of the hospitals, the pandemic of COVID-19 influenced the provision status of acute stroke rehabilitation. At many hospitals, the daily duration of acute stroke rehabilitation was reduced due to the pandemic. Conclusion: Currently, the provision of acute stroke rehabilitation might be insufficient at some PSCs in Japan. In the future, the equalization and standardization of acute stroke rehabilitation should be promoted throughout Japan.