Delayed inpatient rehabilitation and functional outcomes for acute stroke: a retrospective cohort study in an Australian regional hospital

Background: The impact of delayed inpatient rehabilitation on the functional outcomes of stroke patients has not been reported in regional Australia. Objective: This study examined the impact of delayed inpatient rehabilitation following acute stroke on functional outcomes (Relative Functional Gain...

Full description

Saved in:
Bibliographic Details
Main Authors: Fan He, Irene Blackberry, Michael Njovu, David Rutherford, George Mnatzaganian
Format: Article
Language:English
Published: Medical Journals Sweden 2025-08-01
Series:Journal of Rehabilitation Medicine
Subjects:
Online Access:https://medicaljournalssweden.se/jrm/article/view/42506
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849684163568861184
author Fan He
Irene Blackberry
Michael Njovu
David Rutherford
George Mnatzaganian
author_facet Fan He
Irene Blackberry
Michael Njovu
David Rutherford
George Mnatzaganian
author_sort Fan He
collection DOAJ
description Background: The impact of delayed inpatient rehabilitation on the functional outcomes of stroke patients has not been reported in regional Australia. Objective: This study examined the impact of delayed inpatient rehabilitation following acute stroke on functional outcomes (Relative Functional Gain and Functional Independence Measure efficiency) and length of stay in rehabilitation at a regional Australian hospital. Methods: Rehabilitation initiated > 24 h after a patient was deemed clinically ready was considered delayed. Associations between delayed inpatient rehabilitation and functional outcomes were investigated with mixed effects linear regression while length of stay was modelled using a negative binomial regression. Results: Of a total 487 patients, 301 (61.8%) experienced delayed inpatient rehabilitation, with a median delay of 2 days (interquartile range: 1–4 days). Multivariate regressions showed delayed inpatient rehabilitation was negatively associated with Relative Functional Gain (Beta: –0.07, 95% confidence interval [CI]: –0.11, –0.02, p = 0.009) and Functional Independence Measure efficiency (Beta: –0.18, 95% CI: –0.32, –0.04, p = 0.014), but positively associated with length of stay in rehabilitation wards (incidence rate ratio: 1.11, 95% CI: 1.02, 1.21, p = 0.021). Bed unavailability was the leading cause of delay. Conclusion: Delayed inpatient rehabilitation is associated with poorer functional outcomes in stroke patients. Timely access to rehabilitation is crucial for optimising recovery.
format Article
id doaj-art-b4de7f4801eb4fc8aaad1eba1f086718
institution DOAJ
issn 1651-2081
language English
publishDate 2025-08-01
publisher Medical Journals Sweden
record_format Article
series Journal of Rehabilitation Medicine
spelling doaj-art-b4de7f4801eb4fc8aaad1eba1f0867182025-08-20T03:23:34ZengMedical Journals SwedenJournal of Rehabilitation Medicine1651-20812025-08-015710.2340/jrm.v57.42506Delayed inpatient rehabilitation and functional outcomes for acute stroke: a retrospective cohort study in an Australian regional hospitalFan He0https://orcid.org/0000-0001-5696-0631Irene Blackberry1https://orcid.org/0000-0003-4482-4936Michael Njovu 2https://orcid.org/0009-0006-7060-635XDavid Rutherford 3https://orcid.org/0009-0006-6569-4797George Mnatzaganian4https://orcid.org/0000-0002-7698-5091John Richards Centre for Rural Ageing Research, La Trobe Rural Health School, La Trobe University, Victoria, Australia; Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia; Care Economy Research Institute, La Trobe University, Albury-Wodonga, Victoria, AustraliaJohn Richards Centre for Rural Ageing Research, La Trobe Rural Health School, La Trobe University, Victoria, Australia; Care Economy Research Institute, La Trobe University, Albury-Wodonga, Victoria, AustraliaRehabilitation Medicine Department, Albury Wodonga Health, Wodonga, Victoria, Australia; School of Clinical Medicine, University of New South Wales, Albury Campus, Albury, AustraliaDivision of Medicine, Albury Wodonga Health, Albury, New South Wales, AustraliaRural Department of Community Health, La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Victoria, AustraliaBackground: The impact of delayed inpatient rehabilitation on the functional outcomes of stroke patients has not been reported in regional Australia. Objective: This study examined the impact of delayed inpatient rehabilitation following acute stroke on functional outcomes (Relative Functional Gain and Functional Independence Measure efficiency) and length of stay in rehabilitation at a regional Australian hospital. Methods: Rehabilitation initiated > 24 h after a patient was deemed clinically ready was considered delayed. Associations between delayed inpatient rehabilitation and functional outcomes were investigated with mixed effects linear regression while length of stay was modelled using a negative binomial regression. Results: Of a total 487 patients, 301 (61.8%) experienced delayed inpatient rehabilitation, with a median delay of 2 days (interquartile range: 1–4 days). Multivariate regressions showed delayed inpatient rehabilitation was negatively associated with Relative Functional Gain (Beta: –0.07, 95% confidence interval [CI]: –0.11, –0.02, p = 0.009) and Functional Independence Measure efficiency (Beta: –0.18, 95% CI: –0.32, –0.04, p = 0.014), but positively associated with length of stay in rehabilitation wards (incidence rate ratio: 1.11, 95% CI: 1.02, 1.21, p = 0.021). Bed unavailability was the leading cause of delay. Conclusion: Delayed inpatient rehabilitation is associated with poorer functional outcomes in stroke patients. Timely access to rehabilitation is crucial for optimising recovery. https://medicaljournalssweden.se/jrm/article/view/42506AustraliaDelayRehabilitationRegionalStrokeoutcomes
spellingShingle Fan He
Irene Blackberry
Michael Njovu
David Rutherford
George Mnatzaganian
Delayed inpatient rehabilitation and functional outcomes for acute stroke: a retrospective cohort study in an Australian regional hospital
Journal of Rehabilitation Medicine
Australia
Delay
Rehabilitation
Regional
Stroke
outcomes
title Delayed inpatient rehabilitation and functional outcomes for acute stroke: a retrospective cohort study in an Australian regional hospital
title_full Delayed inpatient rehabilitation and functional outcomes for acute stroke: a retrospective cohort study in an Australian regional hospital
title_fullStr Delayed inpatient rehabilitation and functional outcomes for acute stroke: a retrospective cohort study in an Australian regional hospital
title_full_unstemmed Delayed inpatient rehabilitation and functional outcomes for acute stroke: a retrospective cohort study in an Australian regional hospital
title_short Delayed inpatient rehabilitation and functional outcomes for acute stroke: a retrospective cohort study in an Australian regional hospital
title_sort delayed inpatient rehabilitation and functional outcomes for acute stroke a retrospective cohort study in an australian regional hospital
topic Australia
Delay
Rehabilitation
Regional
Stroke
outcomes
url https://medicaljournalssweden.se/jrm/article/view/42506
work_keys_str_mv AT fanhe delayedinpatientrehabilitationandfunctionaloutcomesforacutestrokearetrospectivecohortstudyinanaustralianregionalhospital
AT ireneblackberry delayedinpatientrehabilitationandfunctionaloutcomesforacutestrokearetrospectivecohortstudyinanaustralianregionalhospital
AT michaelnjovu delayedinpatientrehabilitationandfunctionaloutcomesforacutestrokearetrospectivecohortstudyinanaustralianregionalhospital
AT davidrutherford delayedinpatientrehabilitationandfunctionaloutcomesforacutestrokearetrospectivecohortstudyinanaustralianregionalhospital
AT georgemnatzaganian delayedinpatientrehabilitationandfunctionaloutcomesforacutestrokearetrospectivecohortstudyinanaustralianregionalhospital