Intensive rehabilitation programme for patients with subacute stroke in an inpatient rehabilitation facility: describing a protocol of a prospective cohort study

Abstract

IntroductionRehabilitation is recognised as a cornerstone of multidisciplinary stroke care. Intensity of therapy is related to functional recovery although there is high variability on the amount of time and techniques applied in therapy sessions. There is a need to better describe stroke rehabilitation protocols to develop a better understanding of current practice increasing the internal validity and generalisation of clinical trial results. The aim of this study is to describe an intensive rehabilitation programme for patients with stroke in an inpatient rehabilitation facility, measuring the amount and type of therapies (physical, occupational and speech therapy) provided and reporting functional outcomes.Methods and analysisThis will be a prospective observational cohort study of patients with subacute stroke admitted to our inpatient rehabilitation facility during 2 years. A therapy recording tool was developed in order to describe the rehabilitation interventions performed in our unit. This tool was designed using the Delphi method, literature search and collaboration with senior clinicians. Therapists will record the time spent on different activities available in our unit during specific therapy sessions. Afterwards, the total time spent in each activity, and the total rehabilitation time for all activities, will be averaged for all patients. Outcome variables were divided into three different domains: body structure and function outcomes, activity outcomes and participation outcomes and will be assessed at baseline (admission at the rehabilitation unit), at discharge from the rehabilitation unit and at 3 and 6 months after stroke.Ethics and disseminationThis study was approved by the Medical Research Committee at Hospital del Mar Research Institute (Project ID: 34/C/2017). The results of this study will be presented at national and international congress and submitted for publication in peer-reviewed journals.Trial registration numberNCT04191109.

Improving multidisciplinary hospital care for acute cerebral circulation disorders in Kazakhstan

“…A better description of stroke rehabilitation protocols is needed to better understand current practice, improve internal validity, and generalize the results of clinical trials. The purpose of this study is to describe an intensive rehabilitation program for stroke patients in an inpatient rehabilitation facility, measuring the amount and type of therapy provided (physical, occupational, and speech therapy), and reporting functional outcomes [ 41 ].…”

Intensive Rehabilitation Program in Older Adults with Stroke: Therapy Content and Feasibility—Preliminary Results from the BRAIN-CONNECTS Study

“…The intensive rehabilitation programs (IRP) offer multidisciplinary care for patients with subacute stroke, and lead to better functional results and less institutionalization. The individual’s cognitive status, comorbidity, and previous functional level are determining factors for admitting patients to IRP [ 3 ]. Advanced age is considered a risk of receiving poorer quality of care and a limitation for rehabilitation outcomes following stroke [ 4 ].…”

“…The medical literature on stroke IRP does not usually report the intensity and content of interventions. Factors such as patient tolerance, the resources of each facility, and the physical environment can modify the intensity of the given therapies [ 3 , 7 , 9 , 10 , 11 , 12 ]. The measurement of the interventions included in the rehabilitation programs represents a challenge for professionals, and it is essential to advance in the demonstration of their benefits.…”

“…Moreover, the standardization of the therapies will provide the external validity necessary for clinical trials. Several objective systems to measure the activities and the time dedicated to each of them have been proposed [ 12 , 14 , 15 ], but only one study gives detailed information about physical, occupational, and speech therapies [ 3 ]. Feasibility studies are important, especially in the development of complex interventions and multidisciplinary programs [ 10 ].…”