Is intense rehabilitation after stroke more beneficial?

This study looked at how intensity of rehabilitation may affect the risk of death in stroke patients. The authors determined that high intensity rehabilitation was associated with a decrease in mortality risk following stroke.

Many stroke patients experience post-stroke disabilities. These can have an impact on everyday life and affect a patient’s ability to carry out day to day functions. Rehabilitation programs are in place to help improve functional ability. It is known that more rehabilitation earlier after stroke results in greater improvement. While some studies show that a higher intensity rehabilitation treatment could be beneficial, a large cohort study is needed to confirm this.

The study analyzed information on 6737 stroke patients included in a medical database in Taiwan. All patients had rehabilitation within 90 days following first-ever stroke. These patients underwent low, medium and high intensity rehabilitation programs. Low intensity involved between 1-3 sessions per program, medium involved 4-14 sessions, while high intensity involved greater than 15 sessions per program.

There was an average follow-up of 3.8 years. At this time 2160 deaths had occurred.

Patients who underwent high intensity treatment programs had a 27% lower risk of death. There was no significant difference between low and medium intensity treatment plans. There was no link between rehabilitation and stroke severity.

The authors concluded that high intensity rehabilitation within the first 90 days after stroke was associated with a reduced mortality risk compared to low intensity rehabilitation.