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

Authors

  • Fan He John 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, Australia https://orcid.org/0000-0001-5696-0631
  • Irene Blackberry John 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, Australia https://orcid.org/0000-0003-4482-4936
  • Michael Njovu Rehabilitation Medicine Department, Albury Wodonga Health, Wodonga, Victoria, Australia; School of Clinical Medicine, University of New South Wales, Albury Campus, Albury, Australia https://orcid.org/0009-0006-7060-635X
  • David Rutherford Division of Medicine, Albury Wodonga Health, Albury, New South Wales, Australia https://orcid.org/0009-0006-6569-4797
  • George Mnatzaganian Rural Department of Community Health, La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Victoria, Australia https://orcid.org/0000-0002-7698-5091

DOI:

https://doi.org/10.2340/jrm.v57.42506

Keywords:

Australia, Delay, Rehabilitation, Regional, Stroke, outcomes

Abstract

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.

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Published

2025-08-05

How to Cite

He, F., Blackberry, I., Njovu , M., Rutherford , D., & Mnatzaganian, G. (2025). Delayed inpatient rehabilitation and functional outcomes for acute stroke: a retrospective cohort study in an Australian regional hospital. Journal of Rehabilitation Medicine, 57, jrm42506. https://doi.org/10.2340/jrm.v57.42506

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Vol. 57 (2025)

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Original Report

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Copyright (c) 2025 Fan He, Irene Blackberry, Michael Njovu , David Rutherford , George Mnatzaganian

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