Dose-response Rehabilitation Organized By Pror In Out-patients With Chronic Cerebrovascular Disorder: A single-center retrospective cohort study.

Purpose: We aimed to investigate whether out-patient rehabilitation with the same concept as physiatrist and registered therapist operating rehabilitation (PROr) would improve activities of daily living in out-patients with chronic cerebrovascular disorder and whether the improvements were related to the frequency and/or time of therapy.

Methods: Out-patients with chronic cerebrovascular disorder, who visited a clinic affiliated with a university hospital for at least a month between April 2010-September 2020, were retrospectively selected. Changes in the functional independence measure (FIM) from the first visit to the 12 month were calculated. Patients were stratified into two subgroups: improved and non-improved groups. The frequency and time of physical and occupational therapies and total rehabilitation were compared between the groups.

Results: Initially, 174 patients were selected and 125 were excluded based on the exclusion criteria. Three patients terminated rehabilitation because of improvements. In 18 of 49 patients, FIM improved at the 12 month by 4.9 [3.1-6.8] (mean [95% CI]). The frequency was ∼2 times/week with no differences between the groups. Physical therapy time/day was higher in the improved group (74.7 [66.7-82.7] min) than the non-improved group (50.7 [44.3-57.0] min; P<0. 001). The total rehabilitation time/day was 121.9 [107.8-136.0] min in the improved group, which was higher than the non-improved group: 97.9 [87.7-107.9] (P=0.001).

Conclusions: Approximately 40% of the patients displayed improved FIM even during the chronic phase, and the improved out-patients took PROr for at least 108 min/day and twice a week. A longer rehabilitation time would be reinforced by patients' motivation.