The Impact of Rehabilitation Frequencies in the First Year after Stroke on the Risk of Recurrent Stroke and Mortality.

BACKGROUND: Rehabilitation is essential for all poststroke patients to improve self-care ability. However, whether an increased frequency of rehabilitation reduces poststroke adverse events remains undetermined.

METHODS: We recruited 4899 patients with newly diagnosed ischemic stroke between January 1, 2000, and December 31, 2008, from our database and divided them into 3 groups according to their Charlson Comorbidity Index, and they were further categorized into 3 groups of different rehabilitation frequencies during their first year after stroke. Clinical adverse events including recurrent stroke, hip fracture, pneumonia, and all-cause mortality were analyzed by Cox regression analysis to investigate the protective effects of aggressive rehabilitation.

RESULTS: We discovered that aggressive rehabilitation in the first year after stroke was significantly associated with a lower incidence of recurrent stroke and all-cause mortality despite the severity of patients' comorbidities. Further Cox regression analysis revealed decreased hazard ratios to develop recurrent stroke and all-cause mortality in patients with more intensive rehabilitation (P for trend <.05). However, no significant associations between rehabilitation frequency and pneumonia and hip fracture were identified in our study.

CONCLUSION: Intensive rehabilitation during the first year after stroke should be recommended to prevent detrimental adverse events for stroke survivors.