| アブストラクト | To examine heterogeneity in the impact of increased early rehabilitation intensity and to identify which ischemic stroke patients benefit most. We analysed 39,140 propensity score-matched ischemic stroke patients using Diagnosis Procedure Combination database. Patients who received >/= 60 min of daily rehabilitation within the 14 hospital days were compared with those who received less, in terms of achieving a modified Rankin Scale (mRS) score of 0, 1, or 2 at 60 days. We employed a causal forest model to estimate individualized treatment effectiveness and assessed for heterogeneity in rehabilitation impact across subgroups. Patients in the highest-benefit quartile showed substantial functional improvement (mean Conditional Average Treatment Effect: +17.1%; 95% CI, 15.3-19.0%), characterized by severe baseline activities of daily living (ADL) impairment, age, fewer comorbidities, higher socioeconomic status, better consciousness, and higher rates of reperfusion therapy. Conversely, patients in the lowest-benefit quartile, typically older with moderate ADL impairment, high comorbidities, low socioeconomic status, and limited reperfusion therapy, showed minimal or negative benefit (-16.5%; 95% CI, -18.1% to -14.9%). Rehabilitation dosing impact varied substantially regarding functional ability, with patients having severe strokes, age, fewer comorbidities, and better baseline consciousness deriving the greatest benefit from increased rehabilitation dosing. |
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| ジャーナル名 | Scientific reports |
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| Pubmed追加日 | 2025/12/13 |
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| 投稿者 | Tani, Takuaki; Kanai, Masashi; Kamada, Masatoshi; Ide, Kazushige; Fushimi, Kiyohide |
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| 組織名 | Department of Pharmacoepidemiology, Showa Medical University Graduate School of;Pharmacy, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.;tanitakuaki1985@gmail.com.;Health Promotional Physical Therapy for Stroke Survivors: HEPPS, Strategic Issues;Resolution Commission, Japanese Society of Neurological Physical Therapy, Tokyo,;Japan. tanitakuaki1985@gmail.com.;Japan.;Institute of Transdisciplinary Sciences for Innovation, Kanazawa University,;Kanazawa, Japan.;Department of Stroke Rehabilitation, National Cerebral and Cardiovascular Center,;Suita, Japan.;Department of Community Building for Well-being Center for Preventive Medical;Sciences, Chiba University, Chiba, Japan.;Institute of Science, Tokyo Graduate School of Medical and Dental Sciences,;Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/41388015/ |
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