Association of physiotherapy dose with motor recovery in early subacute phase after stroke: results from a multicenter Italian study

Introduction: The literature investigating the factors associated with functional recovery after stroke suggests that, in the early subacute phase, time is the factor that most significantly drives the recovery. However, it is unclear whether the dose of physiotherapy (PT) delivered is equally associated with recovery of motor function and independence. Methods: A multivariable modeling of data from a multicenter longitudinal prospective cohort study investigating the contents of neurological PT interventions in Italy was developed, with the aim to estimate the association between the dose of PT received in the early subacute phase after stroke and recovery of walking, motor function, and independence. Results: A total of 96 patients were included in the analyses. PT dose seems associated with recovery of manual dexterity, measured by the Box and Block test (BBT), but not with the level of independence nor walking function. The probability of achieving a score higher than 31 at the BBT is 46% (95%CI: 18-76) after 10 hours and 76% (95%CI: 42-93) after 20 hours of PT, respectively. Conclusions: In the early subacute phase after stroke, the higher the dose of PT provided, the better the probability of significant recovery of upper limb (UL) dexterity should be.