Poster Presentation Australian and New Zealand Stroke Organisation Conference 2025

Comparison of rehabilitation interventions provided between inpatient and bed substitution programs to address self-care goals after stroke. (#132)

Sia Horrobin 1 , Laura Jolliffe 2 3 , Emma Schneider 4 5 , Jacqueline Wheatcroft 1 , Brittni Nielsen 1 , Karen Roberts 4 , Natasha A Lannin 6 7
  1. Occupational Therapy, Alfred Health, Melbourne, VICTORIA, Australia
  2. Department of Occupational Therapy, School of Primary and Allied Health Care, Frankston, VICTORIA, Australia
  3. Occupational Therapy , Peninsula Health, Frankston, VICTORIA, Australia
  4. Occupational Therapy, Monash University, Melbourne, Victoria, Australia
  5. Swinburne University, Melbourne, Victoria, Australia
  6. Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
  7. Occupational Therapy, Alfred Health, Melbourne, VICTORIA, Australia

Background/Aims

Bed substitution rehabilitation models are now common across Australia. Given the specialised nature of stroke rehabilitation, we sought to compare occupational therapy interventions for activities of daily living between home-based and inpatient programs with respect to the type, dose and location of the intervention/s provided.

Method

Retrospective file audit of home-based and inpatient rehabilitation between 01/01/2023-31/12/2023; cases were identified during the most recent Stroke Foundation Rehabilitation Audit. The audit checklist was developed using the Occupational Therapy Taxonomy of Rehabilitation Interventions and Functional Autonomy Measurement System. Descriptive statistics summarised details of therapy provided. Outcome measures included discharge destination and Functional Independence Measure (FIM) scores.  

Results

Total of n=69 files were audited (n=29 home-based; n=40 inpatient). Inpatient rehabilitation demonstrated greater FIM score improvements in both motor (mean improvement 12.13, 95% CI 4.15 to 20.10) and cognitive (2.71, 95% CI -0.51 to 5.93) compared to home-based rehabilitation. Intensity of occupational therapy rehabilitation  (dose, frequency) was greater in the inpatient rehabilitation setting. However, home-based rehabilitation offered more location-specific interventions integrated into daily routines. 

Conclusion

Inpatient rehabilitation programs provided higher intensity and greater functional gains, while home-based services provided better contextual rehabilitation in patients' daily environments. Findings may support clinical decision-making when considering individual needs for rehabilitation location.