Exploring the association between functional gains and length of stay for stroke patients in 2 inpatient rehabilitation facilities in Riyadh city A retrospective cohort study

Stroke remains an important healthcare issue globally, as it causes substantial morbidity and mortality in the population. The relationship between length of stay (LOS) and the functional outcomes of stroke rehabilitation has become an increasingly important area of investigation. Substantial research supports the idea that an extended rehabilitation stay is associated with enhanced functional recovery. This study aimed to explore the relationship between functional recovery, measured using the functional independence measure (FIM), and the LOS, and to analyze the possible predictability of functional recovery by the LOS for stroke patients who underwent an intensive rehabilitation program at the inpatient rehabilitation facility. This retrospective cohort study utilized existing data from the medical records of stroke patients who had undergone an intensive rehabilitation program at 2 tertiary centers in Riyadh city with an inpatient rehabilitation facility. Multivariate linear regression analysis was used to explore the association between FIM scores and LOS. The total included sample was subdivided according to LOS to explore the association between the FIM and other sample demographics and clinical characteristics. A total sample size of 400 was divided into 3 groups: short LOS (<= 30 days) (n = 134), moderate LOS (31-60 days) (n = 234), and long LOS (> 61 days) (n = 32), with mean standard deviation age of 60.3 +/- 14.3, 59.9 +/- 13.8, and 60.1 +/- 15.6 years, respectively. Total-FIM and motor-FIM gains were significantly lower in the short LOS group than in the long LOS group, while motor-FIM gain was also significantly lower in the moderate LOS group. No significant association was found between LOS groups and cognitive-FIM gain. Rehabilitation programs involved diverse interventions delivered through all rehabilitation therapies. Patients with longer rehabilitation duration achieved significantly greater total-FIM and motor-FIM gains, particularly compared with those in the short LOS group. Moderate LOS was also associated with lower motor-FIM gain than long LOS. In contrast, cognitive-FIM gain was not significantly associated with LOS, suggesting that overall and motor recovery may benefit more consistently from longer inpatient rehabilitation duration.