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.
Patients with longer inpatient rehabilitation duration achieved significantly greater total-FIM and motor-FIM gains, while cognitive-FIM gain was not significantly associated with length of stay, suggesting that overall and motor recovery may benefit more consistently from longer inpatient rehabilitation duration.
Key Findings
Results
Total-FIM and motor-FIM gains were significantly lower in the short LOS group compared to the long LOS group.
The total sample of 400 stroke patients 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).
Mean age was similar across groups: 60.3 ± 14.3 years (short), 59.9 ± 13.8 years (moderate), and 60.1 ± 15.6 years (long LOS).
Multivariate linear regression analysis was used to explore the association between FIM scores and LOS.
The study was conducted at 2 tertiary centers with inpatient rehabilitation facilities in Riyadh city, using retrospective medical record data.
Results
Motor-FIM gain was also significantly lower in the moderate LOS group compared to the long LOS group.
The moderate LOS group (31-60 days, n=234) showed lower motor-FIM gain than the long LOS group (>61 days, n=32).
This finding indicates a dose-response relationship between rehabilitation duration and motor functional recovery.
The short LOS group showed the lowest motor-FIM gains among all three groups.
Motor-FIM is a subscale of the Functional Independence Measure assessing physical/motor aspects of independence.
Results
No significant association was found between LOS groups and cognitive-FIM gain.
Cognitive-FIM gain did not differ significantly across the short, moderate, and long LOS groups.
This contrasts with the pattern seen for total-FIM and motor-FIM gains, which both showed significant associations with LOS.
The authors note this suggests 'overall and motor recovery may benefit more consistently from longer inpatient rehabilitation duration' than cognitive recovery.
Cognitive-FIM is a subscale of the Functional Independence Measure assessing cognitive aspects of independence.
Methods
The study used a retrospective cohort design drawing on medical records from 400 stroke patients at two tertiary inpatient rehabilitation facilities in Riyadh.
Data were collected from existing medical records at 2 tertiary centers in Riyadh city with inpatient rehabilitation facilities.
Total included sample size was n=400 stroke patients who underwent an intensive rehabilitation program.
Functional outcomes were measured using the Functional Independence Measure (FIM), including total-FIM, motor-FIM, and cognitive-FIM.
Rehabilitation programs involved diverse interventions delivered through all rehabilitation therapies.
Multivariate linear regression analysis was the primary statistical method used to explore associations.
Results
Patients with longer rehabilitation duration achieved significantly greater total-FIM and motor-FIM gains, particularly compared with those in the short LOS group.
The long LOS group (>61 days, n=32) showed the greatest total-FIM and motor-FIM gains.
The short LOS group (≤30 days, n=134) showed the lowest total-FIM and motor-FIM gains.
The moderate LOS group (31-60 days, n=234) was intermediate for total-FIM gain but showed significantly lower motor-FIM gain than the long LOS group.
These findings support the premise that 'extended rehabilitation stay is associated with enhanced functional recovery.'
What This Means
This research examined whether the length of time stroke patients spend in inpatient rehabilitation is associated with how much functional ability they recover. Researchers looked back at medical records from 400 stroke patients treated at two hospitals in Riyadh, Saudi Arabia, dividing patients into three groups based on their rehabilitation stay: short (30 days or less), moderate (31-60 days), and long (more than 61 days). They measured functional recovery using a standard tool called the Functional Independence Measure (FIM), which assesses both physical/motor skills and cognitive abilities.
This research suggests that longer stays in inpatient rehabilitation were linked to greater improvements in overall function and physical/motor abilities. Patients who stayed the longest showed the biggest gains in both total and motor FIM scores, while those with the shortest stays showed the smallest gains. Interestingly, the length of rehabilitation stay did not appear to significantly affect improvements in cognitive function — suggesting that physical recovery may be more responsive to extended rehabilitation time than cognitive recovery.
These findings matter because they provide evidence from a Middle Eastern healthcare setting supporting the idea that longer inpatient rehabilitation programs may lead to better physical functional outcomes for stroke survivors. However, the retrospective nature of the study means that patients who stayed longer may have had different initial severity levels or other characteristics that also influenced their recovery, so the relationship may not be purely caused by the length of stay itself. This research could inform decisions about rehabilitation program duration for stroke patients in similar healthcare systems.
AlHarbi B, AlGarni F, AlWaqid T, AlShahrani M, AlShanqiti T, Alenazi A, et al.. (2026). 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.. Medicine. https://doi.org/10.1097/MD.0000000000050623