A Cross-Sectional Study of Rehabilitation Training Intensity and Physical Restraints in Patients With Neurocognitive Disorders in an Acute Care Hospital

Background In 2016, the Japanese health insurance system introduced a new dementia care incentive requiring clinical rounds by a dementia care team to promote dementia care in acute hospitals. Due to the nature of acute care, this round is conducted for all patients with neurocognitive disorders, including those with delirium and dementia. Both physical and psychological interventions are important, but the status of physical interventions for these patients is still unclear. This study investigated the current status by focusing on the intensity of rehabilitation training and the level of physical restraint as indicators of physical interventions. Methods Data from dementia care team rounds conducted between July 1, 2021, and October 7, 2024, were reviewed for relationships between clinicopathological characteristics, training programs for rehabilitation treatment, and physical restraint status. Results A total of 596 patients with neurocognitive disorders underwent 1,987 consultations. Patients with dementia, delirium, and a combination of the two were included. By disease groups, the frequency of consultations was higher than average for disuse, cardiovascular, and respiratory diseases, but lower for cerebrovascular, cancer, and musculoskeletal diseases. The training intensity was primarily level 1 (in-bed exercise) or level 5 (gait training) across all groups. A statistically significant relationship was observed between the disease group and the training intensity (p < 0.0001). The physical restraint (PR) level was significantly associated with the intensity of training in rehabilitation therapy (p < 0.0001). Conclusions The incidence of neurocognitive disorders varied according to the disease group. This intensity correlated with the number of patients subjected to physical restraint. To establish a care system, we should consider the characteristics of disease groups.