Physiotherapy and occupational therapy staffing in day services slows functional decline over two years, Japanese cohort finds

A retrospective longitudinal cohort study used propensity-score matching to compare 24-month trajectories of activities of daily living (ADL) among 1,908 community-dwelling older adults in Japan who continuously used adult day services for at least 24 months, divided between services staffed with physiotherapists and occupational therapists and services without rehabilitation professionals Primary Study. After matching, 954 participants in each group were compared using a validated functional independence measure, assessed at baseline and at 6, 12, 18 and 24 months.

Both groups showed significant functional decline over 24 months, but deterioration occurred earlier in the unstaffed group, and by 24 months the physiotherapy/occupational-therapy-staffed group showed significantly smaller declines in both overall functional independence and transfer ability specifically — differences that exceeded the minimal detectable change threshold, indicating the difference is clinically as well as statistically meaningful.

This is a matched observational cohort, not a randomised trial, conducted within Japan’s long-term care day-service system; the authors themselves call for further research to clarify the specific mechanisms driving the effect and its longer-term outcomes.

The finding adds to a growing evidence base that allied health professional presence itself — not only the content of what is delivered — is an active driver of functional preservation in community and day-service settings. For services designing or funding day-service provision, this is direct evidence that physiotherapy and occupational therapy staffing is a plausible lever against functional decline, falls risk and downstream hospitalisation, relevant wherever day-service staffing models are being reviewed.