# Exploring Occupational Therapy Interventions for Heatstroke in Emergency and Critical Care Settings: A Retrospective Study

## TL;DR

This study examines how occupational therapy is used in treating heatstroke patients and finds it is more common in severe cases, with potential benefits for recovery.

## Contribution

The study provides the first retrospective analysis of occupational therapy interventions for heatstroke in emergency and critical care settings.

## Key findings

- OT was primarily used in severe (Grade III) heatstroke cases for daily living training and mobility support.
- OT was associated with longer hospital stays, likely due to greater illness severity.
- Patients with Grade III heatstroke had worse discharge outcomes and were more likely to be transferred to another facility.

## Abstract

Background

Heatstroke is a life-threatening condition, the incidence of which has been exacerbated by climate change and urbanization. Despite its increasing prevalence, rehabilitation for managing heatstroke, particularly occupational therapy (OT), remains underexplored.

Objective

This study aimed to investigate the implementation, characteristics, and effects of OT in patients hospitalized with heatstroke who were admitted to the emergency department.

Methods

We conducted a retrospective analysis of 49 patients diagnosed with heatstroke who were admitted to an emergency critical care center between July and September from 2019 to 2022. The patients were classified according to severity using the Japanese Association for Acute Medicine Heatstroke (JAAM-HS) criteria. Data on demographics, clinical outcomes, and OT interventions were collected. Statistical analyses included t-tests, chi-square tests, logistic regressions, and linear regressions.

Results

Among the 49 patients (median age: 72 years), 20 were classified as Grade II and 29 as Grade III. OT was primarily implemented in severe (Grade III) cases and focused on training in activities of daily living, neurological rehabilitation for cerebellar ataxia, and mobility support. Patients with Grade III heatstroke had significantly worse discharge outcomes (p = 0.006) and were more likely to be transferred to another facility. OT participation was not significantly associated with discharge destination but was associated with longer hospital stays (p = 0.003), likely reflecting greater illness severity. Age and sex were not significant predictors of the outcome.

Conclusion

This study highlights the variable implementation of OT in patients hospitalized with heatstroke and underscores the need for standardized rehabilitation protocols. Considering the potential for long-term neurological sequelae in severe cases, early and structured OT may support functional recovery. Further prospective studies are warranted to investigate the potential effectiveness of OT interventions and to develop evidence-based strategies tailored to illness severity.