COMPARING REHABILITATION OUTCOME IN STROKE PATIENTS, PRESENTING WITHIN AND AFTER THREE MONTHS POST STROKE

Rehabilitation Outcome in Stroke Patients

Abstract

Objective: To compare rehabilitation outcome in stroke patients, presenting within and after three months post stroke.
Study Design: Quasi experimental study
Place and Duration of Study: This study was carried out at Armed Forces Institute of Rehabilitation Medicine Rawalpindi (AFIRM) from 13th Jan 2010 till 5th May 2011.
Patients and Method: Ninety six stroke patients were enrolled. Rehabilitation plan was devised according to their potentials and problem list. Multidisciplinary team approach supervised by Rehab physician was offered that included physiotherapy, occupational therapy, speech therapy, psychotherapy and use of orthotics. Interventions were also carried out according to the need of patients like Phenol blocks (for focal spasticity, interfering with function), intra articular steroids injections (for joints pain, interfering with function). Rehabilitation interventions were given for three months and Barthel Index was used as outcome measurement. Patients Barthel Index score was documented at first visit and after three months of rehabilitation.
Results: A total of 96 patients were studied as per inclusion criteria. 57(59.38%) patients presented within three months post stroke (Group A) while 39 (40.62%) presented after three months (Group B). Average age of group A was 59.15 years (SD =13.3), while in group B it was 56.69 years (SD =11.7). There were 87.7% males in group A, while in group B males were 66.7%.50(52.08%) patients had right and 46(47.92%) had left CVA. 66(68.75%) were diagnosed cases of ischemic stroke while 30(31.25%) were having haemorrhagic stroke. Mean initial Barthel index score for Group A was 46.84 while final score after three months of Rehabilitation was 89.82 (p<0.001). For Group B mean initial Barthel index score was 63.58 and final score was 68.20 (p=0.007). Our interventions showed marked improvement in Group A in term of increased difference in mean initial and final Barthel index scores as compared to group B (p<0.001).
Conclusion: Earlier rehabilitation interventions in stroke patients result in better functional outcome as assessed by Barthel index.