EFFECT OF DELAYED POST-STROKE REHABILITATION PROGRAM ON PATIENT'S FUNCTIONAL OUTCOME

Abstract

Objective:

To examine the effects of delayed admission to rehabilitation on functional outcomes in post stroke patients.

Study Design: Observational study.

Place and Duration of Study: Department of Physical Medicine and Rehabilitation of Combined Military Hospital Kohat, from Sep 2016 to Sep 2017.

Material and Methods:

A total of 55 patients with age ranging from 20-80 years who were diagnosed with first ever stroke and reported within 150 days of the onset of stroke to rehabilitation setup were selected through non-probability purposive sampling. The patients were divided into 2 groups as early (group-A ≤30 days) and delayed admission group (group-B=30-150 days) based on the length of time from stroke onset to admission to inpatient rehabilitation facility. Reasons for delay admission were identified and noted. Functional independence measure (FIM) score was used to assess functional status of the patient at admission. Patients in both groups underwent identical eight weeks of regular rehabilitation program with therapy sessions 3 hours a day, 5 days a week. Functional independence measure score was noted again at eight week of indoor rehabilitation.

Results:

Total 52 patients completed the study with 27 (51.9%) male and 25 (48.1%) female. Lack of awareness of Rehabilitation was the most common patient related factor found in 11 (34.4%) while Lack of care giver support was most common external factor reported in 6 (18.7%). The patients with early admission to inpatient rehabilitation facility had a better functional independent measurement scores gain than the patients with delayed admission to inpatient rehabilitation facility (40.4 ± 11.4 vs. 11.9 ± 8.4, p=0.01). However, FIM scores at admission in both groups were not statistically significant.

Conclusion:

Delayed admission to inpatient rehabilitation facility after stroke event caused poorer functional outcomes in stroke patients.