Authors (including presenting author) :
Cheng YF(1), Leung YY(1), Chui KW(1), O HH(1), Wong CM(1), Sham PK(1), Wong YB(1), Choi YY(1), Lau SC(1)
Affiliation :
(1)Physiotherapy Department, Princess Margaret Hospital
Introduction :
Physiotherapy plays an important role in stroke rehabilitation to promote functional mobility and minimize disability of stroke survivors. In the multi-disciplinary Geriatric Day Hospital (GDH) of Princess Margaret Hospital (PMH), physiotherapists provided tailor-made rehabilitation programme for stroke patients, which included structured exercise regime, electrophysical adjunctive treatments, virtual reality trainings, stroke empowerment talks, care-giver education and home exercise programmes, to regain function and facilitate social re-integration of stroke patients.
Objectives :
This review aimed to investigate the effectiveness of stroke rehabilitation on the functional mobility of stroke survivors attending GDH in PMH.
Methodology :
Patients who had a diagnosis of CVA (ICD 9 codes 430-436.99) as their recent diagnosis and had more than 1 attendance in GDH during 1st April 2019 to 31st March 2020 were included in this review. Clinical outcome data, which included Modified Functional Ambulation Classification (MFAC), Modified Rivermead Mobility Index (MRMI) and Timed Up and Go test (TUG), of included patients were extracted from the Clinical Management System and analysed retrospectively. The outcome data of a patient would be excluded if the data set were incomplete, i.e., either the pre- or post-test result was missing.
Result & Outcome :
Clinical outcome data of 247 patients who had a recent diagnosis of CVA were included. The mean duration between the first and the last attendance in GDH was 83.5±49.1 days. After excluding incomplete data, the MFAC, MRMI and TUG data of 184, 152 and 144 patients respectively were analysed. Shapiro-Wilk test indicated all outcome data deviated from normal distribution (p< 0.05) and Wilcoxon Signed Ranks Test was used to compare the outcome data. Upon discharge, significant improvements in MFAC, MRMI and TUG were observed (p< 0.001). The mean increases in MFAC and MRMI were 0.614±0.708 and 3.83±3.56 respectively. The mean reduction of time in TUG was 8.03±16.3 seconds. The number of lyers or sitters (MFAC I-II) decreased by 36.4% and the number of assisted walkers (MFAC III-V) reduced by 28%. The number of independent walkers (MFAC VI-VII) increased by 200%. The improvement in MRMI and the reduction in TUG time exceeded their respective minimal detectable changes (2.2 for MRMI and 2.9 seconds for TUG). The results suggested that the stroke rehabilitation service in GDH was effective in promoting functional mobility of stroke survivors as reflected by the increased MFAC and MRMI. The reduction in TUG time represented lower fall risk of stroke survivors after GDH rehabilitation.
