Despite evidence showing that structured rehabilitation after stroke improves functional outcomes, providing seamless rehabilitation from hospital to community has been elusive. The service provided should be able to accommodate variable degree of impairments and needs of the stroke survivors. This study aimed to assess the outcome of a multidisciplinary-based outpatient rehabilitation service for stroke patients living in the community. Patients who were discharged from Universiti Kebangsaan Malaysia Medical Centre after an acute stroke were referred to the Combined Stroke Rehabilitation Clinic (CSRC). Post stroke patients were assigned individually designed programs which were problem based and used task specific activities to achieve desired goals. Patients were reviewed on a regular basis either up to completion of the 2 year- program, or are able to be discharged to the community, whichever is earlier. Modified Barthel Index (MBI) and Berg Balance Scores (BBS) were used for monitoring. A total of 68 patients were managed in CSRC for two years since its initiation, with mean age of 62.4 years (SD 12.4) with the mean duration of stroke when first reviewed in CSRC was 11.5 months (SD 11.9). Majority of patients (64.7%) received either two or three types of intervention. Both MBI and BBS demonstrated significant improvement over 12-months period (p value of 0.006 and 0.017 respectively). CSRC proved that structured rehabilitation intervention was beneficial in terms of functional status and improvement in balance to post-stroke patients.
Structured Periodic Rehabilitation Intervention Sessions To Stroke Patients. A Longitudinal Review
Abstrak
Walaupun bukti menunjukkan rehabilitasi secara tersusun meningkatkan fungsi keseluruhan, kewujudan rehabilitasi secara berterusan dari hospital ke komuniti masih lagi belum direalisasikan. Perkhidmatan ini seharusnya mengambilkira pelbagai jenis ketidakupayaan and keperluan pesakit-pesakit strok itu sendiri. Kajian ini bertujuan untuk mengkaji kesan perkhidmatan pesakit luar rehabilitasi pelbagai displin untuk pesakit strok di dalam komuniti. Pesakit yang telah didiscaj dari Pusat Perubatan Universiti Kebangsaan Malaysia selepas mengalami serangan strok akut dirujuk kepada Klinik Strok Bersepadu Rehabilitasi (KSBR). Pesakit strok diberikan program bersifat individu yang berpandukan masalah pesakit serta menggunakan aktiviti berpandukan perkerjaan bagi mencapai objektif yang ditetapkan. Pesakit dipantau secara berkala samada sehingga cukup 2 tahun didalam program, ataupun sehingga mereka boleh kembali berdikari dikomuniti. Pemantauan di lakukan menggunakan ‘Modified Barthel Index’ (MBI) dan ‘Berg Balance Scale’ (BBS). Seramai 68 pesakit dirawat di KSBR selama 2 tahun, dengan purata umur 62.4 tahun (SD 12.4); purata tempoh telah menghidap strok semasa pemeriksaan pertama di KSBR ialah 11.5 bulan (SD 11.9). Majoriti pesakit (67.4%) mendapat samada dua atau tiga jenis intervensi rehabilitasi. Pengukuran MBI dan BBS menunjukkan peningkatan berkesan dalam masa 12 bulan (nilai p 0.006 dan 0.017). KSBR membuktikan intervensi rehabilitasi secara tersusun berfaedah untuk meningkat fungsi fizikal dan keseimbangan badan pesakit-pesakit strok.
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Related Images
a.jpg "Figure 1: Clinical pathway for patient attended the CSRC program")
b.jpg "Figure 2: Types of rehabilitation intervention received by stroke patients in CSRC")
table1.jpg "Table 1: Demographic and clinical profile of stroke patients attending Combined Stroke Rehabilitation Clinic")
table2.jpg "Table 2: Progress of patients over time based on Modified Barthel Index and Berg Balance Score")
