Introduction
Traditionally physiotherapy has been a weekday-rehabilitation for inpatients stroke, with limited service such as chest-physiotherapy at weekends and holidays. Extended weekend rehabilitation for stroke may improve patient care and outcomes by eliminating the interrupting pattern of stroke rehabilitation. Criterion for effective selection of appropriate candidates and feasibility of 365-day rehabilitation for weekend stroke rehabilitation in local context has not been formulated.
Objectives
This study aimed to evaluate correlations of total number of treatment-session of Physiotherapy and functional outcomes by using admission Functional Ambulation Classification (MFAC) stratifying patients into different level of mobility for stroke in Kowloon Hospital.
Methodology
Patients with stroke receiving weekday-rehabilitation admitted to Kowloon Hospital(KH) from October 2018 to December 2018 were recruited. Functional Ambulation Classification(MFAC) was used to stratify level of mobility on-admission. The score of Modified Barthel Index(MBI), Modified Rivermead Mobility Index(MRMI) and MFAC were rated by in-charge Physiotherapist on-admission and at-discharge. The change score of all outcomes were calculated. The total number of Physiotherapy-session during hospital stay in KH was assessed. Spearman’s rho correlation of SPSS 23.0 was used to analyze the correlations of change score of outcomes with total number of Physiotherapy session by using admission categories of MFAC.
Results & Outcome
Data from 46 patients with stroke aged 65.6±15.4 years were analyzed. 60.9% was male and 58.7% diagnosis of stroke from cerebral infarction and 41.3% from haemorrhage. All outcomes improved at discharged including gain score from MBI 23.3±13.2 (N=46), MRMI 9.7±5.9 (N=46) and MFAC demonstrated a median progression of 2 (N=46). The average total number of Physiotherapy-session was 23.1±11.0 (N=46). The total number of Physiotherapy-session were found to be significantly correlated with change score of MBI (ρ=0.86, p< 0.05), MRMI (ρ=0.97, p< 0.05) and with MFAC (ρ=0.764, p< 0.05), respectively in split group of category II admission MFAC. The significant strong associations uncovered between number of therapeutic-session and progression of functional outcomes in group of MFAC II suggested that prudent identified target clients for the upcoming 365-rehabilitation service for stroke would affect performance. The results warranted the feasibility of 365-day rehabilitation service for stroke and supported using MFAC as a user-friendly stratification tool.
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