Authors (including presenting author) :
Cheung SY(1), Chiang KH(1), Ho KF(1), Chan KY(1)
Affiliation :
(1) Department of Physiotherapy, Shatin Hospital
Introduction :
Stroke is the main cause of disability in Hong Kong leading to impairment in functional mobility and loss of independence in daily living. Thus, multidisciplinary comprehensive stroke rehabilitation serves an important role in regaining functional independence. For physiotherapy domain, neuromuscular facilitation is applied for muscle strengthening, mobility training and balance enhancement. Pain relief modalities may be applied as indicated. To evaluate the effectiveness of stroke rehabilitation program in stroke ward (4CD) of Shatin Hospital (SH), patients’ data and outcomes should be regularly reviewed for continuous monitoring and improvement.
Objectives :
To evaluate the effectiveness of stroke rehabilitation program in Physiotherapy aspect in stroke ward of SH for better service planning and service enhancement.
Methodology :
Patients admitted stroke ward (4CD) in SH with a diagnosis of stroke were recruited into stroke rehabilitation program. Outcomes related to physical health and mobility including Modified Functional Ambulation Category (MFAC), Modified Rivermead Mobility Index (MRMI), and Berg Balance Scale (BBS) were assessed upon SH admission and discharge. Stroke patients who were discharged from the Shatin hospital stroke rehabilitation program between 1st April 2017 and 31st March 2018 were extracted for this evaluation.
Result & Outcome :
There was a total of 257 stroke patients discharged from stroke ward within 1st April 2017-31st March 2018. There are 136 and 121 male and female patients respectively. Infarction contributed to 85% of total stroke patients while hemorrhage contributed 15% of total stroke patients. The mean age of stroke patient in 4CD is 73.1±12.4 years old. The average length of stay is 28.3±20.4 days. There is a statistically significant improvement in average ambulatory mobility changed from 3.11±1.45 to 3.96±1.62 upon discharge (P<0.000). Their functional mobility and balance were also shown statistically significant improvement in terms of average MRMI (from 17.20±9.02 to 23.13±11.2) and average BBS (from 17.54±16.20 to 23.21±18.73) respectively. (p<0.000) Patients who participated in stroke rehabilitation improved significantly in their functional mobility and balance. According to the result, patients classified into assisted walker (MFAC category 3 and 4) upon admission were the most beneficial group from the program. Hence, rehabilitation should be more intensive to these patients for more pronounced outcomes. Furthermore, the evaluation is suggested to be done annually for continuous monitoring purpose.
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