Rehabilitation for patients after stroke in a tertiary hospital: is it early and intensive enough?

Background: This study aimed to evaluate the provision of rehabilitation to and the functional recovery of stroke survivors receiving acute care in a tertiary hospital. Methods: Analyses of medical records of stroke patients who were admitted to a main teaching hospital between the years 2006-2009. Variables studied were the demographics, clinical profiles, rehabilitation profiles and the patients' functional recovery at discharge, as measured on a modified Rankin Scale (mRS). Findings: Records of 557 patients; mean age 64 years, 53.7% females were analysed. Mean length of stay was 6.8 days SD=5.8 during which, 62.7% received daily rehabilitation. Mean time from stroke diagnosis to rehabilitation was 3.0 days SD=2.0; 51.0% of cases were seen after 48 hours of hospital admission. Rehabilitation was provided mainly by physiotherapy services to 71.6%, 64.7% and 52.5% of severe, moderate and mild cases, respectively. Mean mRS was 3.5, SD=0.9 and 53.0% had not regained any level of walking ability prior to discharge. Age and severity level significantly predicted mRS at discharge (F6,536=12.26, P<0.001). Conclusions: Provision of rehabilitation to acute stroke survivors in a tertiary hospital was sub-optimal. Establishment of dedicated stroke rehabilitation services is recommended to enable better functional gain in post-stroke survivors. [ABSTRACT FROM AUTHOR]