Efectividad de un tratamiento fisioterápico asociado a un programa educativo en el ictus cerebral agudo

Abstract

ObjectiveTo evaluate the effect of physiotherapy associated with a health education programme for patients with acute cerebral stroke, during the first follow-up month of the condition. The evaluation is based on neurological, motor, functional and social scales. Material and methodPragmatic quasi-experimental study of fifty patients hospitalised with acute stroke and given physiotherapy in hospital, in association with a health education programme. Subjects were evaluated at baseline and after one month of treatment, with respect to functional outcome variables, according to the Canadian Neurological Scale (CNS), the Trunk Control Test (TCT) and the Motricity Index (MI), and with respect to clinical variables, according to the Barthel Index (BI), the Stroke Impact Scale-16 (SIS-16), the Modified Rankin Scale (MRS) and the Multidimensional Scale of Perceived Social Support (MSPSS). ResultsStatistically significant differences were found for all functional and clinical variables except MSPSS (P<.0001 for CNS (t=5.945), TCT (t=7.701), lower-limb MI (t=5.676), BI (t=5.360) and SIS-16 (t=4.809); p=0.001 for MRS (t=-3.503); P=.01 for upper-limb MI (t=3.767)). The size effect measured by Cohen's d was large for CNS (1.26), TCT (1.20), BI (1.06) and SIS-16 (0.95), moderate for lower-limb MI (0.67), small for upper-limb MI (0.47) and zero (0) for MRS. ConclusionsAfter one month, physiotherapy associated with a health education programme achieved improvements in the condition of patients with acute stroke, raising outcome scores by 20% according to CNS, thus confirming our hypothesis in this respect.