Abstract
Stroke represents the main cause of functional dependence and in the Portuguese adult population. Objectiveto analyse the impact of rehabilitation on functional state and basic activities of daily life (ABVD), 8 weeks following a stroke, in a population of elderly people in north-western Portugal. MethodologyObservational, longitudinal and retrospective study. The patients were grouped into 3 groups according to the rehabilitation treatment received: Non-rehabilitation (NR), light rehabilitation (RL) and intense rehabilitation (RI).Sociodemographic data, clinical variables (on stroke), hospital stay, rehabilitative treatment, and functional status (Barthel Index) were collected. Results350 patients, with a mean age of 75.83 (±8.02) years. The hospital stay was longer in the group of RL (19.7 (±8.69)), RI (17.67 (±10.05)) and of those who did not undergo rehabilitation (10.97 (±6.96)), (p = .001).A significant increase (p < .001) was observed in the Barthel index scores from admission to 8 weeks after the stroke.Age (p = .003) and hospital stay (p = .013) were shown as risk factors for functional dependence. Similarly, taking as a reference the patients who did not undergo rehabilitation, the subjects who underwent light rehabilitation (OR (95% CI): 6.37 (1.74−23.25), p = .005) and intensive rehabilitation (OR (95% CI): 2.28 (1.08−4.82, p = .030), had a significantly higher risk of presenting functional dependence Conclusionundergoing intensive rehabilitation improves functional state and ABVD compared to light rehabilitation, 8 weeks following a stroke in elderly patients.
Highlights
Stroke is presently one of the major causes worldwide of disability and death.[1]
The length of hospital stay was longer in the group of patients who received light rehabilitation (19.76 [± 8.69]), followed by the group of Intense rehabilitation (17.67 [± 10.05]) and those who did not carry out rehabilitation (10.97 [± 6.96]), with significant differences existing between them (p = .001)
Significant differences were found between the 3 rehabilitation groups received at the 3 moments of functional dependence assessment (p < .001), with the patients who received light rehabilitation in all cases being those with the lowest scores, followed by those of intense rehabilitation and no rehabilitation
Summary
Stroke is presently one of the major causes worldwide of disability and death.[1]. In Europe, 1.3 million people suffer from a first stroke every year, and the socioeconomic impact is high: estimated at approximately 45 billion Euros.[2]. The decrease in mortality is partly due to advances in the treatment of stroke and the measures used during the last few years for early diagnosis and treatment of cerebrovascular disease.[7] These advancements in the treatment of stroke are essentially based on early neurological care, admittance to stroke units, the application of fibrinolytic treatment in stroke and rehabilition therapy. Rehabilitation therapy has the broadest therapeutic window: it may be applied both to ischaemic and haemorrhagic stroke, improve functional prognosis even several months after the stroke has occurred and reduce costs associated with the disease.[8]
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