Abstract
To investigate the pattern of referral for and utilisation of physiotherapy in the continuum of stroke care at a tertiary hospital in Ibadan, Nigeria. Referral notes and medical records of patients admitted in the University College Hospital, Ibadan with a clinical diagnosis of stroke between January, 2009 and December, 2013 were retrospectively reviewed. Information on age, sex, type of stroke, length of hospital stay, referral for physiotherapy and utilisation of physiotherapy were retrieved. Data were summarised using descriptive statistics and analysed using Chi-square test. A total of 783 patients with stroke were admitted in the hospital during the period under study. The in-patient mortality rate was 37.2%. The mean Length of Hospital Stay (LoHS) was 16.17±12.34 days. Referral rate for physiotherapy was high (75.8%) and the mean time from admission to referral for physiotherapy was three days. Majority of patients referred utilised physiotherapy (63.4%) and mean number of physiotherapy sessions received during in-patient care was 8.69±6.45. There was a significant association between LoHS and utilisation of in-patientphysiotherapy (p=0.02). The referral rate of stroke patients for physiotherapy was relatively high. Utilisation of in-patient physiotherapy reduced length of hospital stay among patients with stroke. Utilisation of out-patient physiotherapy was low. Strategies to enhance out-patient utilisation should be explored.
Highlights
Stroke is a major public health problem, and a leading cause of adult disability and Disability Adjusted Life Years (DALY) loss[1,2] in low and middle income countries
Less than two-thirds (62.8%) of the stroke patients admitted in the hospital survived the stroke event giving an in-patient mortality rate of 37.2% for the period studied
This study examined the proportion of stroke patients admitted in a tertiary hospital referred for physiotherapy and the proportion that utilised physiotherapy
Summary
Stroke is a major public health problem, and a leading cause of adult disability and Disability Adjusted Life Years (DALY) loss[1,2] in low and middle income countries. Rehabilitation following a stroke begins during the acute phase of hospitalization as soon as the diagnosis of stroke is established and life-threatening problems are under control[3,4]. Initiation of rehabilitation procedures can enhance return of neurological function, reduce stroke-related disability, improve long term outcome and quality of life among stroke patient[5,6,7]. Physiotherapy, a key component of stroke rehabilitation[9] focuses on the recovery of physical function for stroke survivors[10,11,12] and plays a positive role in enhancing independent living[13]. Early mobilization and functional training provided by physiotherapists were considered the most important aspect of acute treatment in a Stroke Unit[17]. Timely access to physiotherapy is valuable to the persons concerned, their families and society as a whole[15]
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