Authors (including presenting author) :
Leung CT, Lau LY, Siu CH, Man WK, Yu CH, Yung WS
Affiliation :
Physiotherapy, Caritas Medical Centre
Introduction :
Rising incidence of stroke among younger individuals (~30%) highlights the need for specialized rehabilitation programs. A significant number of stroke patients under 65 years old are referred to geriatric day hospital (GDH) in Caritas Medical Centre (CMC) after inpatient rehabilitation. They face challenges with impaired gait patterns upon community reintegration. Young stroke rehabilitation is different because of expected better likelihood of neurological recovery and relatively unique social issues for younger patients. Recognizing their unique needs, rehabilitation programs must address not only physical impairments but also vocational considerations. Therefore, Young Stroke Rehabilitation program was established since May 2022 for better community reintegration.
Objectives :
(1) To provide individualized training to young stroke patients (2) To improve gait pattern and balance (3) To help them reintegrate into community
Methodology :
Inpatient physiotherapists screen out potential young stroke patients and inform case MO for GDH referral upon discharge. GDH physiotherapists recruited patients based on the following factors: (1) Onset of CVA < 6 months, (2) MFAC ≥ IV, (3) Age ≤ 65, (4) Cognitive competence, (5) Motivation, (6) Family support, (7) Patients’ goal, and (8) Rehabilitation potential. Upon thorough assessment, their problems are identified, treatment plan will be formulated and reviewed regularly. The training frequency is 2 sessions per week. Recovery instead of compensatory approach is used to facilitate normal pattern in various functions. Interventions emphasize sensorimotor impairment, mobility, functional abilities, and vocational needs. The primary outcome measure is the patients’ ability to return to their previous job or role. The secondary outcomes are mobility status, Modified Rivermead Mobility Index (MRMI), Modified Functional Ambulation Classification (MFAC) and Berg Balance Scale (BBS).
Result & Outcome :
20 patients were recruited. (1) 55% returned to their previous roles or jobs. (2) All could walk without physical assistance. (3) 80% could walk unaided. (4) Non-parametric Wilcoxon signed-rank test revealed significant improvement (p<0.05) in MRMI, MFAC and BBS.
