Rehabilitation of stroke patients in Satakunta district – 1-year follow-up

Background Stroke survivors are estimated to benefit from multidisciplinary rehabilitation within the first year after onset of symptoms. The aim of this study was to assess how the stroke rehabilitation process is carried out in practice.

Methods Retrospective study based on the patient registry data. All patients diagnosed with stroke or TIA (I60­I64, G45) in 9/2018­8/2019 in Satakunta Central Hospital were included in the study.

Results Most improvement occurred in functional abilities (according to FIM, mRS) and most outpatient therapy was recommended in the multidisciplinary rehabilitation unit in Satakunta Central Hospital (14 % of patients) compared to other rehabilitation/treatment units. Overall, 32 % of stroke patients were advised to continue outpatient therapy and were set a rehabilitation goal. Within the first year, 22 % of patients received outpatient therapy. After acute care, 32 % of stroke patients continued rehabilitation in multidisciplinary rehabilitation units in Satakunta Central hospital and the primary care Rehabilitation Ward. Sixty-nine percent of patients were functionally independent at discharge from rehabilitation units. Within the first year, 16 % of TIA patients had a new TIA, 5 % had a new stroke and 19 % were diagnosed with another significant disease.

Conclusions Stroke patients in Satakunta received less community-based rehabilitation than suggested by the Finnish Brain Association. We found inequality in receiving rehabilitation and availability of therapy resources. There are no systematically used common measures to assess the benefit of rehabilitation. Consistent care practices and common quality measures are needed to develop clinical pathways and outpatient rehabilitation services. We believe that a quality registry of rehabilitation would enable development of a cost-effective clinical pathway. 

Aet Ristmägi, Vilma Tikka, Vuokko Lampinen-Laine, Hannu Heikkilä