Evaluation of Stroke Rehabilitation Services in the in-Hospital Phase: Findings From a Tertiary Care Centre in India

Abstract

Background- Stroke rehabilitation involves a multidisciplinary team providing comprehensive care to the patient.(1) The functioning of Stroke Units (SU), the highest evidence available for stroke care, is guided by the World Stroke Organisations (WSO) roadmap of core recommendations and key quality indicators.(2) Objectives- To evaluate the quality of stroke rehabilitationin comparison to the WSO core recommendations at a tertiary care centre in India Methodology-A mixed method design with an exploratory research model was used. The study was conducted in 2 phases including retrospective data extraction from medical records and telephonic follow-up on the patients functional status and adherence to physiotherapy post-discharge. 84 patient records (those admitted between Jan –June 2021) were screened. Data was extracted from 49 patient files that fulfilled inclusion criteria. 35 patients were excluded due to unavailability of patient files, non-stroke related hospital admissions. In Phase 2, qualitative data was gathered using telephonic interviews, from 7 patients who consented for the same. Results- The mean age of the sample was 56.9 ±13years with approximately two third being males and a predominance towards ischaemic strokes (62%). Those with severe impairment on Fugl Meyer assessment were 28% of the sample. It was observed that there was inconsistent documentation of various core recommendations provided by WSO (<20%) while 16% of the services provided were not documented at all. Only two of the five key quality indicators of stroke rehab were documented.