Abstract Details

Title A protocol for acute neurofunctional rehabilitative therapy following ischemic stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-040

Objective To assess the safety and feasibility of a structured multi-step neurofunctional rehabilitative therapy protocol as an early intervention for ischemic stroke.

Background Although the benefits of early rehabilitation following stroke seem intuitive, the literature surrounding this topic has resulted in mixed findings. Part of the controversy relates to definitions of early and types of therapy employed. In light of limited public health resources and staff in Brazilian hospitals, we sought to test the safety and feasibility of delivering a standardized neurofuncional rehabilitation protocol at a large urban public hospital in Brazil.

Design/Methods Patients were recruited from Hospital Geral de Fortaleza following acute ischemic stroke and assigned to receive neurofunctional therapy at a stroke unit within 72 hours of ictus and daily until hospital discharge. Therapy protocol included exercises of postural education, reach, balance, mobilization, sensory stimulation, functional exercises with household objects, proprioception, and grip involving gross and fine motor skills. Exclusion criteria included age >80, NIHSS >20, and hemorrhagic stroke.

Results 144 patients (37% F) with mean age of 60.9 (SD=13.3) completed the study. 58% received tPA and 15% had a previous ischemic stroke. Baseline assessments were: NIHSS M=9.7 (SD=6), Functional Independence Measurement M=74.6 (SD=28.4), Modified Rankin Scale M=4 (SD=1). Time to initial therapy session was 33.1 hours (SD=12), the length of each session was 36.1 minutes (SD=4.2), and total sessions were 4.3 (SD=2.8). Multiple regression analyses revealed a significant effect of age on functional improvement and of rehabilitation therapy on upper extremity strength recovery. The number or duration of sessions was not associated with any complications or worsened outcomes.

Conclusions It is feasible to employ a standardized rehabilitation protocol in a busy lower resource public hospital setting. Importantly our early intervention was not associated with any adverse events in this sizable sample.

Authors/Disclosures
Gizely N. Andrade, PhD PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Fabricio Oliveira Lima	No disclosure on file
Fernanda M. Maia, MD, PhD (Hospital General De Fortaleza)	Dr. Maia has nothing to disclose.

��ɫ��

��ɫ��