http://www.neurology.org/content/88/16_Supplement/P5.295.short
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Neurology April 18, 2017 vol. 88 no. 16 Supplement P5.295
- Abstract
Abstract
Objective: To assess the feasibility of integrating post-stroke rehabilitation and recovery guideline assessment during the outpatient
post-stroke follow-up visit.
Background: While a
large focus of post-stroke follow-up is secondary prevention, many
patients experience fatigue, depression, cognitive
and rehabilitation challenges requiring
attention. In May 2016, the AHA/ASA issued guidelines(not protocols) on adult stroke
rehabilitation
and recovery integrating objective assessments
and treatment recommendations. Ensuring these aspects of care(not results) are
adequately
addressed by the provider during follow-up can
be challenging, particularly in mild stroke patients.
Design/Methods: After
IRB approval, a prospective collection of rehabilitation and recovery
parameters for all patients seen in the stroke
clinic after hospital discharge was performed
using a structured questionnaire format completed by trained research
personnel.
Metrics including clinical parameters, stroke
severity, modified Rankin Scale, Patient Health Questionnaire 9, Fatigue
Assessment
Scale, Montreal Cognitive Assessment, and
rehabilitation status including ability to drive, return to work, and
sexual dysfunction
were collected.
Results: Thus far, 37
patients were surveyed with each assessment averaging 15 minutes.
Patients were 60% male with mean age of 65+/−
14.4 years. Despite low mean NIHSS (1 +/−2) and
MoCA score of 25 (+/−3), approximately 16% had clinical depression, 10%
had
mildly depressive symptoms, and 38% complained
of post stroke fatigue. Furthermore, 41% could not return to driving.
Roughly
64% of patients were assessed within 3 months of
stroke and 36% >3 months. All but 4 patients required assistance in
completing
the survey.
Conclusions:
Significant post stroke fatigue, depression and rehabilitative
challenges are prevalent, even in patients with mild stroke.
Utilizing a structured assessment tool with
dedicated personnel is a feasible and sensitive method in evaluating
post stroke
patients and guiding management, particularly
those with mild disability.
Disclosure: Dr. Taboada has nothing to disclose. Dr. Taboada has nothing to disclose. Dr. Nouh has nothing to disclose.
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