Stroke rehabilitation: Benefits of carry over programme in subacute care

Background & Hypothesis: In subacute stroke rehabilitation emphasis is put on acquisition and not application of skills. This study attempts to show the effectiveness of carry over effect from ward practice. Methods: Twenty-five subacute stroke patients were met the selection criteria and randomly assigned to control and intervention wards. Same amount of therapist time were given to the 2 groups of patients. Nursing team from the intervention ward will hand over bathing, transferring, feeding, grooming or toileting tasks to the therapy assistant to practice the new skill daily. Data were collected at baseline and week 3. Results: From T-test, intervention group has shown significant difference after three weeks of therapy intervention from Motor Activity Log Amount Scale (P = 0.000), Motor Activity Log How Well (P = 0.001), Action Research Arm Test (P = 0.05), Physiotherapy Clinical Outcome Variables (P = 0.000), Berg Balance Scale (P = 0.000) and Modified Barthel Index (P = 0.000). However, there is no significant difference in the control group in all the areas except Modified Barthel Index (P = 0.05). Discussion & Conclusion: Although both groups shows significant improvement in Modified Barthel Index (basic activity of daily living), intervention group achieved far more improvement (improved 17.32%) then control group (improved 9.8%). Focusing on the carry over practice for inpatient rehab could achieve better result from stroke arm usage, mobility, balance and activity of daily living.