22. European Stroke Conference 588 © 2013 S. Karger AG, Basel Scientific Programme 33 Rehabilitation and reorganisation after stroke The synergistic effects of mirror therapy and functional electrical stimulation on hand func-tion in severe stroke patients K.L. Joa1, W.H. Kim2, J.H. Min3 Department of Rehabilitation Medicine, Pusan National University School of Medicine, Yan-san- si, SOUTH KOREA1, , , SOUTH KOREA2, , , SOUTH KOREA3 Background: To investigate the synergic effects of mirror therapy and functional electrical stimula-tion (FES) on hand function in severe stroke patients Method: Thirty patients with severe hemiplegia after stroke were included (13 males and 17 fe-males, average age 63.3years). Ten patients had FES applied and simultaneously underwent mirror therapy. Ten patients had FES applied only, and ten patients underwent mirror therapy only. Each treatment was done five days per week, 30 minutes per day, for four weeks. FES was applied on the surface of the extensor digitorum communis, flexor carpi radialis, biceps brachii, and triceps brachii for hand and arm motion. Muscle tone, Fugl-Meyer assessment, box and block test, and 9-hole peg-board test were evaluated before and after treatment. Result: There were significant improvements in the Fugl-Meyer assessment score in the wrist, hand, arm and coordination, as well as power of wrist and hand in all groups after treatment. The mirror combined with FES group showed significant improvements in the box and block test and the Fugl-Meyer scores of hand, wrist, arm, coordination and power of hand extension, flexion, el-bow flexion compared to the other groups. However, the power of elbow extension and 9-hole test showed no significant differences among the three groups. Muscle tone also showed no significant differences in the three groups. Conclusion: Our results showed that there is a synergic effect of mirror therapy and FES on hand function.Therefore, a hand rehabilitation strategy combined with FES and mirror therapy may be more helpful for improving hand function in stroke patients than FES or mirror therapy only. 32 Rehabilitation and reorganisation after stroke Early Supported Discharge for Stroke Patients in Singapore: Patients Characteristics, Clinical Progress and Long-term Outcome J.Q. Yong1, L.X.M. Lim2, S.S. Ong3, I.L. Yeh4, A.M.W. Ling5, Y.J. Liang6, F.H.W. Kee7, B.P.L. Chan8 Department of Rehabilitation, National University Hospital and National University Health System, Singapore, SINGAPORE1, Department of Rehabilitation, National University Hospital and National University Health System, Singapore, SINGAPORE2, Department of Rehabilitation, National University Hospital and National University Health System, Singapore, SINGAPORE3, Department of Rehabilitation, National University Hospital and National University Health System, Singapore, SINGAPORE4, Department of Rehabilitation, National University Hospital and National University Health System, Singapore, SINGAPORE5, Department of Rehabilitation, National Uni-versity Hospital and National University Health System, Singapore, SINGAPORE6, Department of Rehabilitation, National University Hospital and National University Health System, Singapore, SINGAPORE7, Division of Neurology, National University Hospital and National University Health System, Singapore, SINGAPORE8 Objective: Rehabilitation in the home environment provided by early supported discharge (ESD) can reduce the length of hospital stay (LOS) while achieving effective rehabilitation for stroke patients, compared to in-patient rehabilitation. We aim to study the patient characteristics, short-term clinical progress and long-term functional outcome in stroke patients discharged to an ESD program in Singapore. Methods: Consecutive stroke patients discharged from a tertiary hospital and enrolled into the ESD program were recruited. Eligibility for ESD included 1. Within 3 months of stroke onset; 2. Availability of a caregiver at home; and 3. Absence of any medical, nursing or rehabilitative indications for in-pa-tients care. Baseline and outcome data using the modified Rankin Scale (MRS), Functional Indepen-dence Measure (FIM) and Frenchay Activity Index (FAI) were prospectively collected until the last ESD session, and a follow-up FAI was also performed via telephone interview when possible at 1 year post-stroke. Findings: From Aug 2007 to Dec 2011, 350 stroke patients (all ischaemic stroke except 9 ICH) were enrolled in ESD. 10 (2.9%) were readmitted before /during ESD, and another 8 died or defaulted (5.1% total event rate). 335 patients (included 3 readmitted) completed ESD, with mean(SD) age of 64.5(11.7) years, 59% were male. and a mean LOS of 5.7(5.0) days. They received from 5 to 25 (mean 7.8) home therapy sessions. FIM improved from 89(17) on hospital discharge to 98(19) at the first ESD session and 114(17) at the last ESD session. Proportions achieving MRS 0-1 and community-am-bulant status increased from 4.5% and 21.2% to 42.4% and 85.7% respectively. Of the 241 patients with 1 year follow-up data, FAI was 21.7(9.6) before stroke, 1.5(3.7) after stroke, 11(7.8) upon ESD completion and 17.5(10.7) one year post-stroke. Conclusion: ESD is safe for stroke patients who appeared to improve even before commencement and continued improving long after completion of ESD.
Karger_ESC London_2013
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