22. European Stroke Conference 791 Rehabilitation and reorganisation after stroke Life changed existentially. A qualitative study of experiences 6 months post stroke. T. Taule1, J.S. Skouen2, M. Råheim3 Haukeland University Hospital, Bergen, NORWAY1, Haukeland University Hospital and Univer-sity of Bergen, Bergen, NORWAY2, University of Bergen, Bergen, NORWAY3 Background Research related subjective experience after Early Supported Discharge and home-based rehabilita-tion after stroke is limited. The aim of the study was to get more insight into what promotes activity and participation in relation to patients need. Methods A qualitative interpretive design was conducted in the context of a randomised controlled study “Early supported discharge after stroke in Bergen”. A purposive sampling of 4 women and 4 men, aged from 45-80 years and with desired variation in socioeconomic status and stroke severity (NI-HSS < 7, modified Ranking scale from 0-3) were invited and interviewed face to face from Febru-ary to June 2012. A semi-structured guide focusing on experiences and thoughts about activity and participation 6 months post stroke was used. The interview was related to an accomplished defined rehabilitation program in their own homes in the acute phase after stroke. Data were analysed using an interpretive method supplemented by systematic text condensation. Analysis was influenced by International Classification of Function and disability and coping theories. Results Differences and similarities were structured according to the main theme: Life changed existentially. Five sub-themes were identified: 1. Self-perceived health–healthy or ill?, 2. The body–bothersome, unreliable or recovered, 3. Practical doings–even easy little tasks were a challenge, 4. Taking part in society–out and away and 5. Self-perception –am I still good enough? Data provide an understand-ing of how life had changed for people who suffered mild stroke, the challenges they faced and their considerations about future. Conclusion Participants expressed that life had changed existentially. Basic concerns related to self-perceived health, self-perception and body complicated their performance of daily living and/or participation in society. Unresolved rehabilitation needs were still in present 6 months post stroke, and not all captured by objective measures. 764 © 2013 S. Karger AG, Basel Scientific Programme 792 Rehabilitation and reorganisation after stroke Early mobilization after thrombolysis (rt-PA) in acute stroke: Are rt-PA treated patients en-rolled in a trial of early mobilization (AVERT) different from those that are not? M. Dagonnier1, L. Muhl2, J. Kulin3, L. Churilov4, H. Dewey5, T. Lindén6, J. Bernhardt7 The Florey Institute for Neuroscience and Mental Health, Melbourne, AUSTRALIA1, Linköpings University, Linköpings, SWEDEN2, Linköpings University, Linköpings, SWEDEN3, The Florey Institute for Neuroscience and Mental Health, Melbourne, AUSTRALIA4, The Florey Institute for Neuroscience and Mental Health, Melbourne, AUSTRALIA5, The Centre of Brain Re-search and Rehabilitation, , Gothenburg University, Gothenburg, SWEDEN6, The Florey Institute for Neuroscience and Mental Health, Melbourne, AUSTRALIA7 Background: A key treatment for acute ischaemic stroke is thrombolysis (rtPA). However, treatment is not devoid of side effects and patients are carefully selected. AVERT (A Very Early Rehabilitation Trial), a large international phase III trial, currently tests whether starting out of bed activity within 24 hours of stroke onset improves outcome. rtPA treated patients can be recruited if the physician allows (315 included to date). This study aimed to identify factors that might influence the inclusion of rtPA treated patients in AVERT. Methods: Data from all patients thrombolysed at Austin Health, Australia, between September 2007 and De-cember 2011 were retrospectively extracted from medical records. Factors of interest included: de-mographic and stroke characteristics, 24 hour clinical response to rtPA treatment, cerebral imaging and process factors (day and time of admission). Results: 211 patients received rtPA at Austin Health and 50 (24%) were recruited to AVERT (rtPA-AVERT). Of the 161 patients not recruited, 105 (65%) were eligible, and could potentially have been in-cluded (pot-AVERT). There were no significant differences in demographics, Oxfordshire classi-fication or stroke severity (NIHSS) on admission between groups. Size and localization of stroke on imaging and symptomatic intracerebral heamorrhage rate did not differ. Patients included in AVERT showed less change in NIHSS 24 hours post rtPA (median change=1, IQR (-1,4)) than those in the pot-AVERT group (median change=3, IQR (0,6)) by the median difference of 2 points (95%CI:0.3;p=0.03). A higher proportion of rtPA-AVERT patients were admitted on weekdays (p=0.04). Conclusion: Excluding a possible clinical instability, no significant clinical differences were identified between thrombolysed patients included in AVERT and those who were not. Over 400 AVERT patients will be treated with rt-PA at trial end. These results suggest we may be able to generalize findings beyond the trial population.
Karger_ESC London_2013
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