London, United Kingdom 2013 34 Rehabilitation and reorganisation after stroke Intervention to increase the exercise intensity and physical activity in stroke patients A. Willems1, C. Schroder2, T. van der Weijden3, M.J.J. Visser-Meily4 University Medical Center Utrecht and De Hoogstraat, Rudolf Magnus Institute of Neurosci-ence and Center of Excellence for Rehabilitation Medicine, Utrecht, THE NETHERLANDS1, University Medical Center Utrecht and De Hoogstraat, Rudolf Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine, Utrecht, THE NETHERLANDS2, Maastricht University, Department of General Practice School Caphri, Maastricht, THE NETHERLANDS3, University Medical Center Utrecht and De Hoogstraat, Rudolf Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine, Utrecht, THE NETHERLANDS4 Background Guidelines for stroke treatment recommend intensive therapy and physical activity. Observational studies show that in reality stroke-patients are inactive. We aimed to intensify therapy the first weeks post stroke making use of enterprising nurses and therapists i.e. knowledge brokers (KB). We inves-tigated if and to what extend patients perceived to be stimulated by health professionals to be physi-cally active. Methods Design:Pre-post intervention study (T0,T1). Participants:Stroke inpatients in 22 hospitals and rehabilitation centers. We planned to question 15 patients per site. Exclusion criteria:inability to answer questions,not mobilized,>100 days post-stroke. Intervention:KB (2-3 per clinical site) were instructed to intensify therapy and physical activity. They were trained in project-management, neurorehabilitation and implementation strategies and adapted activities to local needs. Measurement:6 questions on perceived stimulation to be physical active with a 4 point answer scales. Analysis:Frequencies per question. Differences were tested using Mann-Whitney U test. Results 243 patients were interviewed at T0, 217 at T1. The groups did not differ for patient characteristics (table 1). The results (table 2) show that at T0 the majority of patients felt stimulated to be physical-ly active, especially patients in rehabilitation centers. In hospitals and to a lesser degree in rehabili-tation centers, patients experienced more stimulation from nurses than from therapists. Family was hardly involved in exercising. At T1 patients felt more stimulated to exercise than at T0, but this was significantly different in hos-pitals only (p<0,05, small/medium effect). Conclusion After the KB intervention patients felt more stimulated to exercise. The intervention seems promis-ing, but an experimental design is needed to make causal inferences. To further improve activity lev-els, it seems worthwhile to involve family in stimulating stroke patients to be physically active. E-Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 589 E-Poster Terminal 5 Table 1. Improvement of Clinical Parameters in Three Groups after 4 Weeks Treatment. MAS: Modified Ashworth scale, HF: Power of hand flexion, HE: Power of hand extension, WF: Power of wrist flexion, WE: Power of wrist extension, FMW: Fugl-Meyer score of wrist, FMH: Fugl-Meyer score of hand, FMC: Fugl-Meyer score of coordination Table 2. Comparison of Improvement after 3 Weeks Treatment in Each Group. MAS: Modified Ashworth scale, HF: Power of hand flexion, HE: Power of hand extension, WF: Power of wrist flexion, WE: Power of wrist extension, FMW: Fugl-Meyer score of wrist, FMH: Fugl-Meyer score of hand, FMC: Fugl-Meyer score of coordination
Karger_ESC London_2013
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