Comparison of Activity Patterns between Rehabilitation Stroke Unit and Mixed Rehabilitation Ward for Stroke Patients

ABSTRACT

OBJECTIVE: To determine if the physical design and organizational structure of rehabilitation stroke unit (RSU) is related to the amount of patients' activity pattern. METHOD: An observational study was conducted using behavioral mapping method. Time samples of the motor activity of patients following stroke were taken at 10-minute interval, between 7 AM and 7 PM both on weekdays and weekends. At each observation, physical activity patterns, location in which the patients spent their time, and other person present were recorded. RESULTS: RSU patient spent less time in non-therapeutic activity and more time in therapeutic activity (p<0.05). There were significant differences in the locations of patient's position between the two types of ward (p<0.05). RSU patients had significantly more interaction with formal carerand less time disengaged (p<0.05). The proportion of time in therapeutic activity was low in all location, with patients spending many hours in bed and doing nothing. There was no significant differences in total Functional Independence Measure (FIM) scores at admission and on discharge, FIM gain, and FIM efficiency between RSU and mixed rehabilitation ward (p<0.05). CONCLUSION: In spite of quantitative difference, the two wards had similar patterns of treatment activity and deployment of staff. These maybe resulted in similar treatment experiences for patient and no functional differences between two wards. It appears that strategies are required so that patients can be practicing at an more appropriate level.