ABSTRACT
AIM: The aim of this study was to look at the type and frequencies of complications after an acute stroke in an inpatient rehabilitation setting. We also looked at the type of complications which required the transfer of patient care back to the primary referring physician. MATERIALS AND METHODS: A retrospective review of case notes of patients transferred to the rehabilitation team was conducted. The study period was a six-month period from the beginning of January 2001 to the end of June 2001. A list of complications was made. Each pre-determined complication was then defined. The frequency of each complication was then calculated. RESULTS: A total of 140 case notes were reviewed. The overall complication rate was 54.3%. The more common complications, in order, from highest to lowest frequencies, were: constipation (complicating 22.9% of strokes); acute retention of urine (ARU, 20.9%); urinary tract infections (UTI, 14.3%); depression (9.3%); and limb pain (8.6%). Females were more likely to have UTI (p=0.038), ARU (p=0.002) and depression (p=0.018). Patients 65 years and above were more likely to suffer multiple complications although the results did not reach statistical significance (p=0.055). The care for eight patients (5.7% of patients with complications) had to be transferred back to the primary referring team or physician. CONCLUSIONS: Complications post stroke are common. Some patients required transfer of care back to the primary referring physician. A pro-active approach is ideal in all post stroke patients, in order to identify and treat any complications early, thereby, improving outcome and reducing costs.
Subject(s)
Rehabilitation Centers/statistics & numerical data , Stroke Rehabilitation , Stroke/epidemiology , Adult , Age Distribution , Aged , Aged, 80 and over , Cardiovascular Diseases/epidemiology , Comorbidity , Constipation/epidemiology , Female , Humans , Male , Middle Aged , Recurrence , Retrospective Studies , Sex Distribution , Singapore/epidemiology , Thromboembolism/epidemiology , Urinary Tract Infections/epidemiologyABSTRACT
The author gives a literature review of the management of spasticity carried out. Physical agents used such as ice, heat and vibration are described. Methods used by physical therapists are discussed. Drugs most commonly used in the treatment of spasticity are Diazepam, Baclofen and Dantrolene. Phenol has been used by injection into motor points, peripheral nerves and intrathecally. Other drugs that have been used are also discussed. Neurosurgical procedures include neurectomies, neurotomies, rhizotomies and more radical procedures such as myelotomies and cordectomies. Orthopaedic procedures involve muscle and tendon lengthening, release of contractures and tendon transfers. Surgery is discussed in terms of function. In considering the options, available care must be taken to achieve and maintain optimal functional level.
Subject(s)
Motor Neuron Disease/rehabilitation , Muscle Spasticity/rehabilitation , Paralysis/rehabilitation , Activities of Daily Living , Humans , Motor Neuron Disease/etiology , Muscle Spasticity/etiology , Neurologic Examination , Paralysis/etiologyABSTRACT
Several features characterise spasticity which may be present in patients with lesions of the upper motor neurones of the brain and spinal cord. Spasticity gives rise to disability depending on the site and extent of the lesion. The manifestations of spasticity and its direct consequences on the locomotor system are discussed in this paper together with the factors affecting it. Management strategies in the rehabilitation of patients with spasticity are outlined, with emphasis on preserving maximum possible function in mobility and activities of daily living.
