Early Intensive Multi-Faceted Rehabilitation in Stroke Patients: What is the Best Effective Rehabilitation Time?

Abstract

Objective: We aimed to evaluate the effects of the intensive and multi-faceted rehabilitation program in patients during the first 3 weeks after stroke, and to determine the most effective time to initiate treatment. Material and Methods: Forty two patients who were treated in our clinic were included in the study. The demographic characteristics of the patients, the level of stroke severity assessed by the National Stroke Institute Severity Scale (NIHSS), the functional stages assessed by the Brunstrom and Chedocke McMaster Stroke Assesment (CMSA) Scale and the disability levels assessed by the Functional Independence Measure scale were recorded. All patients received a multi-faceted and intensive rehabilitation program 20 sessions in total. The patients were divided into 3 groups according to the times of initiation of rehabilitation i.e during the first 9 days (Group 1), between days 10 and 14 (Group 2) and between days 15 and 21 (Group 3). The evaluation parameters assessed before the treatment, 4th weeks and 3th months were compared within and between the groups. Results: According to the treatment start times; the change in CMMS hand, arm, legand postural control scores, Brunstroom upper, lower limbs and hand levels and the NIHSS score was found to be higher in the first 9 days compared to the other 2 groups in the beginning of treatment. Conclusion: Early intensive and multifaceted rehabilitation program is effective for motor and functional recovery in ischemic stroke patients. Moreover, the start of treatment within the first 9 days provides the most improvement.