IMPACT OF EARLY REHABILITATION ON NEUROLOGICAL OUTCOMES IN STROKE PATIENTS
Main Article Content
Keywords
Stroke, Early Rehabilitation, Neuroplasticity, Neurological Outcomes, Functional Independence, Quality of Life, Physical Therapy, Occupational Therapy
Abstract
Background: Stroke is a leading cause of disability and mortality, contributing significantly to global healthcare burdens. While traditional rehabilitation typically begins weeks post-stroke, evidence suggests that early rehabilitation initiated within 24–72 hours—leveraging neuroplasticity may improve outcomes.
Objective: This study aims to evaluate the impact of early rehabilitation on neurological outcomes, functional independence, and quality of life in stroke patients, focusing on the optimal timing and intensity of rehabilitation interventions.
Materials and Methods: A prospective observational study was conducted on 150 stroke patients at People’s University of Medical & Health Sciences, Shaheed Benazirabad from January 2024 to June 2024. Patients were enrolled within 72 hours of stroke onset and underwent individualized physical and occupational therapy for an average duration of 14.2 days, with 5.6 sessions per week. Baseline and post-rehabilitation outcomes were assessed using the National Institutes of Health Stroke Scale (NIHSS), Barthel Index, Functional Independence Measure (FIM), and EQ-5D for quality of life. Statistical analyses, including paired t-tests and multivariate regression, were performed with a significance threshold of p < 0.05.
Results: Of the 150 participants (mean age: 65.3 years; 50% male), 66.7% had ischemic strokes, and 33.3% had hemorrhagic strokes. Rehabilitation began at a mean of 5.4 days post-stroke. Significant improvements were observed across all outcomes: NIHSS scores decreased from 12.5 ± 4.0 to 6.3 ± 2.5 (p < 0.001), Barthel Index increased from 45.2 ± 15.3 to 75.1 ± 12.6 (p < 0.001), FIM scores improved from 56.7 ± 10.8 to 80.4 ± 9.7 (p < 0.001), and EQ-5D scores rose from 0.45 ± 0.15 to 0.75 ± 0.10 (p < 0.001). These results suggest that early rehabilitation enhances neurological recovery, functional independence, and quality of life.
Conclusion: Early rehabilitation significantly improves stroke recovery outcomes, emphasizing the need for timely, structured rehabilitation within the first week post-stroke. Further research is necessary to refine optimal timing and intensity for patients with severe strokes.
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Dr Awais Bashir Larik
FCPS Neurology, Associate Professor of Neurology and HOD Department of Neurology, Peoples University of Medical & Health Sciences for Women (PUMHSW), Nawabshah SBA, Pakistan
Dr Noor Nabi Siyal
FCPS Medicine, FCPS Neurology, Assistant Professor of Neurology, Peoples University of Medical & Health Sciences for Women (PUMHSW), Nawabshah SBA, Pakistan
Dr Mukhtiar Ahmed Abro
FCPS Medicine, Assistant Professor of Medicine, Peoples University of Medical & Health Sciences for Women (PUMHSW), Nawabshah SBA, Pakistan
Dr Shahzad Memon
MD Medicine, Assistant Professor of Medicine, Peoples University of Medical & Health Sciences for Women (PUMHSW), Nawabshah SBA, Pakistan
Dr. Mohammad Ramzan
MBBS, MD Pulmonology, DTCD, Assistant Professor and Head of Department Pulmonology, Peoples University of Medical & Health Sciences for Women (PUMHSW), Nawabshah SBA, Pakistan
Dr Sajjad Hussain Qureshi
MBBS, MS General Surgery, Assistant Professor, Department of Surgery, Peoples University of Medical & Health Sciences for Women (PUMHSW) Nawabshah SBA, Pakistan
Dr Asif Raza Brohi
MBBS, (FCPS) Diploma Diabetes, MSc Endocrinology, Consultant Endocrinologist, Medical Superintendent THQ Qazi Ahmed, Sindh Government, Pakistan
Dr Mujeeb ur Rehman Sahito
MBBS, MS General Surgery, MS Urology, M. Phil Anatomy, Associate Professor, Department of Anatomy, Peoples University of Medical and Health Sciences for Women, Nawabshah SBA, Pakistan