Hall Patricia, Williams David, Hickey Anne, Brewer Linda, Mellon Lisa, Dolan Eamon, Kelly Peter J, Shelley Emer, Horgan N Frances
Royal College of Surgeons in Ireland, Dublin, Ireland.
Cerebrovasc Dis. 2016;42(3-4):247-54. doi: 10.1159/000446080. Epub 2016 May 14.
Stroke is the third leading cause of death and disability. Few studies have assessed the profile and adequacy of access to rehabilitation services after ischaemic stroke both in the inpatient and community setting. The objectives of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) study were to assess the disability and rehabilitation profile, adherence with rehabilitation recommendations and needs of patients 6 months following hospital admission for stroke.
A rehabilitation prescription was completed before hospital discharge for each participant, and adherence to this prescription was assessed at 6 months to determine whether patients received their recommended rehabilitation needs.
Two hundred and fifty six patients were recruited to ASPIRE-S. The average age was 69 (SD 12.8). A majority (n = 221, 86%) were referred to the hospital multidisciplinary team, 59% (n = 132) were referred to all services (physiotherapy (PT), occupational therapy (OT), speech and language therapy (SLT)). Fifty-four percent (n = 119) of patients (seen by the multidisciplinary team) were referred for further rehabilitation in the community on discharge. Of these 119 patients, 112 (95%) recalled receiving community rehabilitation services. However, while most (68%) patients were referred for several disciplines (PT, OT, SLT), the most commonly recalled therapy (55%) was from a single discipline. The most commonly recommended frequency of therapy required was on a weekly basis. Sixty-one patients (51%) reported a delay in services, with some still awaiting services at 6 months.
Results from this prospective study revealed that a significant number of patients (57%) did not receive the therapy recommended on discharge. Future initiatives should include the development of policies, which support more effective, equitable multidisciplinary rehabilitation for stroke patients in the community.
中风是导致死亡和残疾的第三大主要原因。很少有研究评估缺血性中风患者在住院和社区环境中获得康复服务的情况及充分性。中风二级预防干预与康复行动（ASPIRE-S）研究的目的是评估中风患者入院6个月后的残疾和康复情况、对康复建议的依从性以及康复需求。
为每位参与者在出院前完成一份康复处方，并在6个月时评估对该处方的依从性，以确定患者是否获得了推荐的康复需求。
共有256名患者被纳入ASPIRE-S研究。平均年龄为69岁（标准差12.8）。大多数患者（n = 221，86%）被转介至医院多学科团队，59%（n = 132）的患者被转介至所有服务项目（物理治疗（PT）、职业治疗（OT）、言语和语言治疗（SLT））。54%（n = 119）的患者（经多学科团队诊治）出院时被转介至社区接受进一步康复治疗。在这119名患者中，112名（95%）回忆称接受了社区康复服务。然而，虽然大多数（68%）患者被转介至多个学科（PT、OT、SLT），但最常回忆起的治疗（55%）来自单一学科。最常推荐的治疗频率是每周一次。61名患者（51%）报告称服务延迟，其中一些患者在6个月时仍在等待服务。
这项前瞻性研究的结果显示，相当数量的患者（57%）未接受出院时推荐的治疗。未来的举措应包括制定政策，以支持为社区中风患者提供更有效、公平的多学科康复服务。
