Department of Stroke Medicine, Kawasaki Medical School, Okayama, Japan.
Department of Neurology, Tokyo Saiseikai Central Hospital, Tokyo, Japan.
Eur Neurol. 2024;87(4):169-176. doi: 10.1159/000540231. Epub 2024 Jul 31.
Acute stroke rehabilitation is crucial for achieving good functional recovery, even during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to clarify the impact of the COVID-19 pandemic on acute stroke rehabilitation and identify which components in the acute stroke rehabilitation provision system were susceptible to the pandemic.
A web-based questionnaire survey was conducted in all primary stroke centers (PSCs) in Japan between February 7 and April 21, 2022. The survey included questions about the current status of acute stroke rehabilitation and the influence of the pandemic. We classified the influences and investigated the relationship between the influence of the pandemic and the provision of rehabilitation. Additionally, we investigated a group of prefectures divided according to the grade of the pandemic.
The survey response rate was 67% (639 of 959 PSCs). Among them, 387 PSCs (61%) reported that the COVID-19 pandemic affected acute stroke rehabilitation. In PSCs affected by the pandemic, more rehabilitation-related staff were working, and the proportion of weekend/holiday rehabilitation implementation was higher compared to those unaffected. In PSCs from highly infected prefectures, no significant relationship was observed between the influence of the pandemic and the rehabilitation provision system.
PSCs that provide denser acute stroke rehabilitation may be affected to a greater extent by the pandemic. We conclude that stroke hospitals should formulate infection control procedures for acute stroke rehabilitation in advance, depending on the conditions of the region and facility.
急性脑卒中康复对于实现良好的功能恢复至关重要,即使在 2019 年冠状病毒病(COVID-19)大流行期间也是如此。本研究旨在阐明 COVID-19 大流行对急性脑卒中康复的影响,并确定急性脑卒中康复提供系统中哪些部分容易受到大流行的影响。
2022 年 2 月 7 日至 4 月 21 日,在日本所有初级卒中中心(PSC)进行了一项基于网络的问卷调查。该调查包括关于急性脑卒中康复现状和大流行影响的问题。我们对影响进行了分类,并研究了大流行的影响与康复提供之间的关系。此外,我们根据大流行的程度对一组县进行了调查。
调查的回复率为 67%(959 个 PSC 中的 639 个)。其中,387 个 PSC(61%)报告 COVID-19 大流行影响了急性脑卒中康复。在受大流行影响的 PSC 中,更多与康复相关的工作人员在工作,周末/假日康复实施的比例高于未受影响的 PSC。在感染程度较高的县的 PSC 中,大流行的影响与康复提供系统之间没有观察到显著关系。
提供更密集急性脑卒中康复的 PSC 可能受到大流行的更大影响。我们的结论是,卒中医院应根据地区和设施的情况,提前制定急性脑卒中康复的感染控制程序。