gms | German Medical Science

Background: Early rehabilitation is a key element of stroke care. Therefore, rehabilitation treatment of specific neurological symptoms should be initiated already during acute hospitalisation. We investigated frequency of physiotherapy, occupational and speech therapy and factors associated with performance of these therapies in stroke patients admitted to acute care hospitals across Europe.

Methods: Consecutive first-ever stroke patients were sampled prospectively over a one-year-period through 12 hospital-based stroke registers across 11 European countries. The impact of socio-demographic factors, stroke subtype, comorbidities, neurological symptoms, time to admission, day of admission, and type of hospital on performance of physiotherapy or occupational therapy in patients with paresis and on speech therapy in aphasic patients were assessed using multivariate logistic regression analyses.

Results: A total of 1996 patients were included in the study. The mean age was 68.7 years and 53% were female. Overall, 71.6% of patients with paresis received occupational or physiotherapy, ranging from 41.1% to 100% between centres. Older patients (p for trend =0.03) were identified to receive less physiotherapy or occupational therapy, whereas women (Odds ratio (OR) 1.4; 95% confidence interval (CI) 1.1-1.8) and patients admitted to stroke units (OR 2.9; 95% CI 1.5-5.5) were more likely to get these therapies. Among aphasic patients, 39.3% received speech therapy, ranging from 7.5% to 100% between centres. Older patients (p for trend =0.02) and patients living alone pre stroke (OR 0.6; 95% CI 0.4-1.0) were less likely to receive speech therapy.

Conclusions: Recently, two thirds of stroke patients with paresis received early physiotherapy or occupational therapy, but only one third of aphasic patients were treated with speech therapy in acute care hospital settings across Europe. There is much room for improvement, and specific groups such as older patients need to be particularly targeted.