Developing a Proactive Physical Therapy Home Visit for Stroke Patient

Abstract

Kosumphisai hospital has a home visit program for patients with chronic disease. It is performed by a multidisciplinary team of the hospital. However, stroke patients need to have continued rehabilitation on the right time, sufficient number of visits and regular frequency in order to achieve good recovery, particu larly in the first six months of illness. Thus, home visits by multidisciplinary team are not enough. This study aimed to investigate the effectiveness of a proactive physical therapy home visit system implemented by a rapid physical therapist team. In the process, the team followed new cases of stroke patient by home visit system after discharging from the hospital, and setting goal of treatment with the individual patient and caregiver for the period of 6 months after the manifestation of the illness. The rehabilitation program consisted of active and passive daily exercises by the patient and the caregivers, and planning on number and frequencies of the home visits. Daily activities were assessed by using Barthel index questionnaires when the patient stayed in the hospital and 6 months later. It was found that among 56 patients recruited in the program, 46 of them (82.14%) had increased the score of Barthel index within 6 months compared to 71.42% in patients under the old home visit system. This study concluded that the proactive physical therapy home visits and the rehabilitation program for the individual stroke patient is a versatile system with sufficient number of times and frequency of visits. It could help the patient gaining functional recovery in appropriate timing and reduce burden of the caregivers.