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Stroke Recovery Revolutionised: Early Rehab Makes All the Difference

Getting access to early, comprehensive, high-intensity rehabilitation can make all the difference for stroke patients. Rehabilitation doesn’t only start once you move from the hospital to the physical rehabilitation unit. It is all about gaining access to rehabilitation as quickly and seamlessly as possible.

A growing understanding of strokes and how to treat them has led to new, highly effective stroke-care pathways that improve outcomes and empower patients and their families with options for a better quality of life.

The World Stroke Organization (WSO), established in 2006, has begun a movement towards better stroke management practices, with a focus on hyper-acute and acute care. The programme includes tools to implement stroke pathways, and monitor stroke outcomes, which includes the Angels Initiative, a healthcare intervention dedicated to improving stroke patients’ chances of survival and a disability-free life.

Early identification of strokes and stroke-ready hospitals

This enhanced commitment to stroke care has also been embraced in South Africa, where Life Healthcare offers integrated hyperacute and acute care from the emergency units, through the acute hospital setting and finally to the Life Rehabilitation units.

“We offer standardised stroke care to all our patients who access our services to ensure they receive the most appropriate care that drives the best possible clinical outcomes ,” says Life Healthcare Rehabilitation Support Specialist Nina Strydom. “All of our acute hospitals enrolled in the Stroke Restore programme are stroke-ready hospitals and have implemented the integrated stroke pathway. They all provide critical interventions like intravenous thrombolysis treatment to dissolve any clots in the brain where indicated and offer immediate access to neuro-rehabilitative services.” Some hospitals are also capable of performing mechanical thrombectomies.

The World Health Organisation (WHO) reports that 15 million people are affected by strokes every year. Of these, 5 million die and another 5 million are permanently disabled.

The sooner stroke treatment starts, the better – ideally within the first three hours. It is critical that oxygen is returned to the brain as soon as possible so that nervous function recovers, and the person is not affected by lifelong complications. As part of this work we partner with the Angels Initiative, to increase access to stroke-ready hospitals and to optimise the quality of stroke management.

Early access to rehabilitation is another vital intervention in ensuring optimal recovery and minimising readmissions to hospital. It is therefore critical that patients are treated as soon as possible, and that they have seamless access to rehabilitation.  

FAST Heroes, launched in partnership with the Angels Initiative and the Heart and Stroke Foundation, and an award-winning educational initiative aimed at raising awareness of stroke symptoms and the need for speedy action,  is supported by Life Healthcare.

This initiative focusses on educating people, especially children about the early identification of a stroke through the FAST acronym:

  • Face drooping
  • Arm weakness
  • Speech difficulty
  • Time to call help

Comprehensive stroke rehabilitation is a complex process and requires teamwork. To this end, Life Rehabilitation follows an “interdisciplinary” approach, which differs from the traditional, doctor-led approach to guide stroke care.  Life Rehabilitation units employ these a range of therapists who, make patient-care decisions alongside the doctor.

“To help patients return to their families, lives and work you need to have everybody on board,” says Strydom. “To ensure a safe discharge home, the team works together to comprehensively address the patient’s health needs. The rehabilitation doctor manages chronic and contributing medical conditions, and speech and language therapists help with swallowing assessments before eating and drinking is attempted as many patients may lose their ability to talk and swallow which makes eating and drinking potentially very dangerous activities. Physiotherapists can begin muscle conditioning and regaining mobility and function, occupational therapists help with activities of daily living such as feeding and dressing. Nurses support patients with general health and hygiene needs and dietitians help prescribe the most appropriate diets and making sure the necessary lifestyle changes are made to support patients’ recovery. Social workers and psychologists help in managing changing family dynamics, assisting patients in overcoming adjustment and mental health challenges as well as liaising with employers ahead of the return to work. And lastly, the team assists with caregiver training where necessary to ensure patients are adequately cared for when they are discharged home. At its core, it’s all about coordination of care.”

Tracking outcomes

Life Healthcare uses the internationally benchmarked industry-standard Functional Independence Measure (FIM) to assess patient care needs and track treatment outcomes.

“More than 30% of our rehabilitation patients are admitted because of strokes,” says Strydom. “To assess and demonstrate the progress of their rehabilitation, we use tools such as the FIM clinical outcomes measure.”

FIM looks at how much assistance patients need to perform certain motor and cognitive activities, including eating, grooming, walking and bladder control. Another measure also used by the team, Functional Assessment Measure (FAM), helps assess the impairment of a patient in greater detail and includes cognitive, behavioural, communication and community functioning measures.

FIM scores are assessed weekly to show the progress of a patient’s rehabilitation, and can help inform treatment decisions, or to decide when the patient is ready for home integration.

High-intensity rehabilitation

Life Rehabilitation follows a high-intensity, acute rehabilitation programme, to make a significant impact in the critical early stages.

“We have this window of opportunity to make a difference, and we put all the resources we have into achieving that,” says Strydom. “Efficiency measures of our treatment approach show that this approach is successful.” 

The focus is on providing the best improvement in the shortest time frame (FIM efficiency). 

“Our superior outcome efficiency has won us the confidence of major funders, who trust us with the care of proportionally more serious stroke patients.”

Industry-leading results

Data from 2024 shows a 38% FIM+FAM score improvement among Life Rehabilitation stroke patients over the period of their stay of approximately 32 days.

The Life Rehabilitation facilities also compare well to stroke-rehabilitation outcomes across the healthcare sector. In reports from a major medical aid administrator, stroke patients at Life Rehabilitation facilities show a superior average gain per week compared to the industry average in four out of five stroke categories – especially severe strokes.

In terms of medically complex patient outcomes, Life Rehabilitation similarly outperforms the industry average in five out of six categories, including severe and moderate functional impairment.

“We believe we manage complex cases better than the industry average because of the interdisciplinary care at our acute facilities, and the seamless integration with our rehabilitation centres,” says Strydom.

Data also shows that a major medical aid funder entrusts Life Rehabilitation with the treatment of proportionally more neurological patients than the industry average.

Furthermore, eight Life Healthcare hospitals have been recognised through the WSO Angels Awards for meeting strict criteria. This prestigious programme recognises outstanding hospitals that have consistently provided valuable data, contributing to crucial research and helping to identify areas for improvement in the treatment of stroke patients.

Get informed, get involved

Strydom’s message to stroke patients and their loved ones is that they have the power to make decisions that will affect the outcomes of the condition.

“The first step is to be able to identify a stroke,” she says. “Next, get the patient to the nearest stroke-ready emergency unit. From there, patients and their families have the right to choose their healthcare and rehabilitation facility, by talking to their doctor, or their medical aid fund manager. So do your research.”

Strydom encourages everyone to empower themselves with knowledge about strokes.

“Get informed, and get involved,” she says. “The decisions that affect your quality of life are within your control.”

Learn more about how Life Rehabilitation can support you or your loved one in their stroke recovery here.