RESUMO
The intrathecal baclofen pump (ITB) is one of the advanced treatment options in the management of spasticity. This retrospective cohort study was conducted to identify the complications of ITB treatment at a tertiary care rehabilitation facility. Various demographic and technical factors were analyzed, which are less often reported in the literature. All patients with ITB who had their refill at the ITB clinic between November 2019 and March 2020 were included. Of 48 patients, 17 patients had 18 (37.5%) ITB-related complications. Catheter-related complications were most common, whereas loss of efficacy (16.7%) and baclofen withdrawal (14.5%) were the most common outcomes of complications. Only catheter occlusion had a significant relationship with the pattern of spastic quadriparesis (p = 0.001). Gender, rehabilitation diagnosis, patients' residence, and facility of ITB placement did not have significant association. Similarly, age, distance from hospital, disease onset, ITB therapy duration, and baclofen dose were not statistically significant in relation to ITB-related complications.
RESUMO
Objective In this retrospective study, we aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on rehabilitation services including outpatient rehabilitation clinic visits, speech therapy, and occupational therapy and physiotherapy sessions. Materials and methods This was a retrospective, observational, single-center study, which included all patients who presented to the rehabilitation clinic at the King Fahad Specialist Hospital, Dammam (KFSHD) from January to August 2020 (study period), and they were matched with parallel groups from 2017 to 2019 (control period). Results A total number of 1,435 patient visits were recorded in the outpatient rehabilitation clinics during the study period as compared to the 1,496 patient visits during the control period. However, the number of patients seen by the speech therapists, physiotherapists, and occupational therapists significantly came down from 482, 963, and 171, respectively in the control period to 77, 218, and 130, respectively in the study period. The occupational therapy, physiotherapy, and speech therapy services were significantly affected during the COVID-19 pandemic. Conclusions Our findings revealed the negative consequences of the COVID-19 pandemic on the outpatient rehabilitation services, which was reflected in the sharp decline in the number of patients who attended the rehabilitation clinics as well as in the reduced number of sessions. The rehabilitation facilities should be better prepared for such pandemics in the future to deliver appropriate and timely rehabilitation programs with a patient-centered approach.
RESUMO
OBJECTIVE: To determine the incidence and risk factors of falls in individuals with stroke undergoing inpatient rehabilitation. METHODS: Retrospective analysis of all patients with stroke admitted to from January 2011 to June 2013 was carried out in Inpatient rehabilitation Unit at King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. Data collected included demographic variables, types of stroke, comorbidities, characteristics of falls, factors affecting falls and length of hospital stay. Data was descriptively analyzed. The Pearson Chi-square test was used to determine any significant relationship between the categorical variables. Binary logistic regression was used to evaluate predictors of falls during rehabilitation. RESULTS: Out of 146 stroke survivors, 36 patients had a fall during inpatient rehabilitation. Majority did not sustain any injury. Fall status was significantly associated with age group (p=0.048), type of stroke (p=0.005) and previous history of stroke (p=0.020). The side of stroke (p=0.011) and fall risk were statistically significantly related to fall outcomes (p=0.005). Length of hospital stay (LOS) was also associated with fall outcome (p=0.044). CONCLUSION: Age, hemorrhagic stroke, laterality of stroke and previous history of stroke were identified as risk factors associated with falls. Injured patients tend to stay longer for inpatient rehabilitation. Due to different culturual, environmental and health system variations, development of regional guidelines for fall prevention in stroke survivors can help to reduce the risk of falls.
