Saudi Stroke Standards

Outpatient Rehabilitation Purpose Studies demonstrated significant functional gains with intensive outpatient therapy at 3- 6- months post stroke. The greatest benefits were achieved in the first three months. Those patients who are ready for discharge from inpatient facility can continue to receive rehabilitation as outpatient to improve their functional status. Rationale  Stroke patients are having difficulty accessing outpatient rehabilitation clinics early after discharge from hospital due to limited availability of these facilities. When they get the opportunity tend to be late by then they developed multiple secondary complication related to their stroke.  There is no formal hospital transport system for outpatient treatment  Limited and expensive disability assessable private vehicles Standards 1. Stroke patients should have access to outpatient rehabilitation within two weeks of stroke if they are medically stable. This is to maximize their functional improvement during first six to twelve months after the stoke, when maximum recovery is expected. 2. Patients suitable for outpatient rehabilitation should be able to be transferred to the outpatient therapy clinic for treatment 1-3 times per week. 3. The outpatient treatment should be carried out by multidisciplinary professionals who have expertise in stroke rehabilitation. 4. Stroke rehabilitation clinics should address secondary prevention of stroke, management of physical, cognitive and communication difficulties as well as changing care needs. 5. Stroke patients should have access to affordable and appropriate transport to be able to attend outpatient rehabilitation. 6. The rehabilitation clinics should include range of specialist clinics and therapy which include: I. Physical therapy to improve mobility, strengthen muscles and maintain the range of movement; II. Occupational therapy to improve independence with self-care, as well as assessment of educational, vocational and driving abilities; III. Spasticity clinic for management of muscle spasticity secondary to stroke using range of oral and focal injections like Botulinum Toxin; IV. Stroke rehabilitation clinics to address secondary prevention of stroke and manage other symptoms that can develop as a sequel of the stroke; V. The need for wheelchairs, equipment and other assistive devices; VI. Assessment of care support and carers review and training. QM