Comparison of disability levels between haemorrhagic and ischaemic stroke in the sub-acute phase: A cross-sectional study
DOI:
https://doi.org/10.3329/bsmmuj.v18i4.84735Keywords:
stroke, hemiplegia, Barthel Index, disability, rehabilitation, activities of daily livingAbstract
Background: Stroke remains a leading cause of disability worldwide, with hemiplegia being a common consequence. The Barthel Index (BI) is a widely used tool for assessing disability in activities of daily living (ADL). This study aimed to evaluate the level of disability among patients with sub-acute hemiplegic stroke and compare disability levels between ischemic and haemorrhagic stroke within 3 weeks of onset in an acute rehabilitation setting.
Methods: A cross-sectional study was conducted at Sher-E-Bangla Medical College and Hospital in the Barishal division of Bangladesh, from October 2022 to March 2023. Seventy-five patients aged 20–85 years, experiencing a first-ever stroke with hemiplegia, were assessed using the BI. Patients with subarachnoid haemorrhage, recurrent stroke, or severe comorbidities were excluded. BI scores and dependency levels were expressed in mean and standard deviation and compared between groups using Student’s t tests, with statistical significance set at P<0.05.
Results: The mean (standard deviation) BI scores were significantly higher (P<0.001) in ischemic stroke patients, 62.0 (20.8), compared to haemorrhagic stroke patients, 24.6 (21.3). The ischemic stroke patients predominantly exhibited severe dependency (64.1%), while haemorrhagic stroke patients showed total dependency (52.8%). Bathing, bladder control, and stair climbing were the most affected ADL domains in both groups. Hypertension was the most common risk factor (62.7%), followed by diabetes mellitus (37.3%).
Conclusion: Haemorrhagic stroke patients exhibit greater disability than ischemic stroke patients in the acute rehabilitation phase. These findings underscore the need for tailored rehabilitation strategies to address severe dependency, particularly in haemorrhagic stroke survivors.
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