Khoo Teck Puat Hospital1
Early Supported Discharge (ESD) is a service developed by Khoo Teck Puat Hospital (KTPH) in 2019. It is a therapist-led, home-based rehabilitation service. Service is initiated within 48 hours upon discharge and provides individualized stroke rehabilitation regime. It aims to improve functional outcomes, reduce hospitalization stays whilst ensuring accessibility to rehabilitation in community. This study evaluates effectiveness of ESD in improving functional and therapy specific outcomes for patients with acute stroke 3 months post discharge.
A retrospective longitudinal study was conducted. Patients included were from KTPH, had acute strokes with focal neurological deficits, requiring only minimum to moderate assistance in basic activities of daily living and had good social support. Patient demographics, baseline and discharge characteristics were recorded at enrolment and discharge. Primary variables analyzed: Modified Barthel Index (MBI), Berg Balance Score (BBS) and Functional Dexterity Test (FDT).
Mean pre and post intervention scores: MBI (89.7 vs 80.3), BBS (49.3 vs 41.6), FDT (70.8 vs 51.6) and all three showed significant improvement (p < 0.05).
Our study showed improvements in functional and therapy specific outcome measures, suggesting the possibility of exploring ESD as a plausible rehabilitation option for patients with acute stroke. Further research is required to investigate specific contents of intervention including exercise principles or equipment usage for better rehabilitation outcomes. Comparative studies may be considered to evaluate effectiveness of stroke rehabilitation in hospital vs home.