Authors (including presenting author) :
HO LNK (1), WAN PCS (1), LAM CYI (1), CHAN CMA (1)
Affiliation :
(1)Physiotherapy Department, Queen Elizabeth Hospital (QEH)
Keyword 2: :
Physiotherapy
Introduction :
Stroke remains a predominant cause of disability among the elderly, significantly compromising functional mobility and independence. Community-based physiotherapy delivered within the Integrated Care Model (ICM) offers a promising rehabilitative approach, enabling contextually embedded and patient-tailored intervention for post-stroke recovery. Stroke-specific assessments and repetitive, task-oriented interventions are provided to facilitate functional recovery among post-stroke patients.
Objectives :
(1)To examine patient demographics specifically the reasons of referral and discharge
(2)To evaluate the efficacy of community-based physiotherapy on stroke rehabilitation
Methodology :
A retrospective review was conducted on patients with stroke referred under the ICM from September 2023 to November 2025. Primary outcomes were the Modified Barthel Index (MBI) and Modified Functional Ambulation Classification (MFAC), assessed at initial evaluation and discharge. Secondary analyses included reasons of referral and discharge. Data were analyzed using paired t-tests and Wilcoxon signed-rank tests.
Result & Outcome :
Seventy nine patients with a mean age of 79.67 ± 8.91 were analyzed (30 male, 49 female) over a mean service period of 9.17 ± 4.00 weeks. 94.9% of patients were diagnosed with ischemic stroke, while the remaining had hemorrhagic stroke. Patients were referred to physiotherapy for multiple reasons, often concurrently. The most common was exercise or stroke rehabilitation (94.9%), followed by carer education (35.4%), home safety assessment (34.2%), fall prevention (32.9%), disease management (21.5%), pain management (6.3%) and walking aid prescription (1.3%). These illustrated the multifaceted role of community-based physiotherapy in post-stroke care. Most patients (65.8%) were discharged due to optimized condition, while 27.8% transitioned to outpatient physiotherapy or geriatric day hospital services, and the remaining (6.4%) moved to residential home, moved out of service boundary and re-admitted. This highlighted domiciliary physiotherapy not only minimized the need for follow-up care, but also bridged the service gap between in-patient discharge and out-patient ambulatory care. The mean MBI score significantly improved by 4.28 ± 7.37 (p< 0.05), from 86.27 ± 16.85 to 90.54 ± 15.80, indicating enhanced functional independence. A significant improvement in MFAC was observed (Z=-3.841, p< 0.05), underscoring enhanced functional mobility. Community-based physiotherapy with multifaceted nature delivered within the ICM was associated with significant improvement in functional independence and ambulatory capacity among the elderly post-stroke. These findings highlighted the efficacy of domiciliary physiotherapy in bridging post-discharge care gaps and facilitating community reintegration.
