07 Feb 2011
Getting to hospital quickly after suffering a stroke is vital in order to achieve the best possible recovery.
For patients at Singapore General Hospital (SGH), those who get to hospital within 24 hours of a stroke may be eligible to undergo a new stroke rehabilitation programme called AVERT (A Very Early Rehabilitation Trial). The programme provides stroke patients with early exercise therapy by physiotherapists, doctors and nurses.
Stroke is Singapore’s fourth most common cause of death, and the largest cause of disability. Thousands of Singaporeans are admitted to hospitals each year because of stroke or its complications.
Studies have shown that early rehabilitation after acute stroke leads to better outcomes and shorter periods of hospitalisation. However, the intensity and time of initiation of rehabilitation for stroke patients vary across different settings globally, as well as in Singapore. Previous studies have also reported that patients with stroke spent as much as 50% of the day resting in the bed doing nothing. Only 13% of the day was engaged in activities that are likely to aid in their recovery.
A Very Early Rehabilitation Trial (AVERT)
While there have been many studies looking at the impact of different medications after stroke, no high quality trials have looked at whether a very early rehabilitation programme results in fewer deaths and less disability than the current care.
AVERT is a large multi-centre randomised trial that aims to recruit over 2,000 stroke patients over the next three years. The AVERT trial is an initiative of the National Stroke Research Institute, Melbourne, Australia with centres in Australia, New Zealand, Scotland and Wales. Singapore is the first Asian centre for the trial and the SGH team plans to recruit 120 patients over the next two years.
“In the past people believed that stroke patients could not exercise immediately after having a stroke as it might be dangerous. However, recent studies have found that exercise therapy (with a focus on mobilisation) can be started very early. This study could make a difference to stroke patients as there is the potential for less disability and a better quality of life after stroke, just by getting patients up and about earlier and more often,” said Dr Mohammed Tauqeer Ahmad, Registrar, Department of Neurology, NNI-SGH, who is also the Principal Investigator for the study.
He would also like to remind the public on the warning signs of stroke which include sudden weakness of the arm, leg or/and face, sudden difficulty in walking, balance and coordination, sudden confusion and difficulty in speaking or understanding, or sudden severe headaches or dizziness with no known cause. He further emphasised that the warning signs of stroke is a medical emergency as early medical intervention can minimise the extent of brain damage. “Don’t wait for the symptoms to go away. Note the time the symptoms appear and seek immediate medical attention at the nearest hospital, even if the symptoms disappear,” said Dr Ahmad.
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