Barriers to accessing physical rehabilitation after stroke: an integrative review

Authors

DOI:

https://doi.org/10.33448/rsd-v11i4.27224

Keywords:

Stroke rehabilitation; Effective access to health services; Barriers to access of health services.

Abstract

Stroke is one of the main public health problems in the world. It represents the second leading cause of death, and is currently considered the most disabling disease in the world. More than half of the affected patients need rehabilitation, which aims to minimize the sequelae and restore some degree of functional independence, raising their quality of life and reducing the burden generated by the disease. The objective of this review was to know the access to these services offered by the health systems. The search was conducted in the following databases: PubMed, SCOPUS, SciELO, Chocrane, and LILACs. The terms were: "Access to physiotherapy", "stroke", "rehabilitation", and their respective terms in Portuguese present in Medical Subject Headings (MeSH) and in DeCS (Descriptors in Health Sciences). The search included articles published in the last 10 years, in Portuguese, English and Spanish. Of the 353 articles found, 21 met the inclusion criteria for data analysis based on PRISMA guidelines. It was observed in this review that although the approaches and the importance of physical rehabilitation in stroke patients are already well discussed, the access is still difficult, with several barriers such as: insufficient staff, lack of structure, bureaucracy, difficulty in moving around, and lack of understanding about the services. However, the current system of care organization can be improved, using new concepts of structure and care process, creating a more effective communication between the health system, patients and caregivers.

Author Biographies

Ariane Ribas Toneti dos Santos, Faculdade Unisociesc

Professora Mestra da Faculdade Unisociesc.

Fabiane Maria Klitzke dos Santos, Pró-Rim Instituto de Educação e Pesquisa em Saúde

Professora Mestre da Pró-Rim Instituto de Educação e Pesquisa em Saúde.

Fernando Luís Fischer Eichinger, Universidade da Região de Joinville

Professor Mestre da Universidade da Região de Joinville - UNIVILLE.

Helbert do Nascimento Lima, Universidade da Região de Joinville

Professor Doutor do Programa de Pós-graduação em Saúde e Meio Ambiente da Universidade da Região de Joinville - UNIVILLE.

Antonio Vinicius Soares, Universidade da Região de Joinville

Professor Doutor do Programa de Pós-graduação em Saúde e Meio Ambiente da Universidade da Região de Joinville - UNIVILLE, Santa Catarina, Brasil.

References

Abdul, A. F. A. et al (2014). The integrated care pathway for post stroke patients (iCaPPS): A shared care approach between stakeholders in areas with limited access to specialist stroke care services. BMC Health Services Research; 17(1): 1-11.

Campos, L. M. et al. (2017). How many patients become functionally dependent after a stroke? A 3-year population-based study in Joinville, Brazil. PLoS ONE; 12 (1): 1–12.

Cook, C. et al. (2005). Variables associated with occupational and physical therapy stroke rehabilitation utilization and outcomes. Journal of Allied Health; 34(1): 3-10.

Dew, A., Baladin, S., Llewellyn, G. (2008). The Psychosocial Impact on Siblings of People with Lifelong Physical Disability: A Review of the Literature. Journal of Developmental and Physical Disabilities; 20(5): 485–507.

Donnan, G. A. et al (2008). Stroke. Lancet.; 371 (9624): 1612–23.

Ellis, C., Edge, L. E.(2009). Racial/ethnic differences in poststroke rehabilitation utilization in the USA. Expert Rev. Cardiovasc. Ther; 7(4): 405–410.

Faria, C. D. C. de M, Araújo D. C., Carvalho-Pinto B. P. de B. (2017). Assistance provided by physical therapists from primary health care to patients after stroke. Fisioterapia em Movimento; 30 (3): 527–536.

Haan, R. et al. (1993). Measuring quality of life in stroke. Stroke.

Hall, P. et al. (2016). Access to Rehabilitation at Six Months Post Stroke : A Profile from the Action on Secondary Prevention Interventions and Rehabilitation in Stroke ( ASPIRE-S ) Study. Cerebrovasc Dis: 247–254.

Hall, R. et al. (2012). Ontario stroke evaluation report: Prescribing system solutions to improve stroke outcomes: Ontario Stroke Report Card, 2010/11. Toronto: Institute for Clinical Evaluative Sciences.

Hendricks, H. T. (2002). Motor recovery after stroke: A systematic review of the literature. Archives of Physical Medicine and Rehabilitation; 83 (11): 1629–1637.

Hillmann S. et al. (2017). Stroke unit care in germany : the german stroke registers study group (ADSR ). BMC Neurol; 17(1): 1–8.

Irish Heart Foundation (2010). National Clinical Guidelines and Recommendations for the Care of People with Stroke and Transient Ischaemic Attack.

Jan, S. et al. (2013). Are rehabilitation services following stroke accessed equitably in Australia?: Findings from the psychosocial outcomes in stroke (POISE) cohort study. BMC Public Health;13 (1): 884.

Mckevitt, C. et al. (2015). Are There Inequalities in the Provision of Stroke Care? Analysis of an Inner-City Stroke Register. Stroke; 36(2):315–321.

Miranda, R. E. et al. (2018). Avaliação do acesso à fisioterapia após a alta hospitalar em indivíduos com Acidente Vascular Cerebral Assessment of access to physiotherapy after hospital discharge in post-stroke patients. Clin Biomed Res; 38 (3): 245–252.

Mittmann, N. et al. (2012). Impact of disability status on ischemic stroke costs in Canada in the first year. Canadian Journal of Neurological Sciences; [s. l.], v. 39, n. 6, p. 793–800.

Morris, L. D. et al. (2019). Health system challenges affecting rehabilitation services in South Africa. Disability and Rehabilitation; 0 (0): 1–7.

Mukherjee, D, Patil C G (2011). Epidemiology and the global burden of stroke. World Neurosurgery.; 76(6): 85–90.

Nanninga, C. S. et al. (2018). Unpacking community mobility: a preliminary study into the embodied experiences of stroke survivors. Disability and Rehabilitation; 40(17): 2015–2024.

Organização Mundial da Saúde (2020). Rehabilitation 2030. https://www.who.int/rehabilitation/rehab-2030/en/.

O'Sullivan, E. J. et al. (2014). Access to in-patient stroke services and multidisciplinary team (MDT) rehabilitation: current demands and capacity. Irish medical jornal; 107(6):171-3.

Ouriques, Martins S C et al.(2018). Priorities to reduce the burden of stroke in Latin American countries. The Lancet Neurology; 18 (7): 674–683.

Petersen, I, Lund C. (2011). Mental health services in South Africa from 2000 to 2010: a step forward, a step back. Revista Médica da África do Sul; 101(10): 751-757.

Rac, V. E. et al. (2017). The characteristics of stroke units in Ontario: A pan-provincial survey. BMC Health Services Research; 17 (1): 1–10.

Reuter, B. et al. (2016). Access, timing and frequency of very early stroke rehabilitation - insights from the Baden-Wuerttemberg stroke registry. BMC Neurology; 16 (1): 1–10.

Salisbury, L. et al. (2010). “After the stroke”: Patients’ and carers’ experiences of healthcare after stroke in Scotland. Health and Social Care in the Community; 18 (4): 424–432.

Sarzynska-Dlugosz, I, Krawczyk, M, Czlonkowaska A. (2011). Development of early comprehensive post-stroke rehabilitation in Poland - present state and further needs. Neurologia i Neurochirurgia Polska; 45 (3): 245–251.

Teasell, R. W. et al. (2003) Early Supported Discharge in Stroke Rehabilitation. Topics in Stroke Rehabilitation; 10 (2):19–33.

Teasell, R. et al. (2009). Stroke rehabilitation: An international perspective. Topics in Stroke Rehabilitation; 16 (1):44–56.

Urimubenshi, G. et al. (2018). Stroke care in Africa: A systematic review of the literature. International Journal of Stroke; 13 (8):797–805.

Published

27/03/2022

How to Cite

SANTOS, A. R. T. dos .; SANTOS, F. M. K. dos .; EICHINGER, F. L. F. .; LIMA, H. do N. .; SOARES, A. V. Barriers to accessing physical rehabilitation after stroke: an integrative review . Research, Society and Development, [S. l.], v. 11, n. 4, p. e4911427224, 2022. DOI: 10.33448/rsd-v11i4.27224. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/27224. Acesso em: 26 nov. 2024.

Issue

Section

Review Article