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Article type: Case Report
Authors: Finch, Emmaa; b; c; * | Fleming, Jenniferc; d; e | Clark, Kathyb | Hayward, Kathryn S.f
Affiliations: [a] Division of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia | [b] Speech Pathology Department, Princess Alexandra Hospital, QLD, Australia | [c] Centre for Functioning and Health Research, Queensland Health, QLD, Australia | [d] Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia | [e] Occupational Therapy Department, Princess Alexandra Hospital, QLD, Australia | [f] Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia
Correspondence: [*] Address for correspondence: Emma Finch, Speech Pathology Conjoint Research Fellow, Division of Speech Pathology, The University of Queensland, St Lucia, 4072 QLD, Australia. Tel.: +61 7 3896 3133; E-mail: e.finch@uq.edu.au
Abstract: Background:Thrombolysis with recombinant tissue plasminogen activator (rtPA) is part of routine acute stroke clinical practice worldwide. Yet, it is unclear how rtPA influences specific rehabilitation outcomes, such as motor, cognitive and communication function. Objective:The present study aimed to collect pilot data about the effects of rtPA on communication and motor recovery during the first three months post-rtPA. Methods:Four individuals who received thrombolysis with rtPA for a single left hemisphere ischaemic stroke completed an assessment battery two weeks and three months post-stroke. Information pertaining to allied health service usage was also investigated. Results:Reliable changes in assessment scores were observed for lower limb function in two participants with severe functional limitations. There was no reliable change in lower limb function for the two milder participants, or for any participants in upper limb or language function. Service usage varied between participants. Two participants required extensive inpatient rehabilitation. Three participants required outpatient or community rehabilitation. Conclusions:Tailoring of the service delivery approach may be required for individuals who receive rtPA based on functional limitations evident post-rtPA. Future research into the impact of rtPA on motor, cognitive and communication recovery after stroke is vital to inform rehabilitation programs and optimize outcomes.
Keywords: Thrombolysis, interdisciplinary, rehabilitation, stroke, outcome, tissue plasminogen activator
DOI: 10.3233/NRE-141091
Journal: NeuroRehabilitation, vol. 35, no. 1, pp. 9-16, 2014
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