Patient case study: Small left parietal stroke

We take pride in providing exceptional and personalised patient care for each of our patients. Through our strategy of personalised high-intensity rehabilitation, we’re able to achieve strong clinical outcomes like the one below.

Our patient’s background and the challenge

Maggie was 77 years old when she fractured her ankle following a fall in her garden. Unfortunately she had to wait a relatively long time for an ambulance to arrive, and due to her stressful condition she developed a heart issue which then led to a small left parietal stroke.

The parietal lobe is a key part of the brain associated with the processing of sensory information, like spacial awareness, our sense of touch, and the part of our vision that deals with the location of objects. As a result, Maggie had difficulty moving as we would in every day life. For example, getting out of bed, getting in and out of the shower, or walking up a flight of stairs. This left her with a reliance on care, which in turn affected her quality of life.

Exceptional outcome

Immediately after the stroke, Maggie was admitted to her local acute hospital and stayed there for 5 weeks until her condition stabilised. She was then admitted to Circle Rehabilitation. Her main goal when she arrived at our facility was to restore her strength and improve her mobility.

The expected length of stay at Circle was initially expected to be around 50 days, however following a period of intensive, multidisciplinary rehabilitation, she was able to return home after just 26 days.

Therapy and treatment

During her first week at Circle Rehabilitation, Maggie had four physiotherapy sessions, with an additional three 1-hour occupational therapy sessions and a psychological assessment. In her second week, physiotherapy was increased to six 1-hour sessions, occupational therapy to four 1-hour sessions and two additional hours of exercise were added.

A typical day in rehabilitation will include some of the following activities, but is not restricted to just these:

Hospitality:
Patients are helped to get ready for the day and have several menu options to choose from for breakfast, lunch and dinner.

Physiotherapy:
Vital to the recovery of patients, our skilled staff provide physiotherapy or hydrotherapy.

Ward rounds:
Staff visit patients at regular intervals to check and discuss their progress.

Consultant visits:
The patient’s consultant also checks in to monitor the progress and success of treatment.

Outcome

‘Functional Independence Measure’, also known as ‘FIM’, is way in which we measure a patient’s rehabilitation progress. These assessments are internationally approved outcome measures used to accurately measure disability in the UK. The assessments have a set list of criteria which are used regularly before, during and after treatment. That way we can accurately see changes in how a patient is responding to rehabilitation in real-time and adjust the treatment plan if needed.

A FIM score is based on a scale of 0 to 7, whereby 0 means total dependence and 7 means independence.

A complete list of scores for the FIM is as follows:

1. Total assist needed
2. Maximal assist (you can perform 25 percent of the task)
3. Moderate assist (you can perform 50 percent of the task)
4. Minimal assist (you can perform 75 percent of the task)
5. Supervision needed
6. Modified independence (you use an assistive device)
7. Independence in performing the task

This scale is used to measure 18 separate tasks, including eating, bathing, toileting, walking and social interaction, to name a few.

To learn more about these assessment measures and our overall outcomes across Circle Rehabilitation click on the button below.

FIM & FAM rehabilitation measurements

Maggie was delighted to be in an environment that was dedicated to helping her improve in her recovery after her significant life event. In addition to her rehabilitation stay, she had full access to a range of in-house specialist diagnostic tests including MRI, x-ray and ultrasound. This was particularly important when a Doppler scan was required to eliminate possible DVT.

Having been admitted with moderate levels of care needs, with an average FIM score of 4.6, Maggie was able to leave Circle Rehabilitation with an average FIM score of 6.2. This means she had near independence at the time she was discharged with significant improvement in her mobility and cognitive functions.

*Some patient details have been changed to ensure patient privacy.