Physical therapy in primary care in patients after stroke

Abstract

Introduction. In the primary care of the Sistema Único de Saúde (SUS) there are few reports of home rehabilitation of patients after stroke. Objective. To report cases of home rehabilitation of adults with stroke in primary care, in an area covered by a Family Health Strategy (FHS). Method. Clinical diagnosis, comorbidities, number of sessions, conducts and physical therapy evaluation, vital signs before and after sessions, and adverse effects were collected from patient records affected by stroke in an FHS in Cachoeira do Sul-RS, Brazil. For data analysis, the Student t-test was used to compare the difference between vital signs before and after physical therapy intervention. Results. Four medical records of patients with clinical diagnosis of stroke were evaluated; of both sexes and mean age of 66.25±11.79 years. The most found physical therapy diagnosis was hemiparesis, balance changes and reduced functionality. The most prevalent home rehabilitation behaviors were gait training, stretching, active exercise; guidance to the patient and caregivers and prescription of physical exercises and breathing/ventilatory exercises. No serious adverse effects were observed during consultations. Only one patient showed no increase in vital signs after home rehabilitation sessions. Conclusion. Home rehabilitation in public primary care of stroke patients is feasible, effective, and variable regarding the conducts and evaluations adopted. The physical therapist plays an important and broad role in the clinical context of home care for stroke patients.