Overcoming a stroke is only the first step towards recovery, which also largely depends on the rehabilitation following the acute event. And on this phase there is still a long way to go. In fact, even if 89% of patients declare that they have found improvements, both neurological and physical, following rehabilitation treatments, 34% consider the experience insufficient and 17% consider their quality of life poor. These are some of the data contained in a survey promoted by ISA-AII | Italian Stroke Association – Italian Stroke Association presented today to the Ministry of Health during an event that saw the participation of leading specialists who, in various capacities, intervene on the disease. The survey is part of the ‘Strike on Stroke’ project promoted by the scientific society and carried out thanks to the non-conditioning contribution of Ipsen.
Stroke, in Italy over 100 thousand cases a year. Here is the European plan to improve care
by Tiziana Moriconi
The patient survey
The survey was carried out online on 250 patients, assisted in health facilities throughout the country. There are many data that bring out the discontent of patients due to various factors. For example, over 38% begin recovery in a different health facility than the one where the hospitalization took place. “Strokes can be defeated thanks to prevention, timely therapeutic intervention and the innovative treatments available today – he underlines Mauro Silvestrini, president of ISA-AII. In Italy we are able to guarantee excellent assistance thanks to the preparation of specialist doctors and a network of top-level centers. However, there is still room for improvement on some aspects that are fundamental in the management of a dangerous and disabling pathology such as stroke “.
Spasticity, still too few patients receiving adequate treatment
The spot with Massimo Lopez
Half of the patients also ask for more information on rehabilitation therapies and also a more ongoing relationship with the neurologist specialist. “Up to 38% of patients – continues Silvestrini – have spasticity more than one year after the event and the difficulties in accessing specific therapies were well highlighted in our survey. It therefore seems important to us to continue an information and awareness campaign focused precisely on rehabilitation and quality of life. These are issues that have so far been neglected both in clinical practice and in communication “. The high-impact commercial made with the actor also goes in this direction Massimo Lopez (watch the ad and / or download it) and presented today to the Ministry of Health.
Heart attacks and strokes, a patch will be enough to measure the risk
by Mara Magistroni
The investigation into doctors
A survey of 250 doctors was also carried out in recent months. One in three confess that they do not have PDTA-protocols-guidelines available to refer patients to rehabilitation wards. 38%, on the other hand, work in neurovascular units where rehabilitation management is not carried out before the patient is discharged. Six out of ten doctors admit that they do not know if there are regional regulations for the definition of a rehabilitation path. “Organizational and structural problems make it difficult to obtain therapies capable of significantly improving the quality of life – he continues Danilo Toni, past president ISA-AII. The delays that accumulate are also worrying, given that 64% of specialists spend on average more than seven days from the moment of acute hospitalization to arrival in the rehabilitation department “.
Stroke, still few patients accessing rehabilitation
The importance of rehabilitation
Rehabilitation after stroke is a complex phase of the disease and includes various possible treatments: you can act with stretching and muscle strengthening or with the use of other physical interventions. Pain management occurs through the administration of specific analgesics. “There are also pharmacological therapies against spasticity such as peripheral-acting muscle relaxants, among which botulinum toxin stands out”, continues Toni. “Today it is considered the most effective treatment for focal spasticity. It allows us to treat only the muscles affected by the problem thus favoring the recovery of motor activities. Considering all these options, and the inherent problems, we believe that pre-established paths at regional or national level are necessary. Only in this way will it be possible to manage the rehabilitation of the sick throughout the peninsula in a uniform manner “.
Stroke, rehabilitation passes through video games. Thanks to telemedicine
by Mara Magistroni
Who risks the most
Every year in Italy 185,000 people are affected by stroke. It represents the number one cause of disability and among the top three of death, along with heart disease and cancer. “The most exposed to the risk of the disease are men over 65 years of age, among whom we register about 75% of cases – intervenes Paola Santalucia, elected president of ISA-AII. Even when it is not fatal, the impact it determines is truly remarkable, both for the individual patient and for the entire National Health System. The number of patients is destined to increase in the coming years together with the increase in the average age of the population of our country. An organized and efficient rehabilitation, in all 21 regional health systems of the Peninsula, must be an absolute priority to be achieved. As a Scientific Society we are ready and willing to dialogue with national and local health institutions to find concrete solutions and thus solve current problems “.
Commitment at the European level
The commitment to a common approach at European level was recalled by Francesca Romana Pezzella, ISA-AII secretary and co-chair of ESO’s Stroke Action Plan for Europe (SAP-E) | European Stroke Organization. “Meetings like these, in institutional settings, are also necessary to relaunch SAP-E Europe – he declares – which aims to limit the impact of the disease by 2030 starting from primary prevention, organization of acute stroke care, secondary prevention, rehabilitation, outcome assessment and life after stroke. The recommendations contained in the document would make it possible to reduce the number of new cases by 10% per year. For Italy we are talking about 15 thousand fewer patients “.