Tuesday, 14 December 2010 17:01

By Shahfizal Musa
Pix by PPUKM

KUALA LUMPUR  14, Dec. 2010  – UKM Medical Centre has revolutionised the way stroke patients are rehabilitated in the country with their Combined Stroke Rehabilitation Clinic (CSRC) which has physiotherapists, speech therapists and occupational therapists working together to help stroke victims regain their normal life back.

The programme, part of the Kuala Lumpur  Regional Stroke Intervention systems KRISIS, also teaches stroke victims how to drive again, improve their relationships with their spouses and living healthy lifestyles.

This fully integrated rehabilitation treatment offered by UKMMC aims at helping stroke victims to regain their life back.

Associate Prof Dr Noor Azah Aziz, the Family Medicine Consultant & Stroke specialist said all stroke patients have to undergo rehabilitation. Conventional stroke rehabilitation programmes focussed more on helping patients to cope with their disability. Thus the life for a stroke victim without undergoing the integrated rehabilitation treatment will be different from their normal life prior to the attack.

But with the CSRC, the team of multi-disciplinary experts will through the fully integrated rehabilitation treatment try to help the victims regain their normal lives before the attacks.

“In the last 20 years when a person gets a stroke attack he either live with the resultant complications or his normal life ends there. We have now relooked into that condition. If the patient can sit we will try to make him stand, if he is able to stand we will try to make him walk, if he is able to walk we will make him go outdoors” said Dr Noor Azah.

Custom made Rehab

Before the CSRC was set up, stroke rehabilitation focusses on occupational therapy which involves re-training the stroke survivor’s brain to adapt to the disabilities caused by the stroke.

Basically it is to perform the task of daily living most effectivelyand taking care to avoid any deformities or complications. In other words it is only helping  the victim to cope with the disability that he had instantly acquired.

However each patient have their own set of problems and their own disabilities. The Neuro-rehab team will devise a custom made structured rehabilitation programme for each particular patient, said Dr Noor Azah.

Family support

For a stroke victim his life is completely turned upside down in the blink of an eye. Imagine that one minute you are walking and talking and doing the things that a normal person does and the next minute half of your body is paralysed.

No family member has been trained to deal with such a situation let alone expect that their love ones would become a stroke victim. So it is common for the carer of the stroke victim usually his or her spouse to be under pressure.

“Most importantly the CSRC looks at family support. The family aspects are normally neglected and taken for granted. And some will have carer fatigue”

“Sometimes it causes family problems like putting a strain on the marriage. Currently we only look at the stroke patients but we don’t realise that the carers also needed help,” said Dr Noor Azah.

The CSRC takes all these factors into consideration and also provide assistance to the carers such as counselling on how to deal with the life changing situation.

Stumbling block to recovery

For many stroke patients the biggest stumbling block to recovery is their mental attitude. A lot of them also suffer from depressions, which usually start once they get home.  When they are in such a state they do not want to do their exercises or don’t want to get involved in rehabilitation. Their condition will  then deteriorate, said Dr Noor Azah.

“The CRSC will keep tabs on the stroke victim for two years to ensure that his mental attitude do not get in the way of his recovery and make sure he changes his lifestyles so he will not be inviting another attack.”

Sex and driving after stroke

Some patients take their conditions a little bit too seriously to the detriment of their quality of life. There are patients who after the attack act as if they are doomed for the rest of their lives.

Most of the patients do not want to indulge in sexual activity which can cause a strain to their marriages and can sometimes lead to divorces.

Dr Noor Azah said there are certain parameters to be adhered to but a stroke patient would not suffer another stroke by having sex. Another common predicament was they refused to drive

“You will be surprised that there are patients who would not drive at all after a stroke to the extent that UKMMC have driving assessment and driving rehabilitation. We teach the patient to drive again and we have a car specifically for that,” said Dr Noor Azah.

Though the CRSC will cover all the basics to give a stroke patient the push that he needs to get back on the road to recovery, but it is up to him to be positive and not resigned to the notion that his life is over.

The CRSC is thus passionate in helping patients to get their life back. There are now already patients living a better life than before their attacks.

“Some of the patients, do not know about healthy eating, exercises or what Body Mass Index (BMI) is, but after their rehab they are living a health conscious life and taking better care of themselves, ” she said.