This document summarizes a presentation on stroke rehabilitation challenges in Nepal. It discusses how stroke is a major cause of death and disability in Nepal. Only 4-68% of stroke patients achieve functional independence depending on stroke severity. Goals of rehabilitation are to maximize independence, optimize psychosocial adaptation, and reintegrate patients into the community. Challenges include patient factors like availability of funds as well as a lack of rehabilitation expertise. Proposed solutions involve establishing more rehabilitation centers, acute stroke units, ensuring availability of rehabilitation experts, forming stroke care teams, and increasing stroke insurance coverage and community support.

1. Stroke Rehabilitation Challenges
“Experience from Bhairahawa / Butwal”
Presenter:
Roshan Bishwakarma
Chief Physiotherapist
Neuro & Allied Clinic
Bhairahawa and
DH Physiotherapy & Neuro Rehabilitation
Butwal,Rupandehi,Nepal
Date:9/4/2018

2. Background
 Stroke is an important public health problem in Nepal
 It is one of the major causes of death and disability
 Percentage of people reaching functional
independence:
Very severe stroke: 4%
 Severe stroke: 13%
Moderate stroke: 37%
Mild stroke: 68%

3. Objectives
1. Goals of rehabilitation
2. Challenges in stroke rehabilitation
3. Proposed solution
4. Summary

4. Goals of Rehabilitation
 To maximize functional independence
 To optimize psychosocial adaptation of patients and
families
 To reintegrate into Community
 To enhance quality of life

5. Patient Related Challenges
PatientFund
Facilities
availability
Communication
Time
Health Expertise
Awareness &
knowledge
factor

6. Physiotherapist Related Challenges
Stroke
Rehabilitation
Counseling
Communication
Spasticity
management Motivation
Faith
healers
Lack of
awareness
among
medical
professional

7. Our approach
Stroke
Rehabilitation
Exercise
Therapy
Speech
therapy
Occupational
therapy
Stroke
awareness
Stroke
data
collection
Health 4
the world
stroke

8. Stroke
Rehabilitation
Care
giver
training
Nursing
care
Post stroke
checklist visit
Home based
physiotherapy
Recreational
program
Community
transition
Follow up for
medical checkup
Our approach

9. Stroke Rehabilitation Center
DH Physiotherapy & Neuro
Rehab Center, Butwal
Department of Physiotherapy &
Rehabilitation at Bhairahawa

10. Physiotherapy Department

11. Speech therapy Hand rehabilitation

12. Post stroke Checklist

13. Continue…………

14. Nursing counseling Social officer counseling

15. Research on Quality of life
Data collection Taking consent

16. Proposed Solution
 Rehabilitation centers
 Acute Stroke Unit
 Availability of experts:
– Speech therapist
– Occupational therapist
– Prosthetics & Orthotics
 Stroke care team
 Stroke covering insurance
 Community and Social organizations support
 Fund raising programs
 Guidelines for rehabilitation
 Researches

17. Summary
 Stroke rehabilitation is a big challenge
 Team effort is essential for:
Successful outcome
Enhancing quality of life

18. Thank you