Stroke Rehabilitation in the Philippines: An Audit Study

Consuelo Gonzalez-Suarez; Karen Grimmer; Isaias Alipio; Elda Grace Anota-Canencia; Maria Luisa Santos-Carpio; Janine Margarita Dizon; Lauren Liao; Jan Tyrone Cabrera; Romil Martinez; Eulalia Beredo; Carolina Valdecanas; Vania Yu

doi:10.5463/dcid.v26i3.446

Consuelo Gonzalez-Suarez ⁽¹⁾, Karen Grimmer ⁽²⁾, Isaias Alipio ⁽³⁾, Elda Grace Anota-Canencia ⁽⁴⁾, Maria Luisa Santos-Carpio ⁽⁵⁾, Janine Margarita Dizon ⁽⁶⁾, Lauren Liao ⁽⁷⁾, Jan Tyrone Cabrera ⁽⁸⁾, Romil Martinez ⁽⁹⁾, Eulalia Beredo ⁽¹⁰⁾, Carolina Valdecanas ⁽¹¹⁾, Vania Yu ⁽¹²⁾

(1) University of Santo Tomas, Manila, Philippines,

(2) International Centre for Allied Health Research, University of South Australia, Australia,

(3) College of Medicine, Mariano Marcos State University, and University of Northern Philippines, Philippines,

(4) Cebu City, Philippines,

(5) Davao Medical School Foundation Hospital, Philippines,

(6) Centre for Health Research & Movement Science, University of Santo Tomas, Manila, Philippines,

(7) Metro Manila and Batangas, Philippines,

(8) Metro Manila and Batangas, Philippines,

(9) Rehabilitation Unit of Amang Rodriguez Memorial Medical Centre, Marikina, Philippines,

(10) Philippine Orthopedici Center, Quezon City, Philippines,

(11) St Luke’s Medical Centre, Quezon City, Philippines,

(12) St Luke’s Medical Centre, Quezon City, Philippines

https://doi.org/10.5463/dcid.v26i3.446

Issue
Vol. 26 No. 3 (2015): Autumn 2015

Submitted
September 14, 2020

Published
October 24, 2015

Keywords:

Stroke rehabilitation, Philippines, audit study

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Abstract

Purpose: Although cerebrovascular accident is a leading cause of mortality in the Philippines, there has never been a national survey of stroke client descriptors and rehabilitation practices. This paper reports on data from the audit of stroke care for inpatients in hospitals serviced by physiatrists.

Method: Audit was done of the medical records of stroke clients admitted to hospitals with rehabilitation units. Performance indicators for timely referral to rehabilitation were applied.

Results: A total of 1683 records were audited. The majority of clients had cerebral infarct followed by cerebral haemorrhage. The median length of stay was 7 days; stay was lengthier for haemorrhagic strokes. Only 54.1% of the clients were referred to rehabilitation, with a median delay of 3 days between admission and referral to rehabilitation. 25.4% of the clients had early referral to rehabilitation. 39.2% of the 1397 clients were referred to rehabilitation earlier than 2 days before discharge.

Conclusion: This Filipino study provides valuable information on stroke types and prevalence, demographics and rehabilitation practices. Despite the prevalence of post-stroke rehabilitation, it has been underutilised in the management of stroke.

Conclusions: It is possible to identify a core set of health-related CBR skills. These may be considered in the development of training programmes for new or alternative cadres of CBR workers, using a task-shifting model including appropriate support, supervision and referral mechanisms.

Implications: Further research is required to establish the generalisability of the skills sets identified here, both across contexts and different client groups and their needs. The identification of core sets of skills for other areas of the CBR Matrix - livelihood, social, empowerment and education – could similarly facilitate access to these domains for people with disabilities.

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Authors

Consuelo Gonzalez-Suarez

University of Santo Tomas, Manila

bebetsuarez61@gmail.com (Primary Contact)

Karen Grimmer

International Centre for Allied Health Research, University of South Australia

Isaias Alipio

College of Medicine, Mariano Marcos State University, and University of Northern Philippines

Elda Grace Anota-Canencia

Cebu City

Maria Luisa Santos-Carpio

Davao Medical School Foundation Hospital

Janine Margarita Dizon

Centre for Health Research & Movement Science, University of Santo Tomas, Manila

Lauren Liao

Metro Manila and Batangas

Jan Tyrone Cabrera

Metro Manila and Batangas

Romil Martinez

Rehabilitation Unit of Amang Rodriguez Memorial Medical Centre, Marikina

Eulalia Beredo

Philippine Orthopedici Center, Quezon City

Carolina Valdecanas

St Luke’s Medical Centre, Quezon City

Vania Yu

St Luke’s Medical Centre, Quezon City

Author Biographies

Consuelo Gonzalez-Suarez, University of Santo Tomas, Manila

Consuelo B. Gonzalez-Suarez is a practicing physiatrist in hospitals in Metromanila, Philppines. She is currently a professor in the University of Santo Tomas, Manila, Philippines and is researcher at the Center for Health Research and Movement Science of the University of Santo Tomas. She is currently the chair of the Clinical Practice Guideline Committee of the Philippine Academy of Rehabilitation Medicine and is the project leader of the Implementation of the Stroke Rehabilitation Clinical Practice Guidelines in the Philippines

Karen Grimmer, International Centre for Allied Health Research, University of South Australia

Karen Grimmer is an allied health epidemiologist and biostatistician, who is the director of the International Centre for Allied Health Evidence, University of South Australia (www.unisa.edu.au/cahe). She is committed to improving healthcare practices by applying evidence-based practice principles.

Isaias Alipio, College of Medicine, Mariano Marcos State University, and University of Northern Philippines

Isaias P. Alipio, Jr., MD, FPARM is both an academician and a clinician. He is an Assistant Professor in the College of Medicine at the Mariano Marcos State University and the University of Northern Philippines and; the former dean of three physical therapy schools. He chairs the Physical Medicine and Rehabilitation departments of fourmajor hospitals in Northern Philippines. He is the recipient of the 2015 Dr. Jose P. Rizal Memorial Award in Clinical Practice by the Philippine Medical Association

Elda Grace Anota-Canencia, Cebu City

Elda Grace Anota-Canencia, MD has been practicing as a physiatrist in several hospitals in Cebu City, Philippines since 2001. She has been a Facilitator in Cebu Institute of Medicine (CIM) on Problem-Based Learning. She was working as a part-time faculty member at Velez College - College of Physical and Occupational Therapy in Cebu City. She was also the Head of the Department of Physical Therapy of Remedios Trinidad Romualdez Memorial Foundation (RTRMF) in Tacloban City, Philippines and presently has continued to be a consultant of the department. She has been serving as a Physiatrist in charity centers in Lapu-lapu City in Cebu, Paknaan in Mandaue City in Cebu, Naga City in Cebu.

Maria Luisa Santos-Carpio, Davao Medical School Foundation Hospital

Maria Luisa Santos-Carpio, MD, FPARM is currently the Head of Physical & Rehabilitation Medicine Section at the Davao Medical School Foundation Hospital. She likewise holds the position of Mindanao Member-at-Large for the Philippine Academy of Rehabilitation Medicine and President for Philippine Academy of Rehabilitation Medicine Mindanao Chapter. She is an Associate Professor of the Davao Medical School Foundation.

Janine Margarita Dizon, Centre for Health Research & Movement Science, University of Santo Tomas, Manila

Janine Margarita Dizon is a researcher at the Center for Health Research and Movement Science, University of Santo Tomas, Philippines. Janine’s work is in the area of teaching and implementing evidence-based health care practices in health care for quality health service delivery. She has been awarded a fellowship by Stellenbosch University to work on guideline methodological approaches and evaluation for South African Guidelines Excellence project

Lauren Liao, Metro Manila and Batangas

Lauren Anne S. Liao, MD completed her residency training in Physical Medicine and Rehabilitation at the University of Santo Tomas Hospital, Philippines. She is a practicing physiatrist in various hospital in Metromanila and Batangas. She is currently a part of the working group in establishing an updated clinical practice guideline for stroke in the Philippines.

Jan Tyrone Cabrera, Metro Manila and Batangas

Dr. Jan-Tyrone Cabrera is training in Physical Medicine and Rehabilitation at the University of Santo Tomas Hospital in Manila, Philippines. He is a practicing physiatrist and is an active medical consultant in various hospitals in Metro Manila, Bulacan and Nueva Ecija. He is an associate member of the Philippine Academy of Rehabilitation Medicine and has been working with them in the nationwide implementation of Philippine Stroke Clinical Practice Guidelines

Romil Martinez, Rehabilitation Unit of Amang Rodriguez Memorial Medical Centre, Marikina

Dr. Romil M. Martinez is currently employed and chairman of the Rehabilitation Unit of Amang Rodriguez Memorial Medical Center in Marikina, Philippines. He was the past-president of the Philippine Academy of Rehabilitation Medicine and presently co-chair of the Philippine Board of Rehabilitation Medicine. In the past 15 years, his practice is concentrated in neuro- rehabilitation, pain medicine, electrodiagnosis, and bone densitometry.

Eulalia Beredo, Philippine Orthopedici Center, Quezon City

Dr. Eulalia J Beredo, has been the consultant of the Department of Rehabilitation Medicine of the Philippine Orthopedic Center since 1989 and is the current Chair since 2006. She was the President of the Philippine Academy of Rehabilitation Medicine (2014-2015) and is the current President of the Philippine Medical Association- Makati Medical Society Chapter. She was a member of the Research Committee of the Philippine Orthopedic Center and is currently a member of the Ethics Review Board. She has been an active advocate of researches in the field of Physical Medicine and Rehabilitation.

Carolina Valdecanas, St Luke’s Medical Centre, Quezon City

Dr. Carolina M. Valdecañas, MD is currently practicing at St. Luke’s Medical Center, Quezon City, Philippines and Our Lady of Lourdes Hospital, Manila, Philippines. She was the Assistant Chairman of the Department of Physical and Rehabilitation Medicine of St Luke’s Medical Center from 1993 - 2003. She is currently the Project Leader of the Clinical Practice Guidelines (CPG) in Low Back Pain (LBP) of the Philippine Academy of Rehabilitation Medicine (PARM).

Vania Yu, St Luke’s Medical Centre, Quezon City

Dr. Vania Yu is an active consultant of St. Luke's Medical Center, Quezon City, Philippines. She was the former chair of the Department of Physical Medicine and Rehabilitation from 1993-2003. She was the head of the Quality Management Team of the Weight Management Center of St Luke's 2009 – 2013 and presently the adviser to the Quality Management Team of the Department of of Philippine Medicine and Rehabilitation of St. Luke's Medical Center.

1.

Gonzalez-Suarez C, Grimmer K, Alipio I, Anota-Canencia EG, Santos-Carpio ML, Dizon JM, Liao L, Cabrera JT, Martinez R, Beredo E, Valdecanas C, Yu V. Stroke Rehabilitation in the Philippines: An Audit Study. DCIDJ [Internet]. 2015 Oct. 24 [cited 2025 Mar. 14];26(3):44-67. Available from: https://dcidj.uog.edu.et/index.php/up-j-dcbrid/article/view/193

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