Benjamin Diem
University Hospital Zurich
Switzerland
Abstract Title: Implementation of an outpatient rehabilitation programme after stroke
Biography:
Benjamin Diem has completed his BSc Physiotherapy at Applied University of Zurich. He is a physiotherapist, specialized in neurological rehabilitation at University Hospital of Zurich.
Research Interest:
Cardiovascular disease, including stroke, is the leading cause of death in Switzerland. Many stroke survivors face permanent disability and require care. Patients with mild, transient deficits are often discharged without physiotherapy, despite evidence that this group is at a higher risk of recurrence—30% experience a recurrence within ten years, with 18% of these being fatal. While pharmacological intervention is common in secondary prevention, research suggests lifestyle changes, particularly targeted exercise, can positively influence cardiovascular risk factors such as hypertension, hypercholesterolemia, and diabetes. This article proposes an outpatient rehabilitation program for stroke patients with a modified Rankin Scale (MRS) of 0-2 to support secondary prevention alongside pharmacological treatments. A literature review revealed parallels to cardiac rehabilitation, highlighting a gap in physiotherapy support for mild stroke patients at the University Hospital Zurich. A consensus discussion confirmed the need for a secondary prophylactic approach tailored for these patients. The program includes cardiopulmonary endurance, strength, and balance training, alongside education aimed at enhancing self-efficacy and reducing cardiovascular and thromboembolic risks. Supported by the latest literature, this initiative has led to the development of an outpatient rehabilitation protocol, in-house SOP, and patient information materials. Physiotherapists, collaborating with neurologists, manage the program, and staff have been trained in triage and implementation. Program outcomes have demonstrated improvements in cardiovascular endurance, weight management, quality of life, and healthy lifestyle changes in participants. This study underscores the need for a structured rehabilitation pathway for patients with minor cerebrovascular events. Standardizing this program across the canton or nationwide could provide lasting benefits similar to established cardiac rehabilitation programs.