Role of Physiotherapy in Improving Functional Outcomes and Quality of Life after Spontaneous Subarachnoid Haemorrhage

Abstract

Background
Spontaneous subarachnoid haemorrhage (SAH) is a life-threatening neurological emergency that often results in significant functional disability despite definitive surgical intervention. While microsurgical clipping secures the aneurysm, post-operative rehabilitation plays a crucial role in patient recovery. The role of physiotherapy in improving functional outcomes in these patients remains underexplored in low-resource settings. The objective of thi study is to evaluate the effect of physiotherapy on functional recovery in patients undergoing microsurgical clipping for spontaneous SAH.
Methods
This was a retrospective study conducted at Nobel Medical College Teaching Hospital, Biratnagar, Nepal, from February 2022 to January 2024. All patients who underwent microsurgical clipping received standardized in-hospital physiotherapy followed by home-based rehabilitation. Functional outcomes were assessed using the Functional Independence Measure (FIM) at post-operative baseline, discharge, and at 6-month follow-up.
Results
A total of 47 patients (34 males and 13 females) were included. At the 6-month follow-up, 70.2% of patients showed significant improvement in FIM scores, with marked gains in self-care, mobility, and cognitive domains. Patients who adhered to the prescribed physiotherapy regimen demonstrated significantly higher functional independence than those with irregular or poor physiotherapy compliance (p < 0.01). No adverse effects related to physiotherapy were reported.
Conclusions
Physiotherapy significantly contributes to the functional recovery of patients after microsurgical clipping for spontaneous SAH. Incorporating structured physiotherapy into the standard post-operative care pathway can enhance long-term outcomes, especially in resource-limited neurosurgical centres.