Keeping a brain stroke patient in a supine position would not alter the outcome of the treatment, medical researchers have found, dispelling a popular notion held by many doctors.
The conclusion was reached on the basis of a major trial involving 11,093 brain stroke patients from 114 hospitals from nine countries. This includes 499 Indian patients from six hospitals.
The 21 months long trial that began in March 2015 and continued till November 2016 examined the clinical outcome of patients with different head positions.
“The head positions – lying flat or an incline position with support behind the back – don't affect the treatment outcome,” Jeyaraj D Pandian, head of neurology at Christian Medical College, Ludhiana and one of the researchers involved in the study told DH.
For a brain stroke patient, first 9 hours is crucial for medical intervention whereas first 24 hours is important to address the symptoms with medication and nursing care.
“Many stroke specialists believe that the way the body is positioned after stroke makes a difference to their patient’s recovery. But, there was really no conclusive evidence to back this up. We know the first 24 hours of care post-stroke is crucial to recovery, so it was vital to find out if sitting up or lying down flat could make any difference,” said lead investigator Craig Anderson from The George Institute of Global Health, Sydney.
During the study, the patients were either assigned to lie flat with their face upwards or with their head raised to at least 30 degrees during the first 24 hours after being admitted to the hospital for a stroke. They were then assessed 90 days later.
“We showed that the variations don't matter. We found is that patients who were lying flat, felt somewhat uncomfortable, but it certainly didn’t make their condition any worse. Our findings suggest a review of current clinical practice guidelines is warranted,”said Pandian.
The study has been published in the June 22 issue of the New England Journal of Medicine.
From India 499 patients were enrolled from half a dozen stroke centers viz. CMC Ludhiana; Post Graduate Institute for Medical Education and Research, Chandigarh; Dr Ramesh Superspeciality Hospitals, Guntur; Sree Chitra Tirunal Institute for Medical Science and Technology, Thirvananthapuram; and Baby Memorial Hospital, Kozhikode and Narayana Hrudalaya, Bengaluru.