BACKGROUND AND PURPOSE: The optimal organization of rehabilitation services after discharge from a stroke unit has not been determined. This study sought to evaluate the effect of early supported discharge and continued rehabilitation at home (ESD), in terms of patient outcome 5 years after stroke and changes in selected data over time. METHODS:Eighty-three patients from Southwest Stockholm, mildly or moderately impaired 5 to 7 days after acute stroke, were enrolled in a randomized controlled trial. The core components of the ESD service were initial treatment in a stroke unit and the involvement of an outreach team to deliver and coordinate home-based rehabilitation in partnership with the patient. At the 5-year follow-up, measures used to assess patient outcome included survival, motor capacity, dysphasia, activities of daily living (ADL), social activities, subjective dysfunction, and self-reported falls. RESULTS: Fifty-four patients (30 in the intervention group and 24 in the control group) were evaluated 5 years after stroke, at which time a significantly larger proportion of patients in the intervention group were independent in extended ADL and active in household activities. CONCLUSIONS: This ESD service has a beneficial effect on extended ADL 5 years after stroke for mildly to moderately impaired patients.
RCT Entities:
BACKGROUND AND PURPOSE: The optimal organization of rehabilitation services after discharge from a stroke unit has not been determined. This study sought to evaluate the effect of early supported discharge and continued rehabilitation at home (ESD), in terms of patient outcome 5 years after stroke and changes in selected data over time. METHODS: Eighty-three patients from Southwest Stockholm, mildly or moderately impaired 5 to 7 days after acute stroke, were enrolled in a randomized controlled trial. The core components of the ESD service were initial treatment in a stroke unit and the involvement of an outreach team to deliver and coordinate home-based rehabilitation in partnership with the patient. At the 5-year follow-up, measures used to assess patient outcome included survival, motor capacity, dysphasia, activities of daily living (ADL), social activities, subjective dysfunction, and self-reported falls. RESULTS: Fifty-four patients (30 in the intervention group and 24 in the control group) were evaluated 5 years after stroke, at which time a significantly larger proportion of patients in the intervention group were independent in extended ADL and active in household activities. CONCLUSIONS: This ESD service has a beneficial effect on extended ADL 5 years after stroke for mildly to moderately impairedpatients.
Authors: Binith Cheeran; Leonardo Cohen; Bruce Dobkin; Gary Ford; Richard Greenwood; David Howard; Masud Husain; Malcolm Macleod; Randolph Nudo; John Rothwell; Anthony Rudd; James Teo; Nicholas Ward; Steven Wolf Journal: Neurorehabil Neural Repair Date: 2009-02 Impact factor: 3.919
Authors: R J Morecraft; J Ge; K S Stilwell-Morecraft; D W McNeal; S M Hynes; M A Pizzimenti; D L Rotella; W G Darling Journal: J Comp Neurol Date: 2015-08-18 Impact factor: 3.215
Authors: Ian D Cameron; Suzanne M Dyer; Claire E Panagoda; Geoffrey R Murray; Keith D Hill; Robert G Cumming; Ngaire Kerse Journal: Cochrane Database Syst Rev Date: 2018-09-07
Authors: Cheryl D Bushnell; Pamela W Duncan; Sarah L Lycan; Christina N Condon; Amy M Pastva; Barbara J Lutz; Jacqueline R Halladay; Doyle M Cummings; Martinson K Arnan; Sara B Jones; Mysha E Sissine; Sylvia W Coleman; Anna M Johnson; Sabina B Gesell; Laurie H Mettam; Janet K Freburger; Blair Barton-Percival; Karen M Taylor; Janet Prvu-Bettger; Gladys Lundy-Lamm; Wayne D Rosamond Journal: J Am Geriatr Soc Date: 2018-03-23 Impact factor: 7.538
Authors: Raquel Boix; José Luis del Barrio; Pedro Saz; Ramón Reñé; José María Manubens; Antonio Lobo; Jordi Gascón; Ana de Arce; Jaime Díaz-Guzmán; Alberto Bergareche; Félix Bermejo-Pareja; Jesús de Pedro-Cuesta Journal: BMC Neurol Date: 2006-10-16 Impact factor: 2.474
Authors: Geert S A F Verheyden; Vivian Weerdesteyn; Ruth M Pickering; Dorit Kunkel; Sheila Lennon; Alexander C H Geurts; Ann Ashburn Journal: Cochrane Database Syst Rev Date: 2013-05-31