BACKGROUND: To develop and examine the effectiveness of individual 6-month home rehabilitation program in ischemic stroke patients upon disability and quality of life at 2 years. METHODS: This is a prospective randomized controlled trial (RCT) in 60 patients with recent ischemic stroke. They were randomly assigned to receive either home rehabilitation program once a month for 6 months with audiovisual materials (intervention group) or usual care (control group). We collected outcome data after discharge from the hospital until 2 years. The Barthel index (BI), the modified Rankin Scale (mRS) and utility index (EQ-5D) were measured for function, disability and quality of life respectively. RESULTS: At 2 years, the BI was significantly improved in the intervention group more than the control group: 97.2±2.8 vs. 76.4±9.4, p<0.001. The good outcome, defined as BI 95-100, or mRS 0 or 1. For BI, there were 29 patients (96.7%) in intervention group vs 12 patients (42.9%) in usual care group (95% CI, 42.0, 85.0, p=0.03). For mRS, there were 28 patients (93.3%) in intervention group vs 9 patients (32.1%) in usual care group (95% CI, 38.2, 87.0, p=0.02). Number needed to treat for good outcome in mRS was 2.0 (95% CI: 1.0, 1.3). The mean (SD) of utility index in intervention group and control group were 0.9±0.02 and 0.7±0.04 respectively (p=0.03). There was no significant interaction in baseline characteristics and treatment outcome. CONCLUSIONS: Early home rehabilitation program in the first 6 months period after ischemic stroke leads to more rapid improvement in function, reducing disability and increase quality of life than usual care.
RCT Entities:
BACKGROUND: To develop and examine the effectiveness of individual 6-month home rehabilitation program in ischemic strokepatients upon disability and quality of life at 2 years. METHODS: This is a prospective randomized controlled trial (RCT) in 60 patients with recent ischemic stroke. They were randomly assigned to receive either home rehabilitation program once a month for 6 months with audiovisual materials (intervention group) or usual care (control group). We collected outcome data after discharge from the hospital until 2 years. The Barthel index (BI), the modified Rankin Scale (mRS) and utility index (EQ-5D) were measured for function, disability and quality of life respectively. RESULTS: At 2 years, the BI was significantly improved in the intervention group more than the control group: 97.2±2.8 vs. 76.4±9.4, p<0.001. The good outcome, defined as BI 95-100, or mRS 0 or 1. For BI, there were 29 patients (96.7%) in intervention group vs 12 patients (42.9%) in usual care group (95% CI, 42.0, 85.0, p=0.03). For mRS, there were 28 patients (93.3%) in intervention group vs 9 patients (32.1%) in usual care group (95% CI, 38.2, 87.0, p=0.02). Number needed to treat for good outcome in mRS was 2.0 (95% CI: 1.0, 1.3). The mean (SD) of utility index in intervention group and control group were 0.9±0.02 and 0.7±0.04 respectively (p=0.03). There was no significant interaction in baseline characteristics and treatment outcome. CONCLUSIONS: Early home rehabilitation program in the first 6 months period after ischemic stroke leads to more rapid improvement in function, reducing disability and increase quality of life than usual care.
Authors: Lynn A Legg; Sharon R Lewis; Oliver J Schofield-Robinson; Avril Drummond; Peter Langhorne Journal: Cochrane Database Syst Rev Date: 2017-07-19
Authors: Louis S Matza; Katie D Stewart; Shravanthi R Gandra; Philip R Delio; Brett E Fenster; Evan W Davies; Jessica B Jordan; Mickael Lothgren; David H Feeny Journal: BMC Health Serv Res Date: 2015-04-22 Impact factor: 2.655
Authors: Remedios López-Liria; Francisco Antonio Vega-Ramírez; Patricia Rocamora-Pérez; José Manuel Aguilar-Parra; David Padilla-Góngora Journal: PLoS One Date: 2016-11-11 Impact factor: 3.240