Moderately impaired stroke patients do better with early supported discharge from the hospital and continued rehabilitation at home.
Moderately impaired stroke patients do better with early supported discharge from the hospital and continued rehabilitation at home. This approach, compared with standard post-stroke treatment, has a beneficial effect on activities of daily living five years after the stroke.Researchers from the Karolinska University Hospital in Stockholm evaluated 83 patients who were mildly or moderately impaired 5 to 7 days after suffering a stroke. The subjects were randomly assigned to early supported discharge or conventional rehabilitation.
The findings, despite uncertainties about why early supported discharge after stroke works so well, will have implications for further research on allocation of health-care resources including provision of informal care.
The early-discharge group received home-based rehabilitation from a team of occupational therapists, physiotherapists, and a speech-and-language specialist. Rehabilitation lasted for an average of 14 weeks, with a focus on speech and communication, activities of daily living and ambulation. If necessary, the conventional treatment group received additional rehabilitation. Thirty subjects in the early intervention group and 24 in the conventional care group were available for follow-up after five years.A significantly higher percentage of intervention-group patients were independent in extended activities of daily living, scored better in movement ability, and were active in household activities. More intervention patients were able to wash dishes, wash clothes and read books. However, no significant difference in the number of falls was observed.
The findings, despite uncertainties about why early supported discharge after stroke works so well, will have implications for further research on allocation of health-care resources including provision of informal care.
Stroke,
February 2005
February 2005
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