Article

OBJECTIVE: To evaluate if home-based rehabilitation of inpatients improved outcome compared to standard care. DESIGN: Interventional, randomised,
safety/efficacy open-label trial. SETTING: University hospital stroke unit in
collaboration with three municipalities. SUBJECTS: Seventy-one eligible stroke
patients (41 women) with focal neurological deficits hospitalised in a stroke
unit for more than three days and in need of rehabilitation. INTERVENTIONS:
Thirty-eight patients were randomised to home-based rehabilitation during
hospitalization and for up to four weeks after discharge to replace part of usual
treatment and rehabilitation services. Thirty-three control patients received
treatment and rehabilitation following usual guidelines for the treatment of
stroke patients. MAIN MEASURES: Ninety days post-stroke the modified Rankin Scale
score was the primary endpoint. Other outcome measures were the modified
Barthel-100 Index, Motor Assessment Scale, CT-50 Cognitive Test, EuroQol-5D, Body
Mass Index and treatment-associated economy. RESULTS: Thirty-one intervention and
30 control patients completed the study. Patients in the intervention group
achieved better modified Rankin Scale score (Intervention median = 2, IQR = 2-3;
Control median = 3, IQR = 2-4; P=0.04). EuroQol-5D quality of life median scores
were improved in intervention patients (Intervention median = 0.77, IQR =
0.66-0.79; Control median = 0.66, IQR = 0.56 - 0.72; P=0.03). The total amount of
home-based training in minutes highly correlated with mRS, Barthel, Motor
Assessment Scale and EuroQol-5D scores (P-values ranging from P<0.00001 to
P=0.01). Economical estimations of intervention costs were lower than total costs
of standard treatment. CONCLUSION: Early home-based rehabilitation reduced
disability and increased quality of life. Compared to standard care, home-based
stroke rehabilitation was more cost-effective.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS