Domiciliary and hospital-based rehabilitation for stroke patients after discharge from hospital "DOMINO"


Phase N/A Results

Trial Description

To determine whether domiciliary rehabilitation would result in greater improvements in instrumental activities of daily living (ADL) in stroke patients who have been discharged from the hospital and also whether caregiver stress would be reduced compared to patients treated by conventional hospital-based services.


Trial Design

Randomized, stratified, controlled trial of 327 patients at 5 centers. Patients were stratified into the following 3 groups based on the type of ward from which they were discharged: Health Care of the Elderly, General Medical, and Stroke Unit.

Patient Involvement

Patients were randomized to receive domiciliary or hospital-based care after discharge. The domiciliary service consisted of 6 months of physiotherapy and occupational therapy by a domiciliary team, followed by routine services if further rehabilitation was needed. Hospital-based care consisted of outpatient rehabilitation or care at a day hospital.


Type Measure Time Frame Safety Issue
Primary Extended Activities of Daily Living (ADL) score three and six months after discharge.
Secondary Barthel Index and Nottingham Health Profile at six months. Caregivers were assessed by Brief Assessment of Social Engagement and the Nottingham version of the Life Satisfaction Index at six months.