Home or Hospital for Stroke Rehabilitation?

Completed

Phase N/A Results

Trial Description

To compare early hospital discharge and home-based rehabilitation with usual inpatient rehabilitation and follow-up care for patients with acute stroke.

Interventions

Trial Design

Randomized, controlled trial of 86 patients at 2 centers.

Patient Involvement

Patients were randomized to receive early hospital discharge with home-based rehabilitation or inpatient rehabilitation. Efforts were made to discharge patients in the intervention program within 48 hours of randomization. Therapy sessions were conducted in these patients' homes and were individually tailored, with the aim of achieving a set of mutually agreed-upon goals over several weeks. Emphasis was placed on self-learning and adjustment to disability, and structured practice sessions were encouraged between visits. Patients randomized to the control group received conventional care and rehabilitation in hospital, either on an acute-care medical/geriatric ward or in a multidisciplinary stroke rehabilitation unit run by specialists in rehabilitation or geriatric medicine. All patients (and their caregivers) were followed up at 1, 3, 6, and 12 months after randomization.

Outcomes

Type Measure Time Frame Safety Issue
Primary Self-reported general health status (SF-36) at 6 months after randomization.
Secondary Nottingham Health Profile, MFAD, AAP, GHQ-28, and the Caregiver Strain Index for caregivers; modified Barthel Index, Mini-Mental State Examination, 28-itme General Health Questionnaire, Adelaide Activities Profile, General Functioning Subscale of the McMaster Family Assessment Device for patients and caregivers; use of community services, readmissions to hospital, history of falls, place of residence, and patient and caregiver satisfaction with their medical care, rehabilitation, and recovery were assessed with questionnaires developed for the study.

Sponsors

South Australian Health Commission