To compare early hospital discharge and home-based rehabilitation with usual inpatient rehabilitation and follow-up care for patients with acute stroke.
Randomized, controlled trial of 86 patients at 2 centers.
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.
|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.|