Acute Stroke
Conditions
Keywords
Stroke, rehabilitation, motor recovery, cognition, quality of life
Brief summary
Objective: To evaluate the effect of interdisciplinary home rehabilitation of patients with acute stroke. The trial seeks to evaluate: 1. Can early home rehabilitation affect the degree of independence (motor capacity, activities of daily living and cognitive status), quality of life and the possibility of discharge to own home? 2. Can home rehabilitation influence the length of admission at a rehabilitation centre in the municipality, readmission to hospital, the use of healthcare services and death? 3. To what extend can home rehabilitation be implemented according to finances? Materials and methods: Patients at the age 18 years or more admitted to the stroke unit at the University Hospital of Gentofte. The patients were eligible when meeting the following criteria: symptoms of stroke, need of rehabilitation tree days after admission, living in own home in the Municipality of Gentofte, Lyngby-Taarbaek or Rudersdal and Modified Rankin Score between 0 and 3. The trial was conducted as a randomised controlled trial. The control group patients were rehabilitated according to normal procedure. The intervention group patients were rehabilitated according to normal procedure and were additionally rehabilitated at home during admission and four weeks after discharge.
Detailed description
Objectives were to assess the efficacy of home-based stroke rehabilitation compared to standard care in stroke patients using an interventional, randomised, safety/efficacy open-label trial and parallel assignment. The setting was single-center, stroke unit at the University Hospital of Copenhagen, Gentofte, although patients were recruited through a collaboration of several municipalities. Participants were eligible patients with a clinical diagnosis of stroke and focal neurological deficits hospitalised in a stroke unit for more than three days and in need of rehabilitation. Interventions patients were randomised to home-based rehabilitation during hospitalization and for up to 4 weeks after discharge to replace part of usual treatment and rehabilitation services. Control patients received treatment and rehabilitation following usual guidelines for the treatment of stroke patients. Main outcome measures 90 days post-stroke, modified Rankin Scale, and motor rehabilitation, cognitive abilities, quality of life and treatment-associated economy as secondary outcomes.
Interventions
Rehabilitation at home during hospital stay and after discharge
OTHERStandard care
Standard care during hospital stay and in the municipality after discharge
Sponsors
Ministry of the Interior and Health, Denmark
University Hospital, Gentofte, Copenhagen
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 18 years or more, * Symptoms of stroke, * Need of rehabilitation tree days after admission, * Living in own home, * Modified Rankin Score between 0 and 3
Exclusion criteria
* Terminal care, * Discharged from another department, Living in nursery home, * Can not understand the Danish language, * Memory difficulties
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| modified Rankin Scale | 90 days | To investigate differences in the modified Rankin Scale among intervention and control patients at the inclusion time point and 90 days later. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| EuroQol-5D™ quality of life measurement | 90 | To measure differences of perceived quality of life in the EuroQol-5D™ quality of life test (EQ-5D) among intervention and control patients at the inclusion time point and 90 days later. |
| Barthel-100 Index | 90 | To investigate differences in the Barthel-100 Index scores among intervention and control patients at the inclusion time point and 90 days later. |
| Motor Assessment Scale | 90 | To investigate differences in Motor Assessment Scale test scores among intervention and control patients at inclusion time point and after 90 days. |
| CT-50 Cognitive Test | 90 | To investigate differences in CT-50 Cognitive Test scores among intervention and control patients at inclusion time point and after 90 days. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Body Mass Index | 90 | To investigate differences in Body Mass Index (BMI) scores among intervention and control patients at inclusion time point and after 90 days. |
| Economy | 90 | To estimate differences in treatment associated costs among intervention and control patients at inclusion time point and after 90 days. |
Countries
Denmark
Outcome results
None listed