Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life: a randomised controlled trial

Rune Skovgaard Rasmussen; Ann Østergaard; Pia Kjær; Anja Skerris; Christina Skou; Jane Christoffersen; Line Skou Seest; Mai Bang Poulsen; Finn Rønholt; Karsten Overgaard

doi:10.1177/0269215515575165

Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life: a randomised controlled trial

Rune Skovgaard Rasmussen, Ann Østergaard, Pia Kjær, Anja Skerris, Christina Skou, Jane Christoffersen, Line Skou Seest, Mai Bang Poulsen, Finn Rønholt, Karsten Overgaard

Hjerne- & Nervesygdomme HeH

72 Citationer (Scopus)

Abstract

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.

Originalsprog	Engelsk
Tidsskrift	Clinical Rehabilitation
Vol/bind	30
Udgave nummer	3
Sider (fra-til)	225-36
Antal sider	12
ISSN	0269-2155
DOI	https://doi.org/10.1177/0269215515575165
Status	Udgivet - mar. 2016

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10.1177/0269215515575165

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Rasmussen, R. S., Østergaard, A., Kjær, P., Skerris, A., Skou, C., Christoffersen, J., Seest, L. S., Poulsen, M. B., Rønholt, F., & Overgaard, K. (2016). Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life: a randomised controlled trial. Clinical Rehabilitation, 30(3), 225-36. https://doi.org/10.1177/0269215515575165

@article{cf597cc713f540d6802d5439c7414dd1,

title = "Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life: a randomised controlled trial",

abstract = "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{\texttrademark}, 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{\texttrademark} 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{\texttrademark} 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.",

author = "Rasmussen, {Rune Skovgaard} and Ann {\O}stergaard and Pia Kj{\ae}r and Anja Skerris and Christina Skou and Jane Christoffersen and Seest, {Line Skou} and Poulsen, {Mai Bang} and Finn R{\o}nholt and Karsten Overgaard",

note = "{\textcopyright} The Author(s) 2015.",

year = "2016",

month = mar,

doi = "10.1177/0269215515575165",

language = "English",

volume = "30",

pages = "225--36",

journal = "Clinical Rehabilitation",

issn = "0269-2155",

publisher = "Sage Science Press (UK)",

number = "3",

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TY - JOUR

T1 - Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life

T2 - a randomised controlled trial

AU - Rasmussen, Rune Skovgaard

AU - Østergaard, Ann

AU - Kjær, Pia

AU - Skerris, Anja

AU - Skou, Christina

AU - Christoffersen, Jane

AU - Seest, Line Skou

AU - Poulsen, Mai Bang

AU - Rønholt, Finn

AU - Overgaard, Karsten

PY - 2016/3

Y1 - 2016/3

N2 - 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.

AB - 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.

U2 - 10.1177/0269215515575165

DO - 10.1177/0269215515575165

M3 - Journal article

C2 - 25758941

SN - 0269-2155

VL - 30

SP - 225

EP - 236

JO - Clinical Rehabilitation

JF - Clinical Rehabilitation

IS - 3

ER -

Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life: a randomised controlled trial

Abstract

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