London, United Kingdom 2013 3 Rehabilitation and reorganisation after stroke A 8:50 - 9:00 Balance and walking outcome after stroke rehabilitation – a randomized controlled trial comparing two early discharge models with treatment as usual. B.E.B. Gjelsvik1, T. Smedal2, H. Hofstad3, G.E. Eide4, J.S. Skouen5, B. Frisk6, S. Daltveit7, L.I. Strand8 Haukeland University Hospital, Bergen, NORWAY1,Haukeland University Hospital, Ber-gen, NORWAY2, Haukeland University Hospital, Bergen, NORWAY3, Haukeland University Hospital, Bergen, NORWAY4, Haukeland University Hospital, Bergen, NORWAY5, Haukeland University Hospital, Bergen, NORWAY6, Haukeland University Hospital, Bergen, NORWAY7, Department of Public Health and Primary Health Care, Physiotherapy Research Group, Univer-sity Cerebrovasc Dis 2013; 35 (suppl 3)1-854 95 of Bergen, Bergen, NORWAY8 Background: Early supported discharge (ESD) has been found in previous studies to accelerate discharge from hospital to home after stroke. The home environment is believed to play a key role for perceived health over time and is considered beneficial, especially with the provision of rehabilitation and support in the community. ESD models may differ, and the effectiveness of different models should be examined and compared using a wide specter of subjective and ob-jective measures. As there is limited information regarding performance of important physical activities, such aspects were explored in the present study. The aim of the study was to compare changes in balance and walking 3 months after stroke in patients randomized to two different ESD groups and one “treatment as usual” group. Methods: A randomized controlled trial was applied with 306 acute stroke patients recruited consecutively from a hospital over three years (2008-2011). The patients should be included 2–7 days after stroke onset, and have a National Institutes of Health Stroke Scale score of 2–26. They were assessed by blinded testers at baseline and 3 months. Interventions were treatment either in a community day-rehabilitation center or in the patients’ own homes, while the con-trols followed the usual treatment regime after hospital discharge. Results: 171 patients completed physical tests at both time-points. No significant differences in change between the groups for Postural Assessment Scale for Stroke (main outcome) or other outcome measures were detected. Walking in the day-unit group and self-reported activities of daily living in the home-rehabilitation group demonstrated, however, the largest within group effect sizes for change. The controls were discharged from hospital just as early as patients in the intervention groups. Conclusion: The rehabilitation models demonstrated similar improvements, but effect sizes in-dicated more improved walking ability after day-unit rehabilitation.
Karger_ESC London_2013
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