22. European Stroke Conference 2 Rehabilitation and reorganisation after stroke A 8:40 - 8:50 Post-stroke rehabilitation at home reduced disability and improved quality of life: a ran-domized controlled trial R.S. Rasmussen1, K Overgaard2, A Østergaard3, P Kjær4, A Skerris5, C Skou6, J Christoffers-en7, L.S. Seest8, M.B. Poulsen9, F. University Hospitals of Copenhagen, Herlev Hospital, Herlev, DENMARK1,University Hospitals of Copenhagen, Herlev Hospital, Herlev, DENMARK2, University Hospitals of Co-penhagen, Gentofte Hospital, Gentofte, DENMARK3, University Hospitals of Copenhagen, Gentofte Hospital, Gentofte, DENMARK4, University Hospitals of Copenhagen, Gentofte Hospital, Gentofte, DENMARK5, University Hospitals of Copenhagen, Gentofte Hospital, Gentofte, DENMARK6, University Hospitals of Copenhagen, Gentofte Hospital, Gentofte, DENMARK7, University Hospitals of Copenhagen, Gentofte Hospital, Gentofte, DENMARK8, University Hospitals of Copenhagen, Herlev Hospital, Herlev, DENMARK9, University Hospitals of Copenhagen, Herlev Hospital, Herlev, DENMARK10 Background: In Denmark stroke is the most frequent cause of disability among adults, and many patients suffer from permanent physical, cognitive and speech impairments. The cost of treatment and rehabilitation of stroke patients represents 4% of the total health expenditure. The present study was designed to evaluate the efficacy of home based compared to standard reha-bilitation in stroke patients. Methods: The study was a randomised, controlled intervention study. Included patients were at least 18 years old, hospitalised in our stroke unit for more than three days, diagnosed with fo-cal neurological deficits from acute stroke and in need of rehabilitation. The intervention group received home based rehabilitation for up to 10 weeks to replace part of usual treatment and rehabilitation services. The control group received treatment and rehabilitation following usual guidelines for stroke treatment. Three months after inclusion, all participants were re-tested. The following parameters were used as endpoints: motor rehabilitation, cognitive rehabilitation, quality of life and treatment-associated economy. Results: Sixty-four patients completed the study (31 intervention and 33 control patients). Three months after inclusion, patients in the intervention group experienced improved quality of life (P<0.05) and achieved higher difference in motor rehabilitation scores (P=0.01) com-pared to controls. The amount of home based training correlated with both Barthel-100 Index scores (P<0.00001, Spearman R = 0.49), Motor Assessment Scale scores (P<0.001, Spearman R = 0.62) and quality of life scores (P=0.01, Spearman R = 0.47). Economically, total savings of both hospitals and municipalities were about € 100 for each intervention patient compared to controls. Conclusion: Early home based rehabilitation improved motor rehabilitation and quality of life, and the amount of home based training proportionally correlated with both rehabilitation of functions and quality of life. Table 1 Prediction equation and model results for a European multi-center prediction of person-al and extended activities of daily living six months after stroke Prediction equation and model results for personal activities of daily living (Barthel Index score ≥ 95/100): P/(1-P)=e-7.32 + 0.09 (Barthel Index score at 2 months) - 0.77 (gender; male=0/female=1) + 0.07 (RMA-Arm(*) at 2 months) Variable B P-value Exp(B) 95% CI for Exp (B) Barthel Index at 2 months 0.09 0.000 1.09 1.07-1.12 Gender -0.77 0.005 0.46 0.27-0.80 RMA-Arm(*) 0.07 0.037 1.07 1.00-1.14 at 2 months Prediction equation and model results for extended activities of daily living (Nottingham Extended ADL ≥ 12/22): P/(1-P)=e-6.004 + 0.08 (Barthel Index score at 2 months) - 1.32 (gender; male=0/female=1) + 0.04 (RMA-Arm(*) difference between 2 months and intake) Variable B P-value Exp(B) 95% CI for Exp (B) Barthel Index at 2 months 0.08 0.000 1.09 1.07-1.11 Gender -1.32 0.000 0.27 0.16-0.46 RMA-Arm(*) 0.04 0.049 1.04 1.00-1.09 difference: 2 months - in-take (*)RMA-Arm: Rivermead Motor Assessment - Arm section score 94 © 2013 S. Karger AG, Basel Scientific Programme
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