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| Comparing stroke rehabilitation outcomes between acute inpatient and nonintense home settings |
| Ozdemir F, Birtane M, Tabatabaei R, Kokino S, Ekuklu G |
| Archives of Physical Medicine and Rehabilitation 2001 Oct;82(10):1375-1379 |
| clinical trial |
| 4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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OBJECTIVE: To compare outcomes in stroke survivors who received rehabilitation services in an acute inpatient rehabilitation setting (multidisciplinary rehabilitation team) with outcomes in survivors in a home-based setting (family caregivers, limited team supervision). DESIGN: Randomized clinical trial, with mean follow-up after 60 days. SETTING: Inpatient rehabilitation setting and home-based settings. PATIENTS: Sixty patients (age range 43 to 80 yr) who had a stroke between 1996 and 1999 and had been referred after medical stabilization, randomly divided into 2 groups: group 1, inpatient rehabilitation; group 2, home-based rehabilitation. INTERVENTIONS: Group 1: therapeutical and neuromuscular exercises with occupational therapy with professional supervision; group 2: conventional exercises with family caregiver and limited professional supervision. MAIN OUTCOME MEASURES: Spasticity was evaluated with the Ashworth Scale, motor status with Brunnstrom's stages, functional status with the FIM instrument, and cognitive status with the Mini-Mental State Examination before and after rehabilitation. RESULTS: Patients rehabilitated in acute inpatient settings had better motor, functional, and cognitive outcomes (p < 0.05). Spasticity changes did not differ between the groups. CONCLUSION: Intense inpatient rehabilitation services for stroke survivors provide significantly more favorable functional and cognitive outcomes with relatively low complications than did nonintense rehabilitation efforts in home settings.
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