To evaluate two commonly practised methods of stroke aftercare we have conducted a randomized comparison trial of day hospital (DH) and home physiotherapy (HPT). Patients over 60 years discharged from hospital following a new stroke event were eligible. One hundred and twenty-four patients were recruited, stratified by disability measured on the Barthel INdex and by length of time since stroke onset, then randomized to attend a DH twice weekly ot to receive HPT. Outcome measurements included the Parthel Index, Motor Club Assessment, Frenchay Activities Index, Nottingham Health Profile and the General Health Questionnaire. One hundred and seven patients completed an eight week course of treatment. Both the DH and the HPT treated patients showed a significant but small further improvement in functional abilities with the HPT patients being significantly more able on stairs. Social function of both groups was poor but the HPT treated patients were signficantly less so. More than a third of patients in each treatment group were depressed and more than a quarter of the carers were 'stressed'. The HPT patients received significantly less physiotherapy and virtually no occupational therapy compared to the DH group. The findings suggest that HPT is slightly more effective for stroke aftercare that DH attendance and is considerably more resource efficient.

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