Early discharge and home rehabilitation (EDHR) for stroke patients seems logical as an alternative to rehabilitation in stroke units, as these patients often show impaired ability to perform activities of daily living. The objective of this review is to present the effects of EDHR for stroke patients on health, quality of life and costs, and to describe the physiotherapy provided. Seventeen randomised controlled trials were included, assessed with the PEDro scale and rated using Sackett's rules of scientific evidence. The results showed that EDHR can reduce the length of time spent in hospital. It might improve basic activities of daily living, but is more likely to improve patients' instrumental activities of daily living and quality of life. The context is a core issue for the physiotherapy intervention. Early discharge and home rehabilitation seems to be cost-effective if rehabilitation at home is provided by a multidisciplinary team from a hospital. It is important to consider patients' coping capacities and possible strain on caregivers as contributing factors to the efficacy of EDHR.

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A brief summary and a critical assessment of this review may be available at DARE