EFFECTS OF DAY-HOSPITAL REHABILITATION IN STROKE PATIENTS - A REVIEW OF RANDOMIZED CLINICAL-TRIALS

The purpose of this study was to review the literature on the effects of day-hospital rehabilitation (DHR) in stroke patients. In The Nether lands DHR concerns a multidisciplinary approach to decrease disability and handicap and to optimize quality of life in an outpatient setting . Data were collected by a computer-aided search of published randomiz ed trials. Fifteen articles reporting on seven randomized controlled t rials were selected. Data extraction included a score for quality of t he methods, based on four categories: ''study population'', ''interven tions'', ''effects'' and ''data presentation and analysis''. To each c riterion a weight was attached and the maximum score was set at 100 po ints. In judging the methodological quality of the selected studies, o ne study proved insufficient. Of the remaining studies the sum score v aried from 34 to 67, with a mean of 50, Comparison of the results of t he studies is complicated by different definitions of DHR, different n atures of the control group and the study population, and the variety of measurement instruments applied. Often instruments were applied who se reliability and validity was not proven. As of now it is not possib le to prove that DHR for stroke patients is effective. In future resea rch a standardized definition of DHR, a uniform control group, an acce ptable research methodology and adequate measurement instruments must be applied.