A randomized controlled trial of rehabilitation at home after stroke in Southwest Stockholm: Outcome at six months

A 6-month follow-up of a single-blind, randomized, controlled trial in Sout hwest Stockholm was performed in order to evaluate the effect of early supp orted discharge and continued rehabilitation at home after stroke. Eighty-t hree stroke patients with moderate neurological impairments, continent, ind ependent in feeding, and mental function within normal limits one week afte r onset were included in the study. The patients were allocated 1:1 to earl y supported discharge and continued rehabilitation at home by a specialized team, versus routine rehabilitation. Patient outcomes measured were motor capacity, dysphasia, activities of daily living, social activities, perceiv ed dysfunction, mortality and reported falls. Data on length of stay in hos pital; initial and recurrent during 6 months were compared. The 6-month fol low-up of 78 patients showed no statistically significant differences in pa tient outcome. The results of multivariate logistic regression analysis sug gest a positive effect of home rehabilitation on activities of daily living . At 3-6 months the frequency of significant improvements was higher in the intervention group. Death or dependency in activities of daily living was 24% in the intervention group compared with 44% in the control group. The m ean initial hospitalization was 29 days in routine rehabilitation group ver sus 14 days in the home rehabilitation group. We conclude that for moderate ly disabled stroke patients with mental function within normal limits, earl y supported discharge and continued rehabilitation at home had no less a be neficial effect on patient outcome than routine rehabilitation, reduced ini tial hospitalization significantly and had no adverse effects on mortality and number of falls.