Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life: a randomised controlled trial
Abstract
OBJECTIVE: To evaluate if home-based rehabilitation of inpatients improved outcome compared to standard care. DESIGN: Interventional, randomised, safety/efficacy open-label trial. SETTING: University hospital stroke unit in collaboration with three municipalities. SUBJECTS: Seventy-one eligible stroke patients (41 women) with focal neurological deficits hospitalised in a stroke unit for more than three days and in need of rehabilitation. INTERVENTIONS: Thirty-eight patients were randomised to home-based rehabilitation during hospitalization and for up to four weeks after discharge to replace part of usual treatment and rehabilitation services. Thirty-three control patients received treatment and rehabilitation following usual guidelines for the treatment of stroke patients. MAIN MEASURES: Ninety days post-stroke the modified Rankin Scale score was the primary endpoint. Other outcome measures were the modified Barthel-100 Index, Motor Assessment Scale, CT-50 Cognitive Test, EuroQol-5D, Body Mass Index and treatment-associated economy. RESULTS: Thirty-one intervention and 30 control patients completed the study. Patients in the intervention group achieved better modified Rankin Scale score (Intervention median = 2, IQR = 2-3; Control median = 3, IQR = 2-4; P=0.04). EuroQol-5D quality of life median scores were improved in intervention patients (Intervention median = 0.77, IQR = 0.66-0.79; Control median = 0.66, IQR = 0.56 - 0.72; P=0.03). The total amount of home-based training in minutes highly correlated with mRS, Barthel, Motor Assessment Scale and EuroQol-5D™ scores (P-values ranging from P<0.00001 to P=0.01). Economical estimations of intervention costs were lower than total costs of standard treatment. CONCLUSION: Early home-based rehabilitation reduced disability and increased quality of life. Compared to standard care, home-based stroke rehabilitation was more cost-effective.
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The experimental group showed a 33% higher percentage of change on SAQOL-39 compared to the control group.
“The experimental group have shown a 33% higher percentage of change on SAQOL-39 compering to the control group, being consistent with quality-of-life improvements from a previously published study [4].”
From Early Occupational Therapy Intervention post-stroke (EOTIPS): A randomized controlled trial (2024) · cites this paper as [4]
Articles have included quality of life as a secondary variable and have shown significant improvements after the intervention.
“However, there are articles that have included it as a secondary variable and have shown significant improvements after the intervention [4].”
From Early Occupational Therapy Intervention post-stroke (EOTIPS): A randomized controlled trial (2024) · cites this paper as [4]
Decision on evaluations and intervention duration was made after reviewing recent and similar published papers showing main changes between groups 3 months after discharge, and Barthel Index and mRS were the most widely used evaluations.
“Decision on evaluations and intervention duration was made after reviewing recent and similar published papers, as showing main changes between groups 3 months after discharge [3, 4, 49, 53, 58] and being Barthel Index and the mRS the most widely used evaluations [3, 4, 53, 59].”
From Early Occupational Therapy Intervention post-stroke (EOTIPS): A randomized controlled trial (2024) · cites this paper as [4]
Stroke discharges and rehabilitation plans are usually carried out in a multidisciplinary manner, making it difficult to evaluate the extent OT contributes to patients' recovery.
“Stroke discharges and rehabilitation plans are usually carried out in a multidisciplinary manner, making it difficult to evaluate the extent OT contributes to the patients’ recovery [3–5, 54].”
From Early Occupational Therapy Intervention post-stroke (EOTIPS): A randomized controlled trial (2024) · cites this paper as [4]
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References 32 · Cited by 114
- Authors
- Rasmussen, R. S., Østergaard, A., Kjær, P., Skerris, A., Skou, C., Christoffersen, J., Seest, L. S., Poulsen, M. B., Rønholt, F., & Overgaard, K.
- Affiliations
- Herlev Hospital (DK)
- Gentofte Hospital (DK)
- Corresponding author
- Rasmussen, Rune Skovgaard
- Venue
- Clinical Rehabilitation
- Publisher
- SAGE Publications
- Published
- 2015-03-10
- Volume
- 30
- Issue
- 3
- Pages
- 225-236
- ISSN
- 0269-2155 (ISSN-L)
- 1477-0873
- OpenAlex
- W2112064987
- Cited by
- 114
- References
- 32
- Citations by year
- 2026: 6 · 2025: 13 · 2024: 14 · 2023: 20 · 2022: 10 · 2021: 13 · 2020: 10 · 2019: 10 · 2018: 7 · 2017: 7 · 2016: 4
- FWCI
- 6.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministeriet Sundhed Forebyggelse
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- stroke rehabilitation, home-based rehabilitation, inpatient rehabilitation, stroke unit, disability, quality of life, modified Rankin Scale, Barthel Index, motor function, cognitive function, cost-effectiveness, early rehabilitation
- MeSH terms
- Stroke Rehabilitation, Activities of Daily Living, Aged, Aged, 80 and over, Female, Home Care Services, Hospitalization, Humans, Male, Quality of Life, Treatment Outcome, Recovery of Function, Stroke
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