Although specialized units and inpa...

Although specialized units and inpatient therapy have been shown to improve issues in stroke patients, less is known about the effectiveness of community-based rehabilitation services for these patients after hospital discharge. The British Outpatient Service Trialists arrange studied outcomes of rehabilitation services provided to calamity patients who had returned home

They searched electronic databases, professional journals, and allusion lists, and also contacted [i]connoisseur[/i]s to identify relevant studies. The identified studies were rated independently for quality on two reviewers. From more than 4900 relations 27 trials were identified for potential inclusion in the analysis, moreover only 14 were eligible for the application of mind Data were extracted from the eligible studies using a standard data recording form.

The average age of the more than 1600 patients studied was 70 years, and they generally had mild to moderate disability (Barthel index, 14 to 18 gone out of 20). In all moreover two studies, patients were recruited after hospital discharge. The 14 studies had different meanings and designs. Some aimed to compare different forms of therapy, whereas others sought to evaluate therapy against usual care. In the six trials that reported changes in activities of daily living (ADL) scores, the chances of deterioration were significantly lower in patients who received therapy (odd ratio, 067) The authors calculate that the absolute reduction in risk of deterioration in the ability to perform ADL was seven by 100 patients receiving therapy. In the 12 studies that addressed colony in ADL, scores also were improved on an average of about the same point on the Barthel index in the therapy assemblage Significant improvements also were recorded in expanded ADL in the nine trials that examined this issue Data were insufficient to draw conclusions about the impact of therapy forward quality of life, mood, hospital readmission, and admission to longterm care facilities.

The authors judge that home-based rehabilitation services for thump survivors are associated with reduc risk of deterioration in ability to perform ADL. Although the gains appear to be retiring further study could indicate specific impressed signs of therapy that would be more helpful or subgroup of patients who could benefit the mostly from such services.

Outpatient Service Trialists. Rehabilitation therapy services for hit patients living at home: systematic review of randomised trials. Lancet January 31 2004;363:352-6

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group