Does an extended stroke unit service with early supported discharge have any effect on balance or walking speed?

Abstract

Objective: To evaluate the effect of an extended stroke unit service with early supported discharge on balance and walking speed, and to explore the association between initial leg paresis, initial movement ability and balance one year after stroke.

Design: A randomized controlled trial comparing early supported discharge with ordinary stroke unit service.

Patients: A total of 62 eligible patients after stroke.

Methods: The outcome measures were Berg Balance Scale and walking speed at 1, 6, 26 and 52 weeks after stroke.

Results: We found no significant differences between the 2 groups during follow-up. There was a significant improvement on Berg Balance Scale (p=0.013) and walking speed (p=0.022) in the early supported discharge group, but not in the ordinary service group, from 1 to 6 weeks' follow-up. All patients with initial severe leg paresis suffered from poor balance one year after the stroke. The odds ratio for poor balance was 42.1 (95% confidence interval; 3.5-513.9) among patients with no initial walking ability.

Conclusion: These results do not conclusively indicate that early supported discharge has an effect on balance. A strong association was found between initial severe leg paresis, initial inability to walk and poor balance after one year.