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. 2009 Nov 16;1(1):e10.
doi: 10.4081/ni.2009.e10.

Effectiveness of home rehabilitation for ischemic stroke

Pakaratee Chaiyawat  1 , Kongkiat Kulkantrakorn, Paskorn Sritipsukho
Affiliations

Effectiveness of home rehabilitation for ischemic stroke

Pakaratee Chaiyawat et al. Neurol Int. .

Abstract

The objective of this study was to develop and examine the effectiveness of an individual home rehabilitation program for patients with ischemic stroke. This was a randomized controlled trial in 60 patients with recent middle cerebral artery infarction. After hospital discharge for acute stroke care, they were randomly assigned to receive either a home rehabilitation program for three months (intervention group) or usual care (control group). We collected outcome data over three months after their discharge from the hospital. The Barthel Index (BI), the Modified Rankin Scale (MRS), the health-related quality-of-life index (EQ-5D), the Hospital Anxiety and Depression score (HADs), and the Thai Mental State Examination (TMSE) were used to analyze the outcomes. In the intervention group, all outcomes were significantly better (p<0.05) than in the control group, except in the case of TMSE. A favorable outcome, which was defined as minimal or no disability as measured by BI (score 95-100), was achieved by 93.33% of patients in the intervention group, and 90% had favorable scores (0 or 1) on the MRS. This showed a benefit in reducing disability, with two being the number of patients considered as needed-to-treat (NNT) (95% CI, 1.0-1.2). All dimensions of EQ-5D in the intervention group were significantly better for quality of life and generic health status than in the control group (p=0.001). Depression was found in one patient (3.33%) in the intervention group and in two patients (6.67%) in the control group. Dementia was found in three patients (10%) in the intervention group and in four patients (13.33%) in the control group. We concluded that an early home rehabilitation program for patients with ischemic stroke in the first three-month period provides significantly better outcomes in improving function, reducing disability, increasing quality of life, and reducing depression than a program of usual care does.

Keywords: effectiveness; home rehabilitation; ischemic stroke.

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Figures

Figure 1
Figure 1
Study flow chart.
Figure 2
Figure 2
Post-treatment effects of the intervention for three months, adjusted for age, depression, and baseline measurement of outcome by the Barthel index. *p=0.001 (ANCOVA, significant at p<0.05).
Figure 3
Figure 3
Outcome of the modified rankin scale at three months, according to treatment group.
See this image and copyright information in PMC

References

    1. Viriyavejakul A, Senanarong V, Prayoonwiwat N, et al. Epidemiology of stroke in the elderly in Thailand. J Med Assoc Thai. 1998;81:497–505. - PubMed
    1. Dharmasaroja P. Baseline characteristics of patients with acute ischemic stroke in a suburban area of Thailand. J Stroke Cerebrovasc Dis. 2008;17:82–5. - PubMed
    1. American Heart Association. Heart Disease and Stroke Statistics – 2004 Update. Dallas, Texas: American Heart Association; 2003.
    1. Brandstater ME. An overview of stroke rehabilitation. Stroke. 1990;21:1140–2. - PubMed
    1. Burvill PW, Johnson GA, Jamrozik KD, et al. Anxiety disorders after stroke: results from the Perth Community Stroke Study. Br J Psychiatry. 1995;166:328–32. - PubMed

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