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Randomized Controlled Trial
. 2021 Feb 23;21(1):134.
doi: 10.1186/s12877-021-02082-4.

Effectiveness of an integrated multidisciplinary geriatric rehabilitation programme for older persons with stroke: a multicentre randomised controlled trial

Tom P M M Vluggen  1   2 , Jolanda C M van Haastregt  3   4 , Frans E Tan  4   5 , Jeanine A Verbunt  4   6   7 , Caroline M van Heugten  8   9 , Jos M G A Schols  3   4
Affiliations
Randomized Controlled Trial

Effectiveness of an integrated multidisciplinary geriatric rehabilitation programme for older persons with stroke: a multicentre randomised controlled trial

Tom P M M Vluggen et al. BMC Geriatr. .

Abstract

Background: Almost half of the stroke patients admitted to geriatric rehabilitation has persisting problems after discharge. Currently, there is no evidence based geriatric rehabilitation programme available for older stroke patients, combining inpatient rehabilitation with adequate ambulatory aftercare in the community. Therefore, we developed an integrated multidisciplinary rehabilitation programme that includes aftercare for older persons with stroke. We evaluated the effectiveness of this newly developed rehabilitation programme in comparison to usual care.

Methods: A multicentre randomised controlled trial was conducted in eight geriatric rehabilitation stroke units and their collaborating partners in primary care. The study population involved stroke patients and their informal caregivers who were aged 65 or over, living in the community before admission to geriatric rehabilitation, and expected to be able to return home after discharge. The programme consisted of three modules: inpatient neurorehabilitation, home-based self-management training, and stroke education. For patients, daily activity (FAI) was assessed as primary outcome and functional dependence (Katz-15), perceived quality of life (SSQoL) and social participation (IPA) as secondary outcomes. Additionally, among informal caregivers perceived care burden (self-rated burden VAS), objective care burden (Erasmus iBMG), and quality of life (CarerQol), were assessed as secondary outcomes.

Results: In total 190 patients and 172 informal caregivers were included. Mean age of the patients in the intervention group was 78.9 years (SD = 7.0) and in the usual care group 79.0 years (SD = 6.5). Significant favourable effects for the programme were observed for the subscale autonomy outdoors of the IPA (- 2.15, P = .047, and for the informal caregivers perceived care burden (1.23, P = .048. For the primary outcome daily activity and the other secondary outcomes, no significant effects were observed.

Conclusion: The integrated multidisciplinary programme had no effect on daily activity of older stroke patients. However, patients participating in the programme had a higher level of perceived autonomy of outdoor activities and their informal caregivers perceived a lower care burden. The programme might be promising in providing adequate (after) care, although adaptation of the programme is recommended to increase its feasibility and improve its effects.

Trial registration: Current Controlled Trials ISRCTN62286281 . Registered 19-3-2010.

Keywords: Aftercare; Elderly persons; Geriatric rehabilitation; Randomised controlled trial; Stroke.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
flowchart of patients through the study
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References

    1. Katan M, Luft A. Global burden of stroke. Semin Neurol. 2018;38(2):208–211. doi: 10.1055/s-0038-1649503. - DOI - PubMed
    1. Feigin VL, Norrving B, Mensah GA. Global burden of stroke. Circ Res. 2017;120(3):439–448. doi: 10.1161/CIRCRESAHA.116.308413. - DOI - PubMed
    1. Actiz . Infographic geriatrische revalidatiezorg. 2015.
    1. Vaartjes I, van Dis I, Visseren FLJ, Bots ML. Hart- en vaatziekten in Nederland 2010, cijfers over leefstijl- en risicofactoren, ziekte en sterfte. In: Vaartjes I, Dis I, Visseren FLJ, Bots ML, editors. Incidentie en prevalentie van hart- en vaatziekten in Nederland. Den Haag: Nederlandse Hartstichting; 2010.
    1. Gommer AM, Poos MJ. Beroerte: prevalentie, incidentie en sterfte naar leeftijd en geslacht. Volksgezondheid Toekomst Verkenning, Nationaal Kompas Volksgezondheid. Bilthoven: RIVM; 2011.

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