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Evidence summaries

Rehabilitation for Stroke Patients at Home

Therapy-based rehabilitation for stroke patients living at home appear to improve independence in personal activities of daily living and reduce the odds of death or poor outcome. Level of evidence: "B"

A Cochrane review [Abstract]1 included 14 studies with a total of 1 617 subjects. The mean age ranged from 55 to 75 years, the duration of follow up was between 3 and 12 months. Therapy-based rehabilitation services reduced the odds of death or poor outcome (deterioration or dependency) (OR 0.72, 95% CI 0.57 to 0.92; p = 0.009; 12 trials, n=1350) and increased personal activity of daily living scores (SMD 0.14, 95% CI 0.02 to 0.25; p = 0.02; 12 trials, n=1180). For every 100 stroke patients receiving therapy-based rehabilitation services, 7 (95% CI 2 to 11) patients would be spared a poor outcome, assuming 37.5% would have had a poor outcome with no treatment.

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in treatments and outcomes).

    References

    • Outpatient Service Trialists. Therapy-based rehabilitation services for stroke patients at home. Cochrane Database Syst Rev 2003;(1):CD002925. [PubMed]

Primary/Secondary Keywords