Comparison of Two Post-Stroke Rehabilitation Programs: A Follow-Up Study among Primary versus Specialized Health Care

PLoS One. 2016 Nov 11;11(11):e0166242. doi: 10.1371/journal.pone.0166242. eCollection 2016.

Abstract

Objective: To compare home-based rehabilitation (RITH) and standard outpatient rehabilitation in a hospital setting, in terms of improving the functional recovery and quality of life of stroke patients.

Study design and setting: This was a prospective cohort study in Andalusia (Spain).

Participants: One hundred and forty-five patients completed the outcome data.

Measures: Daily activities were measured by the Barthel index, Canadian Neurological Scale (to assess mental state), Tinetti scale (balance and gait), and Short Form Health Survey-36 (SF-36 to compare the quality of life).

Results: No statistically significant differences were found between the two groups regarding the clinical characteristics of patients in the initial measurement, except for age and mental state (younger and with greater neurological impairment in the hospital group). After physical therapy, both groups showed statistically significant improvements from baseline in each of the measures. These improvements were better in RITH patients than in the hospital patients on all functionality scales with a smaller number of sessions.

Conclusions: Home rehabilitation is at least as effective as the outpatient rehabilitation programs in a hospital setting, in terms of recovery of functionality in post-stroke patients. Overall quality of life is severely impaired in both groups, as stroke is a very disabling disease that radically affects patients' lives.

Publication types

  • Comparative Study

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Ambulatory Care / methods
  • Ambulatory Care / statistics & numerical data
  • Delivery of Health Care / methods*
  • Delivery of Health Care / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Home Care Services / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data
  • Physical Therapy Modalities / statistics & numerical data
  • Primary Health Care / methods*
  • Primary Health Care / statistics & numerical data
  • Prospective Studies
  • Quality of Life
  • Recovery of Function
  • Stroke / physiopathology
  • Stroke / psychology
  • Stroke / therapy*
  • Stroke Rehabilitation / methods*
  • Surveys and Questionnaires

Grants and funding

The authors would like to acknowledge the Andalusian Regional Government for funding this investigation. Research Project PI 0449/2008 issued by the Ministry of Health of the Government of Andalusia, through the General Secretariat of Quality and Modernization, within the Biomedical and Health Sciences Research frame in Andalusia (resolution of 26th December, 2008). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.