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Therapy-based rehabilitation services for patients living at home more than one year after strokeAziz NA, Leonardi-Bee J, Phillips MF, Gladman J, Legg LA, Walker M
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SummaryTherapy-based rehabilitation services for patients living at home more than one year after strokeIt is unclear if rehabilitation provided more than one year after a stroke can improve recovery. People who are recovering from a stroke for one year or more often have persistent disabilities. Although therapy-based rehabilitation for such patients is an accepted part of stroke management, the evidence base for such practice is unclear. We identified only five clinical trials, including 487 participants, which showed a tendency towards improved recovery but the results were inconclusive.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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April 16. 2008 AbstractBackgroundCurrent practice of rehabilitation intervention mainly concentrates on the first six months of stroke. At present, there is no agreed consensus about the benefits of such a service more than one year after stroke. ObjectivesTo ascertain whether therapy-based rehabilitation services can influence outcome one year or more after stroke. Search strategyWe searched the trials registers of the following Cochrane Review Groups: Stroke Group (last searched September 2007), Effective Practice and Organisation of Care Group (last searched October 2006) and Dementia and Cognitive Improvement Group (last searched October 2006). We also searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2006), MEDLINE (1966 to October 2006), EMBASE (1980 to October 2006), CINAHL (1982 to October 2006), AMED (1985 to October 2006), PEDro (1952 to October 2006), British Nursing Index (1993 to October 2006), DARE (1994 to October 2006), HMIC (1979 to October 2006) and NHS EED (1991 to October 2006). We also searched dissertation databases and ongoing trials and research registers, scanned reference lists and contacted researchers and experts in the field. Selection criteriaAll randomised controlled trials of community-based stroke patients, in which at least 75% were recruited one year after stroke and received a therapy-based rehabilitation intervention that was compared with conventional care. Data collection and analysisTwo review authors independently selected trials and extracted data on a number of pre-specified outcomes. The primary outcomes were the proportion of participants who had deteriorated or were dependent in personal activities of daily living at the end of scheduled follow up. Main resultsWe identified five trials of 487 participants that were eligible for the review. Overall, there was inconclusive evidence as to whether therapy-based rehabilitation intervention one year after stroke was able to influence any relevant patient or carer outcome. Trials varied in design, type of interventions provided, quality, and outcomes assessed. Authors' conclusionsThis review highlights the dearth of evidence investigating long-term therapy-based rehabilitation interventions for patients with stroke. |