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Background and Purpose:The optimal organization of rehabilitation services af ter discharge from a stroke unit has not been determined. This study sought to e valuate the effect of early supported discharge and continued rehabilitation at home (ESD), in terms of patient outcome 5 years after stroke and changes in sele cted data over time. Methods:Eightythree patients from Southwest Stockholm, mil dly or moderately impaired 5 to 7 days after acute stroke, were enrolled in a ra ndomized controlled trial. The core components of the ESD service were initial t reatment in a stroke unit and the involvement of an outreach team to deliver and coordinate home-based rehabilitation in partnership with the patient. At the 5 -year follow-up, measures used to assess patient outcome included survival, mo tor capacity, dysphasia, activities of daily living (ADL), social activities, su bjective dysfunction, and self-reported falls. Results:Fifty-four patients (3 0 in the intervention group and 24 in the control group) were evaluated 5 years after stroke, at which time a significantly larger proportion of patients in the intervention group were independent in extended ADL and active in household act ivities. Conclusions:This ESD service has a beneficial effect on extended ADL 5 years after stroke for mildly to moderately impaired patients.
Background and Purpose: The optimal organization of rehabilitation services af ter discharge from a stroke unit has not been determined. This study sought to e valuate the effect of early supported discharge and continued rehabilitation at home (ESD), in terms of patient outcome 5 years after stroke and changes in sele cted data over time. Methods: Eightythree patients from Southwest Stockholm, mil dly or moderately impaired 5 to 7 days after acute stroke, were enrolled in a ra ndomized controlled trial. The core components of the ESD service were initial t reatment in a stroke unit and the involvement of an outreach team to deliver and coordinate home-based rehabilitation in partnership with the patient. At the 5 -year follow-up, measures used to assess patient outcome included survival, mo tor capacity, dysphasia , activities of daily living (ADL), social activities, su bjective dysfunction, and self-reported falls. Results: Fifty-four patients (30 in the intervention group and 24 in th e control group) were evaluated 5 years after stroke, at which time a significantly larger proportion of patients in the intervention group were independent in extended ADL and active in household act ivities. Conclusions: This ESD service has a beneficial effect on extended ADL 5 years after stroke for mildly to moderately impaired patients.