Effectiveness of home rehabilitation program for ischemic stroke upon disability and quality of life: a randomized controlled trial

Clin Neurol Neurosurg. 2012 Sep;114(7):866-70. doi: 10.1016/j.clineuro.2012.01.018. Epub 2012 Feb 8.


Background: To develop and examine the effectiveness of individual 6-month home rehabilitation program in ischemic stroke patients upon disability and quality of life at 2 years.

Methods: This is a prospective randomized controlled trial (RCT) in 60 patients with recent ischemic stroke. They were randomly assigned to receive either home rehabilitation program once a month for 6 months with audiovisual materials (intervention group) or usual care (control group). We collected outcome data after discharge from the hospital until 2 years. The Barthel index (BI), the modified Rankin Scale (mRS) and utility index (EQ-5D) were measured for function, disability and quality of life respectively.

Results: At 2 years, the BI was significantly improved in the intervention group more than the control group: 97.2±2.8 vs. 76.4±9.4, p<0.001. The good outcome, defined as BI 95-100, or mRS 0 or 1. For BI, there were 29 patients (96.7%) in intervention group vs 12 patients (42.9%) in usual care group (95% CI, 42.0, 85.0, p=0.03). For mRS, there were 28 patients (93.3%) in intervention group vs 9 patients (32.1%) in usual care group (95% CI, 38.2, 87.0, p=0.02). Number needed to treat for good outcome in mRS was 2.0 (95% CI: 1.0, 1.3). The mean (SD) of utility index in intervention group and control group were 0.9±0.02 and 0.7±0.04 respectively (p=0.03). There was no significant interaction in baseline characteristics and treatment outcome.

Conclusions: Early home rehabilitation program in the first 6 months period after ischemic stroke leads to more rapid improvement in function, reducing disability and increase quality of life than usual care.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Brain Ischemia / psychology
  • Brain Ischemia / rehabilitation*
  • Dementia / complications
  • Dementia / psychology
  • Depression / etiology
  • Depression / psychology
  • Disability Evaluation*
  • Disabled Persons / rehabilitation
  • Exercise Therapy
  • Female
  • Follow-Up Studies
  • Home Care Services
  • Humans
  • Infarction, Middle Cerebral Artery / psychology
  • Infarction, Middle Cerebral Artery / rehabilitation
  • Long-Term Care
  • Male
  • Middle Aged
  • Quality of Life / psychology*
  • Sample Size
  • Stroke / psychology
  • Stroke Rehabilitation*
  • Treatment Outcome