THE INFLUENCE OF STROKE UNIT REHABILITATION ON FUNCTIONAL RECOVERY FROM STROKE

被引:98
作者
KALRA, L
机构
[1] BROMLEY HOSP, ORPINGTON STROKE UNIT, BROMLEY, ENGLAND
[2] UNIV LONDON KINGS COLL, SCH MED, DEPT HLTH CARE ELDERLY, LONDON WC2R 2LS, ENGLAND
关键词
HOSPITALIZATION; REHABILITATION;
D O I
10.1161/01.STR.25.4.821
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose Shorter lengths of hospital stay in stroke units could be due to quicker functional recovery or mechanisms of expediting hospital discharge. Methods Stroke survivors with an intermediate prognosis at 2 weeks after stroke (n = 146) were randomized for management in a stroke rehabilitation unit or in general wards. Barthel scores were monitored at weekly intervals until hospital discharge. The duration and type of physiotherapy and occupational therapy received by patients in either setting were also recorded. The rate of change of Barthel scores, therapy input, and the duration of hospital stay were compared between the two settings. Results Neurological deficits and median initial Barthel scores were comparable between patients in the stroke unit (n = 73) and general wards (n = 68). Median discharge Barthel score of patients managed in the stroke unit was significantly higher than that of patients managed in general wards (15 versus 12). Median Barthel scores in the stroke unit group rose rapidly after 2 weeks, reaching a plateau at 6 weeks. The change in median Barthel score in patients in general wards was significantly slower, reaching a plateau at 12 weeks despite similar therapy input. There was a significant delay in discharging stroke patients in general wards (20 weeks) compared with those in the stroke unit (6 weeks). Conclusions Functional recovery is significantly greater and more rapid in a stroke rehabilitation unit compared with general wards despite similar therapy input. These units also shorten hospital lengths of stay by expediting appropriate discharges.
引用
收藏
页码:821 / 825
页数:5
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