A randomized controlled trial to evaluate intensity of community-based rehabilitation provision following stroke or hip fracture in old age

RYAN, A., ENDERBY, P. and RIGBY, A. S. (2006). A randomized controlled trial to evaluate intensity of community-based rehabilitation provision following stroke or hip fracture in old age. Clinical rehabilitation., 20 (2), 123-131.

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Link to published version:: 10.1191/0269215506cr933oa

Abstract

Objective: To compare intensive with non-intensive home-based rehabilitation provision following stroke or hip fracture in old age (65 years+). Design: Parallel single-blind randomized control trial. Setting: Domiciliary provided multidisciplinary rehabilitation. Subjects: One hundred and sixty patients aged 65 or over recently discharged from hospital after suffering a stroke or hip fracture. Intervention: Patients assigned to receive six or more face-to-face contacts or three or less face-to-face contacts from members of a multidisciplinary rehabilitation team. Main measures: Patients assessed using the Barthel Index, Therapy Outcome Measure, Euroqol 5D (EQ-5D), Hospital Anxiety and Depression Scale (HADS) and Frenchay Activities Index (FAI) at three months. All follow-up assessments were conducted blind to allocation. Results: Subgroup analysis was conducted on the basis of incident condition (stroke or hip fracture). Significant differences were detected for the stroke subgroup at three months [Therapy Outcome Measure Handicap (median difference 0.5 (P < 0.05)) and EQ-5D (median difference 0.17 (P < 0.05))] and in change at three months [Therapy Outcome Measure (mean difference 0.52 (SD 0.85) 95% CI (0.16, 0.88)) and EQ-5D (mean difference 0.15 (SD 0.25) 95% CI (0.05, 0.26))]. No significant differences were detected between the two arms of the study for the hip fracture subgroup. Conclusion: Following stroke older people who receive a more intensive community-based multidisciplinary rehabilitation service may experience short-term benefit in relation to social participation and some aspects of health-related quality of life. A more intensive service after discharge from hospital following a hip fracture is unlikely to result in similar patient benefit.

Item Type: Article
Uncontrolled Keywords: medical rehabilitation, elderly, hip fractures
Research Institute, Centre or Group: Centre for Health and Social Care Research
Identification Number: 10.1191/0269215506cr933oa
Depositing User: Ann Betterton
Date Deposited: 19 Aug 2008
Last Modified: 09 Dec 2009 18:23
URI: http://shura.shu.ac.uk/id/eprint/330

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