Self-perceived mobility in the first year after mild stroke – a comparison between Very Early Supported Discharge and ordinary discharge routine

• Background: People with mild stroke mostly present with good basic but may experience difficulties with complex ADL activities. Knowledge about effects of common rehabilitation interventions after mild stroke is scarce. Objective: To investigate perceived mobility after Very Early Supported Discharge (VESD) compared to standard discharge. Methods: At an inpatient stroke unit 140 participants (39% women) were included day 2 post stroke. Inclusion criteria: stroke according to WHO criteria, age >18 years, living ≤30 min from the hospital, NIHSS score 0-16, Barthel Index score 50-100 and Montreal Cognitive Assessment <26 if BI=100. Exclusion criteria: life expectancy <1 year, non-communicating in Swedish prior stroke. Patients were randomised to VESD delivered at home by occupational therapist, physiotherapist and nurse from the stroke unit, for 4 weeks or to a control group discharged according to standard routine. VESD was focused on individual goals in personal care, transfers, household and leisure activities. The control group received standard rehabilitation as needed. The Mobility domain (0-100) of the Stroke Impact Scale (SIS) was administered 5 days after onset, 3 and 12 months after discharge. Results: Participants’ mean age was 74 (SD 11) year and NIHSS score median 2 (min-max 0-11). Mean (SD) SIS Mobility was 71.2 (22,7) and 73.6 (23.6) at baseline, in the VESD and control groups respectively. At the 3-month follow up SIS mobility score was significantly higher in the VESD group, 89.6 (15.0) compared to the controls’ 80.9 (21.3), p 0.027. There was no group difference at 12 months after discharge with 85.0 (18.1) and 86.6 (16.8), respectively. We conclude that stroke specialised team rehabilitation at home in the subacute phase may be beneficial for both basic and more demanding mobility situations in the first months, in people with mild stroke.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Sjukgymnastik (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Physiotherapy (hsv//eng)

Keyword

Stroke

mobility

patient-reported outcome measure

Publication and Content Type

vet (subject category)

kon (subject category)