After a stroke, ability with daily tasks of living improves after therapy based rehabilitation services

Question

Do post-discharge rehabilitation services change recovery after stroke?

Study design

Systematic review with meta-analysis.

Main results

Fourteen trials met inclusion criteria; 12 trials comparing therapy-based rehabilitation services were included in the meta-analysis (occupational therapy = 6 trials, physiotherapy = 2 trials and mixed services = 4 trials). At a median follow-up of 6 months, therapy-based rehabilitation services reduced the risk of deterioration in ability to undertake daily living tasks compared with control, (OR 0.72, 95% CI 0.57 to 0.92). Ability to carry out extended activities of daily living significantly improved in people undergoing therapy-based rehabilitation services compared with control (mean difference 0.17 95% CI 0.04 to 0.30). When similar categories of therapy were compared, only occupational therapy significantly reduced deterioration rate (occupational therapy: OR 0.73, 95% CI 0.55 to 0.96; physiotherapy OR 0.67, 95% CI 0.24 to 1.89; mixed services OR 0.72, 95% CI 0.41 to 1.27). Data were inconclusive with respect to mood, quality of life, need for long-term care and hospital readmission.

Authors’ conclusions

People discharged to their homes after stroke are less likely to deteriorate if therapy-based rehabilitation services are provided compared with usual care or no routine intervention.