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(Stroke. 2007;38:2101.)
© 2007 American Heart Association, Inc.

Original Contributions

Motor and Functional Recovery After Stroke

A Comparison of 4 European Rehabilitation Centers

Liesbet De Wit, PT, PhD; Koen Putman, PT, PhD; Birgit Schuback, PT, MSc; Arnot Komárek, PhD; Felix Angst, MD, MPH; Ilse Baert, PT, MSc; Peter Berman, MB, BS, FRCP; Kris Bogaerts, MSc; Nadine Brinkmann, PT, BSc; Louise Connell, PT, BSc; Eddy Dejaeger, MD, PhD; Hilde Feys, PT, PhD; Walter Jenni, MD; Christiane Kaske, PT, BSc; Emmanuel Lesaffre, PhD; Mark Leys, PhD; Nadina Lincoln, PhD; Fred Louckx, PhD; Wilfried Schupp, MD; Bozena Smith, OT, MSc Willy De Weerdt, PT, PhD

From Department of Rehabilitation Sciences (L.D.W., I.B., H.F., W.D.W.), Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Belgium; Department of Health Sciences and Medical Sociology (K.P., M.L., F.L.), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Belgium; RehaClinic Zurzach (B.S., F.A., C.K., W.J.), Switzerland; NHS Trust (P.B.) Nottingham, UK; Biostatistical Center (A.K., K.B., E.L.), Katholieke Universiteit Leuven, Belgium; Fachklinik Herzogenaurach (N.B., W.S.), Germany; Institute of Work, Health and Organisations (L.C. N.L., B.S.), University of Nottingham, Nottingham, UK; University Hospital Pellenberg (E.D.), Belgium.

Correspondence to Liesbet De Wit, Katholieke Universiteit Leuven, Faculty of Kinesiology and Rehabilitation Sciences, Tervuursevest 101, 3001 Heverlee (Leuven), Belgium. E-mail Liesbet.Dewit{at}faber.kuleuven.be

Background and Purpose— Outcome after first stroke varies significantly across Europe. This study was designed to compare motor and functional recovery after stroke between four European rehabilitation centers.

Methods— Consecutive stroke patients (532 patients) were recruited. They were assessed on admission and at 2, 4, and 6 months after stroke with the Barthel Index, Rivermead Motor Assessment of Gross Function, Rivermead Motor Assessment of Leg/Trunk, Rivermead Motor Assessment of Arm, and Nottingham Extended Activities of Daily Living (except on admission). Data were analyzed using random effects ordinal logistic models adjusting for case-mix and multiple testing.

Results— Patients in the UK center were more likely to stay in lower Rivermead Motor Assessment of Gross Function classes compared with patients in the German center (OR, 2.4; 95% CI, 1.3 to 4.3). In the Swiss center, patients were less likely to stay in lower Nottingham Extended Activities of Daily Living classes compared with patients in the UK center (OR, 0.7; 95% CI, 0.5 to 0.9). The latter were less likely to stay in lower Barthel Index classes compared with the patients in the German center (OR, 0.6; 95%CI, 0.4 to 0.8). Recovery patterns of Rivermead Motor Assessment of Leg/Trunk and Rivermead Motor Assessment of Arm were not significantly different between centers.

Conclusions— Gross motor and functional recovery were better in the German and Swiss centers compared with the UK center, respectively. Personal self-care recovery was better in the UK compared with the German center. Previous studies in the same centers indicated that German and Swiss patients received more therapy per day. This was not the result of more staff but of a more efficient use of human resources. This study indicates potential for improving rehabilitation outcomes in the UK and Belgian centers.

Key Words: recovery • rehabilitation centers • stroke

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Motor and Functional Recovery After Stroke: A Comparison Between 4 European Rehabilitation Centers

Tobias Brandt
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