Stroke, Vol 25, 821-825, Copyright © 1994 by American Heart Association
L Kalra
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.
ARTICLES
The influence of stroke unit rehabilitation on functional recovery from stroke
Orpington Stroke Unit, Bromley Hospitals, UK.
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