An evaluation of domiciliary rehabilitation for stroke patients after discharge from hospital

Not only can stroke kill, but it can also disable and handicap the survivors. There is no medical treatment for stroke and not all stroke can be prevented. Rehabilitation, to promote recovery, or maintenance, to support those who do not recover, is required. Evidence about the efficacy of stroke...

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Main Author: Gladman, John R.F.
Format: Thesis (University of Nottingham only)
Language:English
Published: 1992
Subjects:
Online Access:https://eprints.nottingham.ac.uk/28040/
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author Gladman, John R.F.
author_facet Gladman, John R.F.
author_sort Gladman, John R.F.
building Nottingham Research Data Repository
collection Online Access
description Not only can stroke kill, but it can also disable and handicap the survivors. There is no medical treatment for stroke and not all stroke can be prevented. Rehabilitation, to promote recovery, or maintenance, to support those who do not recover, is required. Evidence about the efficacy of stroke rehabilitation is poor. There is little evidence to support many of the specific techniques used, but there is evidence to support the use of organised rehabilitation in hospitals. After leaving hospital there is some evidence that rehabilitation in out-patient departments and at home may be of further help. In this thesis, the results of a study undertaken to add to this slender body of knowledge by comparing domiciliary to hospital-based rehabilitation after hospital discharge are presented and discussed. Overall, no difference was found in terms of survival, institutionalisation, disability or perceived health between a domiciliary and a hospital-based rehabilitation service (day hospitals and out-patient departments). However, young stroke patients who had required considerable amounts of rehabilitation in a Stroke Unit, were best given further therapy at home rather than in out-patient departments, since it improved household and leisure abilities. This result is compatible with the only other controlled study of domiciliary stroke rehabilitation after hospital discharge. For frail elderly patients, the day hospital service may have had advantages over the domiciliary service because death and institutionalisation rates were lower. The latter finding may be spurious, due to allocation bias and small sample size. In view of the expense of day hospitals, more research is required to examine their efficacy. It is concluded that domiciliary rehabilitation is a small step forward for stroke rehabilitation and will benefit some disabled stroke survivors, and may be a more resource-efficient way of treating many others.
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spelling nottingham-280402025-02-28T11:33:00Z https://eprints.nottingham.ac.uk/28040/ An evaluation of domiciliary rehabilitation for stroke patients after discharge from hospital Gladman, John R.F. Not only can stroke kill, but it can also disable and handicap the survivors. There is no medical treatment for stroke and not all stroke can be prevented. Rehabilitation, to promote recovery, or maintenance, to support those who do not recover, is required. Evidence about the efficacy of stroke rehabilitation is poor. There is little evidence to support many of the specific techniques used, but there is evidence to support the use of organised rehabilitation in hospitals. After leaving hospital there is some evidence that rehabilitation in out-patient departments and at home may be of further help. In this thesis, the results of a study undertaken to add to this slender body of knowledge by comparing domiciliary to hospital-based rehabilitation after hospital discharge are presented and discussed. Overall, no difference was found in terms of survival, institutionalisation, disability or perceived health between a domiciliary and a hospital-based rehabilitation service (day hospitals and out-patient departments). However, young stroke patients who had required considerable amounts of rehabilitation in a Stroke Unit, were best given further therapy at home rather than in out-patient departments, since it improved household and leisure abilities. This result is compatible with the only other controlled study of domiciliary stroke rehabilitation after hospital discharge. For frail elderly patients, the day hospital service may have had advantages over the domiciliary service because death and institutionalisation rates were lower. The latter finding may be spurious, due to allocation bias and small sample size. In view of the expense of day hospitals, more research is required to examine their efficacy. It is concluded that domiciliary rehabilitation is a small step forward for stroke rehabilitation and will benefit some disabled stroke survivors, and may be a more resource-efficient way of treating many others. 1992 Thesis (University of Nottingham only) NonPeerReviewed application/pdf en arr https://eprints.nottingham.ac.uk/28040/1/317413.pdf Gladman, John R.F. (1992) An evaluation of domiciliary rehabilitation for stroke patients after discharge from hospital. DM thesis, University of Nottingham. Cerebrovascular disease Hospital based rehabilitation Home based rehabilitation
spellingShingle Cerebrovascular disease
Hospital based rehabilitation
Home based rehabilitation
Gladman, John R.F.
An evaluation of domiciliary rehabilitation for stroke patients after discharge from hospital
title An evaluation of domiciliary rehabilitation for stroke patients after discharge from hospital
title_full An evaluation of domiciliary rehabilitation for stroke patients after discharge from hospital
title_fullStr An evaluation of domiciliary rehabilitation for stroke patients after discharge from hospital
title_full_unstemmed An evaluation of domiciliary rehabilitation for stroke patients after discharge from hospital
title_short An evaluation of domiciliary rehabilitation for stroke patients after discharge from hospital
title_sort evaluation of domiciliary rehabilitation for stroke patients after discharge from hospital
topic Cerebrovascular disease
Hospital based rehabilitation
Home based rehabilitation
url https://eprints.nottingham.ac.uk/28040/