Home versus day rehabilitation: a randomised controlled trial - PubMed (original) (raw)
Randomized Controlled Trial
Home versus day rehabilitation: a randomised controlled trial
Maria Crotty et al. Age Ageing. 2008 Nov.
Abstract
Objective: to assess the effect of home versus day rehabilitation on patient outcomes.
Design: randomised controlled trial.
Setting: post-hospital rehabilitation.
Participants: two hundred and twenty-nine hospitalised patients referred for ambulatory rehabilitation.
Interventions: hospital-based day rehabilitation programme versus home-based rehabilitation programme.
Main outcome measures: at 3 months, information was collected on hospital readmission, transfer to residential care, functional level, quality of life, carer stress and carer quality of life. At 6 months, place of residence, hospital re-admissions and mortality status were collected.
Results: there were significant improvements in the functional outcomes from baseline to 3 months for all participants. At discharge, carers of patients in day hospital reported higher Caregiver Strain Index (CSI) scores in comparison to home rehabilitation carers (4.95 versus 3.56, P = 0.047). Patients in day hospital had double the risk of readmission compared to those in home rehabilitation (RR = 2.1; 95% CI 1.2-3.9). This effect persisted at 6 months.
Conclusions: day hospital patients are more likely to be readmitted to hospital possibly due to increased access to admitting medical staff. This small trial favours the home as a better site for post-hospital rehabilitation.
Figures
Figure 1
Recruitment flow of participants
Comment in
- Hospital and home rehabilitation did not differ for functional competence in activities of daily living.
Edwards M. Edwards M. Evid Based Nurs. 2009 Jul;12(3):84. doi: 10.1136/ebn.12.3.84. Evid Based Nurs. 2009. PMID: 19553421 No abstract available.
Similar articles
- An extended stroke rehabilitation service for people who have had a stroke: the EXTRAS RCT.
Shaw L, Bhattarai N, Cant R, Drummond A, Ford GA, Forster A, Francis R, Hills K, Howel D, Laverty AM, McKevitt C, McMeekin P, Price C, Stamp E, Stevens E, Vale L, Rodgers H. Shaw L, et al. Health Technol Assess. 2020 May;24(24):1-202. doi: 10.3310/hta24240. Health Technol Assess. 2020. PMID: 32468989 Free PMC article. Clinical Trial. - Rehabilitation of older patients: day hospital compared with rehabilitation at home. A randomised controlled trial.
Parker SG, Oliver P, Pennington M, Bond J, Jagger C, Enderby PM, Curless R, Chater T, Vanoli A, Fryer K, Cooper C, Julious S, Donaldson C, Dyer C, Wynn T, John A, Ross D. Parker SG, et al. Health Technol Assess. 2009 Aug;13(39):1-143, iii-iv. doi: 10.3310/hta13390. Health Technol Assess. 2009. PMID: 19712593 Clinical Trial. - A cluster randomised controlled trial and economic evaluation of a structured training programme for caregivers of inpatients after stroke: the TRACS trial.
Forster A, Dickerson J, Young J, Patel A, Kalra L, Nixon J, Smithard D, Knapp M, Holloway I, Anwar S, Farrin A; TRACS Trial Collaboration. Forster A, et al. Health Technol Assess. 2013 Oct;17(46):1-216. doi: 10.3310/hta17460. Health Technol Assess. 2013. PMID: 24153026 Free PMC article. Clinical Trial. - Early supported discharge services for people with acute stroke.
Langhorne P, Baylan S; Early Supported Discharge Trialists. Langhorne P, et al. Cochrane Database Syst Rev. 2017 Jul 13;7(7):CD000443. doi: 10.1002/14651858.CD000443.pub4. Cochrane Database Syst Rev. 2017. PMID: 28703869 Free PMC article. Review. - Systematic reviews of the effectiveness of day care for people with severe mental disorders: (1) acute day hospital versus admission; (2) vocational rehabilitation; (3) day hospital versus outpatient care.
Marshall M, Crowther R, Almaraz-Serrano A, Creed F, Sledge W, Kluiter H, Roberts C, Hill E, Wiersma D, Bond GR, Huxley P, Tyrer P. Marshall M, et al. Health Technol Assess. 2001;5(21):1-75. doi: 10.3310/hta5210. Health Technol Assess. 2001. PMID: 11532238 Review.
Cited by
- Pragmatic Solutions for Stroke Recovery and Improved Quality of Life in Low- and Middle-Income Countries-A Systematic Review.
Ekechukwu END, Olowoyo P, Nwankwo KO, Olaleye OA, Ogbodo VE, Hamzat TK, Owolabi MO. Ekechukwu END, et al. Front Neurol. 2020 Jun 25;11:337. doi: 10.3389/fneur.2020.00337. eCollection 2020. Front Neurol. 2020. PMID: 32695058 Free PMC article. - TRialing individualized interventions to prevent functional decline in at-risk older adults (TRIIFL): study protocol for a randomized controlled trial nested in a longitudinal observational study.
Grimmer K, Luker J, Beaton K, Kumar S, Crockett A, Price K. Grimmer K, et al. Trials. 2013 Aug 20;14:266. doi: 10.1186/1745-6215-14-266. Trials. 2013. PMID: 23962259 Free PMC article. Clinical Trial. - Medical day hospital care for older people versus alternative forms of care.
Brown L, Forster A, Young J, Crocker T, Benham A, Langhorne P; Day Hospital Group. Brown L, et al. Cochrane Database Syst Rev. 2015 Jun 23;2015(6):CD001730. doi: 10.1002/14651858.CD001730.pub3. Cochrane Database Syst Rev. 2015. PMID: 26102196 Free PMC article. Review. - Effectiveness of outpatient geriatric rehabilitation after inpatient geriatric rehabilitation or hospitalisation: a systematic review and meta-analysis.
Preitschopf A, Holstege M, Ligthart A, Groen W, Burchell G, Pol M, Buurman B. Preitschopf A, et al. Age Ageing. 2023 Jan 8;52(1):afac300. doi: 10.1093/ageing/afac300. Age Ageing. 2023. PMID: 36626320 Free PMC article. - Validating the Safe and Effective Use of a Neurorehabilitation System (InTandem) to Improve Walking in the Chronic Stroke Population: Usability Study.
Smayda KE, Cooper SH, Leyden K, Ulaszek J, Ferko N, Dobrin A. Smayda KE, et al. JMIR Rehabil Assist Technol. 2023 Nov 20;10:e50438. doi: 10.2196/50438. JMIR Rehabil Assist Technol. 2023. PMID: 37983080 Free PMC article.
References
- Meijer R, van Limbeek J. Early supported discharge: a valuable alternative for some stroke patients. Lancet. 2005;365:455–6. - PubMed
- Jolly K, Taylor RS, Lip GY, et al. Home-based cardiac rehabilitation compared with centre-based rehabilitation and usual care: a systematic review and meta-analysis. Int J Cardiol. 2006;111:343–51. - PubMed
- Cameron ID, Crotty M, Currie C, et al. Geriatric rehabilitation following fractures in older people: a systematic review. Health Technol Assess. 2000;4:1–111. - PubMed
- Caplan GA, Brown A. Post acute care: can hospitals do better with less? Aust Health Rev. 1997;20:43–54. - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical