Early supported discharge in stroke rehabilitation

Area of Science:

• Neurology
• Rehabilitation Medicine
• Health Services Research

Background:

• Stroke rehabilitation aims to optimize functional recovery.
• Early supported discharge (ESD) programs provide home-based care post-stroke.
• Effectiveness of ESD compared to traditional inpatient rehabilitation requires evaluation.

Purpose of the Study:

• To systematically review randomized controlled trials (RCTs) assessing ESD effectiveness in stroke rehabilitation.
• To compare functional outcomes, cost, and length of hospital stay between ESD and inpatient care.

Main Methods:

• Systematic review of RCTs published between 1970 and 2002.
• Inclusion of 10 studies with 1,286 patients.
• Assessment of methodological quality using the PEDro Scale.

Main Results:

• No statistically significant differences in functional outcomes were found between ESD and inpatient groups.
• Patients receiving home-based therapy experienced reduced hospital stays.
• Methodological quality varied across the included studies.

Conclusions:

• Early supported discharge programs offer comparable functional outcomes to traditional inpatient stroke rehabilitation.
• ESD may be a cost-effective alternative, particularly for patients with milder strokes, by reducing hospital length of stay.