A multimodal individualized long-term intervention to prevent functional decline after stroke (LAST-long): a single...

Area of Science:

• Neurology
• Public Health
• Rehabilitation Medicine

Background:

• The Stroke Action Plan for Europe suggests coordinated post-rehabilitation support, despite limited evidence.
• This study evaluated a coordinator-led multimodal intervention versus standard care for stroke patients.

Purpose of the Study:

• To determine if a coordinated stroke intervention prevents dependency and functional decline.
• To assess the efficacy of a multimodal approach in stroke recovery.

Main Methods:

• A single-blinded, randomized controlled multi-center trial involving 301 patients three months post-stroke.
• Intervention group received monthly coordinator follow-up; control group received standard care.
• Assessments included modified Rankin Scale (mRS), daily living activities, cognitive and physical function over 18 months.

Main Results:

• No significant difference in mRS at 18 months between the intervention (0.03, p=0.79) and control groups.
• Serious adverse events were similar: 21.1% in the intervention group and 22.1% in the control group.
• The 18-month intervention did not demonstrate superiority over standard care for mild stroke patients.

Conclusions:

• The coordinator-led multimodal intervention was not superior to standard care in preventing dependency or functional decline 18 months post-stroke.
• Longer follow-up may be necessary to evaluate the intervention's impact on mortality and recurrent vascular events.