[Validating rehabilitation after stroke]

Evaluation of therapeutic efficacy in neurologic rehabilitation is methodologically limited by the well established polypragmasia and the lack of untreated controls. Controversial discussion is generated by the following topics: superiority of specific therapy versus spontaneous recovery, higher efficacy of in-patient-setting versus out-patient-setting and the value of neurorehabilitation treatment in latency of more than 1 year after the event. To develop a practicable method for the evaluation of efficacy, we surveyed retrospectively 30 patients after stroke in a sequential study design on 4 scheduled visits: first admission to in-patient rehabilitation, discharge to out-patient treatment, admission and discharge of second in-patient rehabilitation. Impairment, disability and handicap were documented by NIH-Stroke Scale, Barthel-Index, CGI, WWK-Pflegeskala N and Risk-Profile. A descriptive data-analysis implies a therapeutic gain of stroke rehabilitation in-patient setting which is apparently superior to out-patient treatment. A measurable therapeutic effect was evident even more than one year after the stroke.