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Patients with severe stroke benefit most by interdisciplinary rehabilitation team approach.

Yagura H, Miyai I, Suzuki T, Yanagihara T

Neurorehabilitation Research Institute, Bobath Memorial Hospital, 1-6-5 Higashinakahama, Joto-ku, Osaka, Japan. hiro-1@qf6.so-net.ne.jp

BACKGROUND: We evaluated the efficacy of a regular interdisciplinary stroke team approach on rehabilitation outcome. METHODS: We compared a stroke rehabilitation unit (SRU) with regular interdisciplinary stroke team conferences with general rehabilitation ward (GRW) without such conferences in the same rehabilitation hospital. One hundred and seventy-eight patients within 3 months after stroke were allocated to SRU or GRW, based on bed availability. Main outcome measures were the Functional Independence Measure, Stroke Impairment Assessment Set, length of hospital stay, discharge disposition and cost of hospitalization. RESULTS: The interval between stroke onset and admission to our hospital was significantly longer in the SRU (n = 91) group compared with the GRW group (n = 87, p < 0.05). Although comparable numbers of patients were discharged home (74.7% in the SRU vs. 71.3% in the GRW), significantly more patients (p < 0.0001) with severe disability were discharged home in the SRU group (47.4%) compared with the GRW group (0%). There were no significant differences in the increase in Functional Independence Measure score, Stroke Impairment Assessment Set score,length of hospital stay, or cost. CONCLUSION: Patients with severe stroke appeared to benefit most from regular interdisciplinary stroke team conferences in the SRU and had an improved discharge disposition.

Published 19 September 2005 in Cerebrovasc Dis, 20(4): 258-63.
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Stroke Books

The Clinical Neuropsychiatry of Stroke: Cognitive, Behavioral and Emotional Disorders following Vascular Brain Injury

The Clinical Neuropsychiatry of Stroke: Cognitive, Behavioral and Emotional Disorders following Vascular Brain Injury