Home care helps patients more, say researchers

A review showed they were more likely to be able to carry out daily tasks such as dressing or washing if they were given help such as physiotherapy.

It was known that specialist hospital care in hospital benefited patients.

But University of Glasgow researchers , writing in The Lancet, say this study shows home care helps patients continue to improve once they were discharged.

Developing strong specialist stroke rehabilitation services for stroke patients living at home can help stroke survivors get back on track to leading a fulfilling life Margaret Goose, Stroke Association

The review looked at 14 studies covering 1,617 patients who had been given occupational of physiotherapy, or a combination of the two.

The therapies can help patients improve limb function, or re-learn basic tasks such as dressing or feeding themselves.

It is estimated that around 350,000 people in the UK are living with severe disability after having had a stroke.

It is one of the most frequent causes of disability in developed countries and accounts for considerable costs for health and social services.

'Modest health gain'

Although experts agreed specialist rehabilitation care in hospital improved patient outcomes, there had been no widespread agreement concerning the effects of rehabilitation services for stroke patients once they had left hospital.

The University of Glasgow review found rehabilitation care for patients living at home reduced the odds of deteriorating in personal activities of daily living, such as walking or dressing by 28%.

They were shown to increase the ability of patients to undertake normal daily activities by 14%

Writing in the Lancet, Lynn Legg who led the research, said: "Although the health gain we recorded is fairly modest, we know of no other intervention at present that can provide this increase at this stage of recovery."

She said the review had not examined the specific nature, content and cost of home rehabilitation services had not been considered by the review.

But she added: "What does seem clear is that the debate should move from whether such services are effective to how to make the most of their benefits."

'Growing evidence'

Margaret Goose, chief executive of the Stroke Association, said: "We welcome these findings, which support The Stroke Association's continuing campaign to ensure that stroke patients have access to early and continuing specialist rehabilitation.

"We have consistently campaigned for the best services to be provided for all stroke patients, their families and carers.

"Multi-disciplinary stroke care teams, which are staffed by professionals who have specialist knowledge of the condition, makes a real difference to patient outcome. This study adds to the growing body of evidence confirming this.

"Stroke patients tell us that they embark on a stroke journey and continue to experience improvement in their condition months, and even years, after the devastating effects of a stroke.