Ergebnisqualität der Schlaganfallrehabilitation in der BAR-Phase D

Background, Stroke is a disease of tremendous epidemiologic significance. Approximately 200,000 people in Germany suffer a stroke each year. Stroke is the third most common cause of death and the most common cause of acquired disabilities in adults. About one-fourth of stroke survivors report severe restraints in activities of daily living three months after acute stroke. Motor and cognitive dysfunctions as well as affective problems are the most common stroke sequelae. Stroke rehabilitation plays a crucial role in coping with stroke sequelae. The large number of strokes and the partly severe consequences raise the question which increase in participation can be achieved through medical rehabilitation. Methods, A prospective, multi-centered survey was conducted in six neurological inpatient rehabilitation centers. Recruitment focused on patients who had recently suffered an acute stroke and had a disease severity according to BAR phase D. Patients filled in questionnaires at three points of measurement: at the beginning and at the end of the inpatient rehabilitation and after four months. Primary outcome was participation, secondary outcomes were several parameters of subjective wellbeing. Furthermore utilization of aftercare and satisfaction with the rehabilitation program were measured. Results, At the beginning of the rehabilitation restraints in participation and subjective wellbeing were high. At the end of the inpatient rehabilitation, significant improvements of small effect sizes for subjective wellbeing and medium effect sizes for participation were reached. After four months, effects had decreased, yet improvements compared to initial status were still to be seen. Patient ratings of the rehabilitation program and the results were entirely positive. Two thirds of the patients were advised to make use of aftercare and most patients (83%) made use of some kind of aftercare. Conclusions, The results of this study support the notion that stroke rehabilitation has significant and sustainable effects. Participation, in particular, seems to improve through medical rehabilitation. Partly decreased effects after four months raise the question of adequate follow-up care.