Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-04T21:17:12.860Z Has data issue: false hasContentIssue false

7 - Evidence base for community neurological rehabilitation

Published online by Cambridge University Press:  11 August 2009

Michael P. Barnes
Affiliation:
University of Newcastle upon Tyne
Harriet Radermacher
Affiliation:
University of Newcastle upon Tyne
Get access

Summary

Research in rehabilitation

The growing realization is that rehabilitation does not have to be delivered in institutions. Thus the potential for rehabilitation in the community is being proposed and implemented as a viable alternative to traditional methods of rehabilitation. The potential advantages include greater convenience for clients, a familiar environment, involvement of family members and the costs curtailed by not having to provide accommodation. However, this option may be more time-consuming, expensive in terms of therapy time, difficult to coordinate and too much family involvement may be counterproductive (Rice-Oxley and Turner-Stokes, 1999). By delving into the possible opportunities and charting what investigations have already been made, the balance between these advantages and disadvantages may be found.

This chapter aims to consolidate all the research relating to community rehabilitation, and provide a definitive resource to aid further development. It aims to highlight the gaps in the research, and will address accusations that there is a lack of research to confirm the efficacy of rehabilitation in the community (Lafferty, 1996).

Inclusion criteria

Although the studies included in this evaluation will refer to people with a range of neurological impairments, it is apparent that the majority of the literature focuses on stroke rehabilitation. At times it will be pertinent to refer to studies that are not exclusively neurologically based because the findings and models used may aid discussion and understanding. Care has been taken to include studies that employ sound methodological techniques, however, occasionally studies will be included for alternative merits.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bailey, J. J., Black, M. E. and Wilkin, D. (1994). Specialist outreach clinics in general practice. British Medical Journal 308, 1083–6CrossRefGoogle ScholarPubMed
Barnes, M. P. (1994). A new style therapist for the real world. Therapy Weekly 20, 47Google Scholar
Baskett, J. J., Broad, J. B., Reekie, G. et al. (1999). Shared responsibility for ongoing rehabilitation: a new approach to home-based therapy after stroke. Clinical Rehabilitation 13, 23–33CrossRefGoogle ScholarPubMed
Beech, R., Rudd, A. G., Tilling, K. and Wolfe, C. D. A. (1999). Economic consequences of early inpatient discharge to community based rehabilitation for stroke in an inner-London teaching hospital. Stroke 30, 729–35CrossRefGoogle Scholar
Bernabei, R., Landi, F., Gambassi, G. et al. (1998). Randomised trial of impact of model of integrated care and case management for older people living in the community. British Medical Journal 316, 1348–51CrossRefGoogle ScholarPubMed
Brown, S. A. and Grimes, D. E. (1995). A meta-analysis of nurse practitioners and nurse midwives in primary care. Nursing Research 44, 332–9CrossRefGoogle Scholar
Coast, J., Richards, H. R., Peters, T. J. et al. (1998). Hospital at home or acute hospital care? A cost minimisation analysis. British Medical Journal 316, 1802–6CrossRefGoogle Scholar
Corr, S. and Bayer, A. (1995). Occupational therapy for stroke patients after hospital discharge – a randomised controlled trial. Clinical Rehabilitation 9, 291–6CrossRefGoogle Scholar
Dowswell, G., Lawler, J., Young, J. et al. (1997). A qualitative study of specialist nurse support for stroke patients and care-givers at home. Clinical Rehabilitation 11, 293–301CrossRefGoogle Scholar
Eldar, R. (2000). Rehabilitation in the community for patients with stroke: a review. Topics in Stroke Rehabilitation 6, 48–59CrossRefGoogle Scholar
Flynn, R. J. and Volpe, R. (1993). Issues and choices in the evaluation of out-reach rehabilitation programs. Canadian Journal of Rehabilitation 6, 266–80Google Scholar
Forster, A. and Young, J. (1996). Specialist nurse support for patients with stroke in the community: a randomised controlled trial. British Medical Journal 312, 1642–6CrossRefGoogle ScholarPubMed
Gibbs, I., McCaughan, D. and Griffiths, M. (1991). Skill mix in nursing: a selective review of the literature. Journal of Advanced Nursing 16, 242–9CrossRefGoogle ScholarPubMed
Gilbertson, L. (2000). Home rehab improves stroke outcomes. Health and Ageing (May), 49–51Google Scholar
Gilbertson, L., Langhorne, P., Walker, A. et al. (2000). Domiciliary occupational therapy for patients with stroke discharged from hospital: randomised controlled trial. British Medical Journal 320, 603–6CrossRefGoogle ScholarPubMed
Gladman, J. R. F. and Lincoln, N. B. (1994). Follow-up of a controlled trial of domiciliary stroke rehabilitation (DOMINO Study). Age and Ageing 23, 9–13CrossRefGoogle Scholar
Gladman, J. R. F., Lincoln, N. B. and Barer, D. H. (1993). A randomised controlled trial of domiciliary and hospital-based rehabilitation for stroke patients after discharge from hospital. Journal of Neurology, Neurosurgery and Psychiatry 56, 960–6CrossRefGoogle ScholarPubMed
Gladman, J. R. F., Juby, L. C., Clarke, P. A. et al. (1995). Survey of a domiciliary stroke rehabilitation service. Clinical Rehabilitation 9, 245–9CrossRefGoogle Scholar
Goldberg, G., Segal, M. E., Berk, S. N. et al. (1997). Stroke transition after inpatient rehabilitation. Topics in Stroke Rehabilitation 4, 64–79CrossRefGoogle Scholar
Grant, C., Goodenough, T., Harvey, I. and Hine, C. (2000). A randomised controlled trial and economic evaluation of a referrals facilitator between primary care and the voluntary sector. British Medical Journal 320, 419–23CrossRefGoogle Scholar
Green, J., Forster, A. and Young, J. (1999). A survey of community physiotherapy provision after 1 year post-stroke. British Journal of Therapy and Rehabilitation 6, 216–21CrossRefGoogle Scholar
Hakuno, A., Ito, T., Koike, J. et al. (1996). Home rehabilitation project for home-bound physically disabled people in Yokohama. Clinical Rehabilitation 10, 283–7CrossRefGoogle Scholar
Hawley, C., Stilwell, J., Davies, C. and Stilwell, P. (2000). Post-acute rehabilitation after traumatic brain injury. British Journal of Therapy and Rehabilitation 7, 116–22CrossRefGoogle Scholar
Hensher, M., Fulop, N., Hood, S. and Ujah, S. (1996). Does hospital-at-home make economic sense? Early discharge versus standard care for orthopaedic patients. Journal of the Royal Society of Medicine 89, 548–51CrossRefGoogle ScholarPubMed
Iliffe, S. (1998). Hospital at home: from red to amber: data that will reassure advocated – but without satisfying the sceptics. British Medical Journal 316, 1761–2CrossRefGoogle Scholar
Jones, A. L., Charlesworth, J. F. and Hendra, T. J. (2000). Patient mood and carer strain during stroke rehabilitation in the community following early hospital discharge. Disability and Rehabilitation 22, 490–4CrossRefGoogle ScholarPubMed
Lafferty, G. (1996). Community based alternatives to hospital rehabilitation services: a review of the evidence and suggestions for approaching future evaluations. Review of Clinical Gerontology 6, 183–94CrossRefGoogle Scholar
Laidler, P. (1994). Stroke Rehabilitation – Structure and Strategy. London: Chapman and Hall
Langhorne, P., Dennis, M. S., Kalra, L. et al. (2000). Services for helping acute stroke patients avoid hospital admission [Review]. The Cochrane Database of Systematic Reviews (Issue 2). The Cochrane Library
Lazarus, S. S., Page, C. and Barcome, D. F. (1984). Rehabilitation services in rural communities: delivery by hospital based and local teams. Archives of Physical Medicine and Rehabilitation 65, 383–7Google ScholarPubMed
Luther, A., Lincoln, N. B. and Grant, F. (1998). Reliability of stroke patients' reports on rehabilitation services received. Clinical Rehabilitation 12, 238–44CrossRefGoogle ScholarPubMed
McNamee, P., Christensen, J., Soutter, J. et al. (1998). Cost analysis of early supported hospital discharge for stroke. Age and Ageing 27, 345–51CrossRefGoogle Scholar
Mundinger, M. O., Kane, R. L., Lenz, E. R. et al. (2000). Primary care outcomes in patients treated by nurse practitioners or physicians. Journal of the American Medical Association 283, 59–68CrossRefGoogle ScholarPubMed
Neuberger, J. (1992). Patients' perspectives. From hospital to home care: the potential for acute service provision in the home. Wales: Welsh Health Planning Forum; The NHS in Wales World Health Organisation; Regional Office for Europe, King's Fund Centre
Noad, R., Lincoln, N. B. and Challen, K. (1998). Community and hospital stroke patients: long term rehabilitation. British Journal of Therapy and Rehabilitation 5, 578–81CrossRefGoogle Scholar
Pace, G. M., Schlund, M. W., Hazard-Haupt, T. et al. (1999). Characteristics and outcomes of a home and community-based neurorehabilitation programme. Brain Injury 13, 535–46Google ScholarPubMed
Petrie, K. J., Weinman, J., Sharpe, N. and Buckley, J. (1996). Role of patients' view of their illness in predicting return to work and functioning after myocardial infarction: longitudinal study. British Medical Journal 312, 1191–4CrossRefGoogle ScholarPubMed
Plant, R., Tait, B., Dawson, P. and Buri, H. (2000). Community Stroke Rehabilitation Team Evaluation Project: Executive Summary. Newcastle upon Tyne: Institute of Rehabilitation
Powell, J., Heslin, J. and Greenwood, R. (2002). Community based rehabilitation after severe traumatic brain injury: a randomised controlled trial. Journal of Neurology, Neurosurgery and Psychiatry 72, 193–202CrossRefGoogle ScholarPubMed
Pozzilli, C., Pisani, A., Palmisano, L. et al. (1999). Service location in multiple sclerosis: home or hospital. In Advances in Multiple Sclerosis: Clinical Research and Therapy, ed. S. Fredrickson and H. Link, pp. 173–80. London: Martin Dunitz
Rice-Oxley, M. and Turner-Stokes, L. (1999). Effectiveness of brain injury rehabilitation. Clinical Rehabilitation 13 (Suppl. 1), 7–24CrossRefGoogle Scholar
Richards, S. H., Coast, J., Gunnell, D. J. et al. (1998). Randomised controlled trial comparing effectiveness and acceptability of an early discharge, hospital at home scheme with acute hospital care. British Medical Journal 316, 1796–801CrossRefGoogle ScholarPubMed
Rodgers, H., Soutter, J., Kaiser, W. et al. (1997). Early supported hospital discharge following acute stroke: pilot study results. Clinical Rehabilitation 11, 280–7CrossRefGoogle ScholarPubMed
Roy, C. W. (1991). An integrated community and hospital service for adults with physical disability: 2 years experience. New Zealand Medical Journal 104, 382–4Google Scholar
Rudd, A. G., Wolfe, C. D. A., Tilling, K. and Beech, R. (1997). “Randomised controlled trial to evaluate early discharge scheme for patients with stroke.” British Medical Journal 315, 1039–44CrossRefGoogle Scholar
Shepperd, S. and Iliffe, S. (2000). Hospital at home versus inpatient hospital care [Review]. The Cochrane Database of Systematic Reviews. Volume (Issue 2). The Cochrane Library
Shiu, A. T. Y., Twinn, S. F. and Holroyd, E. (1999). The contribution of nursing to an interprofessional community-based rehabilitation team: perceptions of nurses, patients and carers. Journal of Interprofessional Care 13, 65–75CrossRefGoogle Scholar
Sims, J., Rink, E., Walker, R. and Pickard, L. (1997). The introduction of a hospital at home service: a staff perspective. Journal of Interprofessional Care 11, 217–24CrossRefGoogle Scholar
Stevenson, D. (2000). Rehabilitation outreach: a grounded theory study. British Journal of Therapy and Rehabilitation 7, 112–15CrossRefGoogle Scholar
Townsend, J., Piper, M., Frank, A. O. et al. (1988). Reduction in hospital readmission stay of elderly patients by a community based hospital discharge scheme: a randomised controlled trial. British Medical Journal 297, 544–7CrossRefGoogle ScholarPubMed
Koch, L., Widen, Holmqvist L., Kostulas, V. et al. (2000). A randomised controlled trial of rehabilitation at home after stroke in southwest Stockholm: outcome at six months. Scandinavian Journal of Rehabilitation Medicine 32, 80–6Google Scholar
Wade, D. T., Langton-Hewer, R., Skilbeck, C. E. et al. (1985). Controlled trial of a home-care service for acute stroke patients. Lancet 1, 323–6CrossRefGoogle ScholarPubMed
Walker, M. F., Gladman, J. R. F., Lincoln, N. B. et al. (1999). Occupational therapy for stroke patients not admitted to hospital: a randomised controlled trial. Lancet 354, 278–80CrossRefGoogle Scholar
Warden, D. L., Salazar, A., Martin, E. M. et al. (2000). A home program of rehabilitation for moderately severe traumatic brain injury patients. Journal of Head Trauma Rehabilitation 15, 1092–102CrossRefGoogle ScholarPubMed
Werner, R. A. and Kessler, S. (1996). Effectiveness of an intensive outpatient rehabilitation programmed for post acute stroke patients. American Journal of Physical Medicine and Rehabilitation 75, 114–20CrossRefGoogle Scholar
Widen, Holmqvist L., Pedro-Cuest, J., Holm, M. and Kostulas, V. (1995). Intervention design for rehabilitation at home after stroke: a pilot feasibility study. Scandinavian Journal of Rehabilitation Medicine 27, 43–50Google Scholar
Widen, Holmqvist L., Koch, L., Kostulas, V. et al. (1998). A randomised controlled trial of rehabilitation at home after stroke in southwest Stockholm. Stroke 29, 591–7Google Scholar
Widen, Holmqvist L., Koch, L. and Pedro-Cuesta, J. (2000). Use of healthcare, impact on family caregivers and patient satisfaction of rehabilitation at home after stroke in southwest Stockholm. Scandinavian Journal of Rehabilitation Medicine 32, 173–9Google Scholar
Willer, B., Button, J. and Rempel, R. (1999). Residential and home-based postacute rehabilitation of individuals with traumatic brain injury: a case control study. Archives of Physical Medicine and Rehabilitation 80, 399–404CrossRefGoogle ScholarPubMed
Wilson, A., Wynn, A. and Bergstrom, J. (1997). Hospital at home: the use of a new service. British Journal of Community Health Nursing 2, 234–7CrossRefGoogle Scholar
Wilson, A., Parker, H., Wynn, A. et al. (1999). Randomised controlled trial of effectiveness of Leicester hospital at home scheme compared with hospital care. British Medical Journal 319, 1542–6CrossRefGoogle ScholarPubMed
Wilson, K. G., Crupi, C. D., Greene, G. et al. (1995). Consumer satisfaction with a rehabilitation mobile outreach program. Archives of Physical Medicine and Rehabilitation 76, 899–904CrossRefGoogle ScholarPubMed
Wolfe, C. D. A., Beech, R., Ratcliffe, M. and Rudd, A. G. (1995). Stroke care in Europe: can we learn lessons from the different ways stroke is managed in different countries?Journal of the Royal Society of Health 115, 143–7CrossRefGoogle ScholarPubMed
Wolfe, C., Rudd, A. and Tilling, K. (1998). Trials of community rehabilitation need to be of adequate sample size. Stroke 29, 1737–9Google Scholar
Wolfe, C. D. A., Tilling, K. and Rudd, A. G. (2000). The effectiveness of community based rehabilitation for stroke patients who remain at home: a pilot randomised trial. Clinical Rehabilitation 14, 563–9CrossRefGoogle Scholar
Young, J. and Forster, A. (1991). The Bradford community stroke trial: eight week results. Clinical Rehabilitation 5, 283–92CrossRefGoogle Scholar
Young, J. and Forster, A. (1992). The Bradford community stroke trial: results at six months. British Medical Journal 304, 1085–9CrossRefGoogle Scholar
Young, J. and Forster, A. (1993). Day hospital and home physiotherapy for stroke patients: a comparative cost-effectiveness study. Journal of the Royal College of Physicians 27, 252–8Google ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×