Integrated care pathway based rehabilitation for acute stroke did not reduce length of hospital stay
QUESTION: Is integrated care pathway (ICP) based management more effective than conventional multidisciplinary care in reducing length of hospital stay in patients with acute stroke who require specialist rehabilitation?
Randomised (allocation concealed), unblinded, controlled trial with follow up to 26 weeks.
A stroke rehabilitation unit in a hospital in London, UK.
152 patients (mean age 75 y, 51% men) who had acute stroke within the previous 2 weeks; and had persistent motor, sensory, vision, speech, perceptual, or cognitive impairment that limited personal activities of daily living (ADL) and required inpatient rehabilitation. Exclusion criterion was severe premorbid disability. Follow up was complete, although some measures had incomplete data (≤18% of records).
76 patients were allocated to rehabilitation managed by an ICP (organised, goal defined, and time managed care plan). The ICP was developed by a multidisciplinary stroke team on the basis of an extensive review of published and unpublished literature. Therapeutic activities, short term goals, and predicted time …