Effects of Day Hospital Rehabilitation After Stroke

Objective: We sought to evaluate with 3 relevant, reliable, and valid measurement instruments the effect of 6 to 8 weeks of day hospital rehabilitation (DHR) after stroke on physical and cognitive functions and self-rated health and health-related quality of life, possible relationships among these variables, and direct costs of the rehabilitation period. Design: We conducted a prospective follow-up study of DHR in a university hospital with pretreatment and posttreatment assessments. Patients: In all, 52 consecutive patients aged 18 to 60 years with first-ever stroke occurring in the mean 6 months before study start comprised the study group. Methods: We conducted assessments using Functional Independence Measure, Medical Outcomes Study 36-item Short Form, and EuroQol. Results: Significant improvements occurred in physical and cognitive functions (P < .0001) and self-rated health and health-related quality of life (P < .0001 for both physical and mental component summaries and P < .0001 for the EuroQol). Improvements correlated inversely with baseline scores (P = .026-P < .0001 for different variables). Improvements in self-rated health and health-related quality of life were not related to improvements in physical and cognitive functions. Direct costs were estimated at about 12,000 euros or $14,500 per patient for the treatment period. Conclusion: During the 6 to 8 weeks of DHR, there is significant improvement in physical and cognitive functions and self-rated health and health-related quality of life, which are not related significantly to each other. Improvements are greater in patients with more severe impairment of physical and cognitive functions and self-rated health and health-related quality of life at baseline.