Authors: Brunner M, Skeat J, Morris ME
Title: Outcomes of speech-language pathology following stroke: Investigation of inpatient rehabilitation and rehabilitation in the home programs
Source: International Journal of Speech-Language Pathology 2008 10(5): 305-313
Year: 2008
Research Design: Non Randomised Controlled Trial
Rating Score: 03/10
This rating is confirmed
Eligibility specified - Y
Random allocation - N
Concealed allocation - N
Baseline comparability - N
Blind subjects - N
Blind therapists - N
Blind assessors - N
Adequate follow-up - Y
Intention-to-treat analysis - N
Between-group comparisons - Y
Point estimates and variability - Y
Abstract:

Speech-language pathology outcomes following stroke are poorly understood, and potential predictors of these, such as age and therapy input have not been well documented. For 12 months, the Australian Therapy Outcome Measures (AusTOMs) for Speech Pathology scales were used to rate swallowing and language outcomes for patients (n = 63) receiving rehabilitation post stroke. Outcomes were compared by service type (inpatient versus home based), amount of input and patient age. Greatest improvement was seen on the Swallowing scale. There was no difference in outcomes of inpatients compared to home based rehabilitation patients. There was a trend towards better outcomes with increasing input for the Swallowing scale and for Participation Restriction and Distress/Wellbeing domains. Patients less than 75 years of age had better Participation Restriction and Distress/Wellbeing outcomes, compared to older patients. These results align with previous studies, suggesting that inpatient and home based service models may be equally effective post stroke. Therapy input and patient age were related to some, but not all, domains of the AusTOMs, and these results may have implications for patient management. They should also direct future research to further explore these relationships; for example, to identify optimal input to achieve best outcomes.

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