Key result
Integrated rehabilitation in patients with ischemic stroke was feasible and associated with a 4.5-year accumulated risk of death of 11.6% versus 43.2% with conventional treatment.
Why the study?
Does integrated rehabilitation reduce the death rate in patients with ischemic stroke?
Case-Control (n=73)
Does integrated rehabilitation reduce the death rate in patients with ischemic stroke?
Integrated rehabilitation is feasible and may be associated with a lower long-term mortality risk in ischemic stroke patients compared to conventional treatment, warranting further investigation in randomized trials.
Answers are grounded in this paper and cite their sources.
May not yet change ischemic stroke rehabilitation practice; leaves open potential long-term survival benefit pending randomized trials.
BACKGROUND AND PURPOSE: Integrated rehabilitation (IR) in patients with stroke with respect to death rate and feasibility, initiated as a reduced death rate, was observed in patients with angina pectoris receiving IR. DESIGN: A case-control study included 73 consecutive patients with ischemic stroke. Death rates were compared with those of the general Danish population matched for age, gender, and observation period, as well as data from the community-based Copenhagen Stroke Study. INTERVENTIONS: IR was conducted in an outpatient clinic, by professionals as well as by the patient: the former as a specific acupuncture treatment, the latter as a comprehensive biofeedback guided stress management program including diets, physical- and relaxation exercise, Chinese health philosophy, cognitive and mindfulness-related exercises, and specific biofeedback guided acupressure. RESULTS: The 4(1/2)-year accumulated risk of death was 11.6% (95 confidence limits: 3.2%-20.0%) for the 73 patients with stroke treated with IR, compared to 18.4% for the general Danish population matched for sex, age, and time period. The corresponding figures for patients receiving conventional stroke treatment were 43.2% (95 confidence limits: 39.7%- 46.7%), and 20.0% for the general Danish population matched for sex, age, and time period. CONCLUSIONS: IR was found to be feasible for patients with stroke as a complementary treatment to conventional stroke treatment, and added no risk of dying when compared to Danish stroke patients receiving conventional medical treatment. The results invite further testing in a randomized trial.
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Magnússon et al. (2010) conducted a case-control in ischemic stroke (n=73). Integrated rehabilitation (IR) vs. Conventional stroke treatment and general population was evaluated on Accumulated risk of death. Integrated rehabilitation in patients with ischemic stroke was feasible and associated with a 4.5-year accumulated risk of death of 11.6% versus 43.2% with conventional treatment.
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