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Going home early no hindrance to a speedy recovery

Gary and Physiotherapist JenicaThere is an increasingly widespread belief that patients recovering from stroke can adequately continue their rehabilitation at home if they are discharged from hospital sooner.

“The assumption is that people are more active at home compared to in hospital. We are investigating whether this assumption is true,” says Peninsula Health physiotherapist and Stroke Detours Program clinician, Jenica Parker.

Using a group of 16 participants with a median age of 69, Jenica is investigating whether there is any evidence to support the theory that a home environment is equally as effective as an inpatient rehabilitation environment in stroke recovery.

Peninsula Health’s Stroke Detours Program is a home-based high intensity early supported discharge program for people who have suffered a stroke.

The program focuses on changing a patient’s rehabilitation environment from an inpatient setting to their own home, while still being visited by a clinician to aid their progress.

These patients leave the hospital at least a week earlier than has traditionally been the case.

“Often the thinking is that people will be more active at home compared to when they are in hospital because of increasing incidental activity or day-to-day activities,” says Jenica.

“There is a lot of research to say that stroke survivors are not very active in a hospital environment compared to healthier people.”

Each participant wore the activity tracker for a month, which gave Jenica access to a large amount of data.

“We found that the participants who went into the Stroke Detours Program on discharge were more physically active in hospital and they continued to be more physically active at home.”

“We also found that going home doesn’t reduce physical activity,” adds Jenica. “People continue to be physically active at home, so there is no negative”

“We also did a health-related ‘quality of life’ measure, a patient-perceived measure, and that showed a significant increase once the patients were at home compared to in hospital.”

“This is key,” says Jenica.

“It’s really the bottom line, patient satisfaction, in terms of person-centred care. Going home early is not detrimental to someone’s recovery, you can continue to recover and be physically active at home, whether you live with someone, or alone.”

With research evidence and data now on the side of innovation in swapping the hospital environment for home, the approach to stroke rehabilitation is beginning to change.

This story first appeared in the 2018 Research Report, read the full edition here.