Half of stroke survivors have some significant disability. One important question is whether rehabilitation after stroke is effective. This has been well reviewed in an Effectiveness Bulletin from the University of Leeds in March 1992.
Organisation saves lives Organised stroke care can, however, save lives.
Langhorne and colleagues published a statistical overview of randomised controlled studies reported between 1962 and 1993 in which the management of stroke patients in a specialist unit was compared with that in general wards. The overview covered 1568 stroke patients, with 766 in special units and 820 in general wards. A detailed analysis of functional outcomes was hampered by lack of consistent recording. However, nine of the ten studies reported functional gains in stroke units, and one reported very similar outcomes. While research evidence often provides provision of the best possible care, this has to be viewed in relation to the resources available to produce a pragmatic solution which is acceptable and achievable at the local level.