Bobath or motor relearning programme? A follow-up one and four years post stroke.
OBJECTIVE
The purpose of this follow-up one and four years post stroke was to find out whether the initial physiotherapy approach had had any long-term effects on mortality, motor function, postural control, activities of daily living, life quality, follow-up from community services and living conditions.


METHODS
A randomized controlled trial of first time ever stroke patients. Group 1 (n = 33) and group 2 (n = 28) had initial physiotherapy according to the Motor Relearning Programme and Bobath, respectively.


METHODS
The Motor Assessment Scale (MAS), the Sødring Motor Evaluation Scale (SMES), the Barthel ADL Index, the Nottingham Health Profile (NHP) and Berg Balance Scale were used. The following parameters were also registered: incidence of new strokes, other diseases, use of assistive devices, the patient's accommodation and use of services from the community.


RESULTS
The mortality rates were similar in the two groups. In both groups the motor function, postural control and ADL had decreased rapidly, leaving many of the patients dependent and with a high risk of falling. Life quality had increased compared to the acute stage, but was still low in comparison with healthy persons. Patients in both groups lived at home, but were dependent on help from relatives and community services. Physiotherapy as follow-up service was seldom used. The initial physiotherapy approach did not seem to have a major influence on the patients' ability to cope in the long-term.


CONCLUSIONS
This follow-up at one and four years post stroke showed no major influence of two different initial physiotherapy regimens on long-term function. The study confirmed a rapid deterioration of ADL and motor function and an increased dependence on relatives. The study reveals a gap between the intense treatment in the acute phase and little or no follow-up of physiotherapy treatment or other rehabilitation activities later.
Langhammer
Birgitta
B
Faculty of Health Sciences/Physiotherapy Programme, Oslo University College, Oslo, Norway. Birgitta.Langhammer@hf.hio.no
Stanghelle
Johan K
JK
D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology; D010043:Outcome and Process Assessment, Health Care; D026741:Physical Therapy Modalities / Q000379:methods*; D004856:Postural Balance / Q000502:physiology; D011788:Quality of Life; D012111:Residence Characteristics; D012656:Self-Help Devices; D012737:Sex Factors; D020521:Stroke / Q000401:mortality / Q000503:physiopathology; D000071939:Stroke Rehabilitation