title: Motor and functional recovery after stroke: a comparison of 4 European rehabilitation centers.
abstract: OBJECTIVE
  Outcome after first stroke varies significantly across Europe. This study was designed to compare motor and functional recovery after stroke between four European rehabilitation centers.
  
  
  METHODS
  Consecutive stroke patients (532 patients) were recruited. They were assessed on admission and at 2, 4, and 6 months after stroke with the Barthel Index, Rivermead Motor Assessment of Gross Function, Rivermead Motor Assessment of Leg/Trunk, Rivermead Motor Assessment of Arm, and Nottingham Extended Activities of Daily Living (except on admission). Data were analyzed using random effects ordinal logistic models adjusting for case-mix and multiple testing.
  
  
  RESULTS
  Patients in the UK center were more likely to stay in lower Rivermead Motor Assessment of Gross Function classes compared with patients in the German center (DeltaOR, 2.4; 95% CI, 1.3 to 4.3). In the Swiss center, patients were less likely to stay in lower Nottingham Extended Activities of Daily Living classes compared with patients in the UK center (DeltaOR, 0.7; 95% CI, 0.5 to 0.9). The latter were less likely to stay in lower Barthel Index classes compared with the patients in the German center (DeltaOR, 0.6; 95%CI, 0.4 to 0.8). Recovery patterns of Rivermead Motor Assessment of Leg/Trunk and Rivermead Motor Assessment of Arm were not significantly different between centers.
  
  
  CONCLUSIONS
  Gross motor and functional recovery were better in the German and Swiss centers compared with the UK center, respectively. Personal self-care recovery was better in the UK compared with the German center. Previous studies in the same centers indicated that German and Swiss patients received more therapy per day. This was not the result of more staff but of a more efficient use of human resources. This study indicates potential for improving rehabilitation outcomes in the UK and Belgian centers.
authors.affiliation: Katholieke Universiteit Leuven, Faculty of Kinesiology and Rehabilitation Sciences, Tervuursevest 101, Heverlee, Belgium. Liesbet.Dewit@faber.kuleuven.be
authors.forename: Liesbet
authors.initials: L
authors.lastname: De Wit
authors.forename: Koen
authors.initials: K
authors.lastname: Putman
authors.forename: Birgit
authors.initials: B
authors.lastname: Schuback
authors.forename: Arnost
authors.initials: A
authors.lastname: Komárek
authors.forename: Felix
authors.initials: F
authors.lastname: Angst
authors.forename: Ilse
authors.initials: I
authors.lastname: Baert
authors.forename: Peter
authors.initials: P
authors.lastname: Berman
authors.forename: Kris
authors.initials: K
authors.lastname: Bogaerts
authors.forename: Nadine
authors.initials: N
authors.lastname: Brinkmann
authors.forename: Louise
authors.initials: L
authors.lastname: Connell
authors.forename: Eddy
authors.initials: E
authors.lastname: Dejaeger
authors.forename: Hilde
authors.initials: H
authors.lastname: Feys
authors.forename: Walter
authors.initials: W
authors.lastname: Jenni
authors.forename: Christiane
authors.initials: C
authors.lastname: Kaske
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Lesaffre
authors.forename: Mark
authors.initials: M
authors.lastname: Leys
authors.forename: Nadina
authors.initials: N
authors.lastname: Lincoln
authors.forename: Fred
authors.initials: F
authors.lastname: Louckx
authors.forename: Wilfried
authors.initials: W
authors.lastname: Schupp
authors.forename: Bozena
authors.initials: B
authors.lastname: Smith
authors.forename: Willy
authors.initials: W
authors.lastname: De Weerdt
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004185:Disability Evaluation; D005060:Europe; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D020127:Recovery of Function; D012047:Rehabilitation Centers; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome