title: ['Neurodevelopmental treatment' following stroke: no beneficial effect shown in measurements taken after 1 year; comparative study].
abstract: OBJECTIVE
  To determine whether neurodevelopmental treatment (NDT) in the care of stroke patients is effective with respect to the functional status and quality of life (QoL) during one year after stroke onset.
  
  
  METHODS
  Prospective, non-randomised, comparative parallel group design.
  
  
  METHODS
  324 consecutive stroke patients from 12 Dutch hospitals were divided into 2 groups: an experimental group (n=223), in which nurses and physiotherapists used the NDT approach, and a control group who received conventional therapy (n=101). Functional status was assessed with the Barthel Index. Primary outcome was considered poor when the Barthel Index <12 after 1 year or when the patient had died. QoL was assessed with the 'Stroke adapted sickness impact profile'-30 and on a visual analogue scale.
  
  
  RESULTS
  At 12 months, 59 patients in the NDT group (26%) and 24 patients in the control group (24%) had a poor outcome (corresponding adjusted odds ratio: 1.7; 95% CI: 0.8-3.5). At point of discharge and after 6 months, the adjusted odds ratio was 0.8 (95% CI: 0.4-1-5) and 1.6 (95% CI: 0.8-3.2) respectively. The adjusted mean differences of the QoL measurements did not show statistically significant differences between the 2 study groups at 6 and 12 months after stroke onset.
  
  
  CONCLUSIONS
  The NDT approach was not an effective method in the care of stroke patients. Health care professionals need to reconsider the use of the NDT approach.
authors.affiliation: Universitair Medisch Centrum Utrecht, Postbus 85.500, 3508 GA Utrecht. t.hafsteinsdottir@umcutrecht.nl
authors.forename: T B
authors.initials: TB
authors.lastname: Hafsteinsdóttir
authors.forename: A
authors.initials: A
authors.lastname: Algra
authors.forename: L J
authors.initials: LJ
authors.lastname: Kappelle
authors.forename: M H F
authors.initials: MH
authors.lastname: Grypdonck