title: Prevention and treatment of hand oedema after stroke.
abstract: OBJECTIVE
  As there is no evidence for a specific treatment for post-stroke-induced hand oedema, rehabilitation centre Blixembosch formalized a best practice protocol. We investigated whether the Blixembosch hand oedema protocol is usable in daily practice and leads to lower incidence (prevention) and shorter duration (treatment) compared with care as usual.
  
  
  METHODS
  In a non-randomised comparative trial, we investigated 206 post-stroke patients admitted to two Dutch rehabilitation centres. Hand volumes were measured at least bi-weekly using a volumeter. Treatment was started according the protocol (Blixembosch) or following care as usual (Leijpark). Usability was assessed with a survey among professionals.
  
  
  RESULTS
  In the Blixembosch group, 16% developed oedema after admission, compared with 21% in the control group (p = 0.019). Average duration of oedema (both developed before and after admission) was 6.5 weeks in the Blixembosch group compared with 3.1 weeks in the control group (p = 0.000). Professionals were positive about the protocol.
  
  
  CONCLUSIONS
  The study showed that the protocol is usable in daily practice and has a small beneficial effect on hand oedema incidence rates compared with care as usual. The negative effect on duration of hand oedema could also be caused by the difference in prognosis between the two groups.
authors: Rehabilitation Centre Blixembosch, Libra Rehabilitation & Audiology, Eindhoven, the Netherlands and.
authors: Stefanie P M
authors: SP
authors: Kuppens
authors: Hanneke C P
authors: HC
authors: Pijlman
authors: Minou W M G C
authors: MW
authors: Hitters
authors: Caroline M
authors: CM
authors: van Heugten
mesh_terms: D000367:Age Factors; D000368:Aged; D002985:Clinical Protocols; D019468:Disease Management; D004487:Edema / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D006225:Hand / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009929:Organ Size; D011379:Prognosis; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
keywords: Hand oedema; prevention; rehabilitation; stroke; treatment