Specialized stroke rehabilitation services in seven countries: Preliminary results from nine rehabilitation centers.
BACKGROUND
There is a lack of defined levels of rehabilitation, indicating possibly random content and access to specialized services.


OBJECTIVE
The aim of the study was to perform a multinational descriptive study of specialized rehabilitation in persons with stroke, to elucidate what the different centers define as prerequisites for specialized rehabilitation, and to analyze whether these descriptions map to currently applied standards or constructs of specialized rehabilitation. A secondary aim was to look for similarities and differences between therapies and services for persons with stroke in the sub-acute stage in the different institutions.


METHODS
Descriptive data of the collaborating centers regarding structure and processes of services were recorded and compared with the British Society of Rehabilitation Medicine and Specialized Services National Definitions sets.


RESULTS
Comparisons of the definitions showed that all centers admitted severely disabled persons with stroke, in need of complex rehabilitation, and provided high levels of physical services, with specialized equipment and facilities. However, funding, size, university affiliation, quality accreditation, staffing levels, specialist training, cognitive and vocational services, coordination of the professional teams, admission procedures, time and type of therapies, estimated length of stay, and follow-up procedures differed between the centers.


CONCLUSIONS
This multinational study of specialized stroke rehabilitation centers shows that a universal definition of specialized rehabilitation is possible, even in quite different countries and settings, in terms of general principles. There were however differences in structures and procedures, which may influence patients' outcomes, indicating a need for refinement of the definitions to be globally applicable.
Faculty of Health, Physiotherapy Programme, Oslo and Akershus University College, Oslo, Norway.|Faculty of Medicine, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.
Birgitta
B
Langhammer
Faculty of Medicine, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.|University of Oslo, Institute of Clinical Medicine, Oslo, Norway.
Frank
F
Becker
University of Oslo, Institute of Clinical Medicine, Oslo, Norway.
Katharina S
KS
Sunnerhagen
China Rehabilitation Research Center, Beijing, China.
Tong
T
Zhang
China Rehabilitation Research Center, Beijing, China.
Xiaoxia
X
Du
Rehabilitation Medicine, Rusk Institute, New York, NY, USA.
Tamara
T
Bushnik
Rehabilitation Medicine, Policlinica nr 2, Petrozavodsk, Russia.
Maria
M
Panchenko
Sheba Medical Hospital, Tel Aviv, Israel.
Ofer
O
Keren
Betlehem Arab Society Rehabilitation, Betlehem, Israel.
Samir
S
Banura
Faculty of Medicine, Islamic University, Gaza, Israel.
Khamis
K
Elessi
El Wafa, Gaza, Israel.
Fuad
F
Luzon
Sahgrenska Academy, Institute of Neuroscience and Physiology, Center for Brain Repair and Rehabilitation, Gothenburg, Sweden.
Åsa
Å
Lundgren-Nilsson
Sichuan Bayi, Chengdu, China.
Xie
X
Li
Faculty of Medicine, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.
Susanne
S
Sällström
Faculty of Medicine, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.|University of Oslo, Institute of Clinical Medicine, Oslo, Norway.
Johan Kvalvik
JK
Stanghelle
D006801:Humans; D038622:Internationality; D011446:Prospective Studies; D012046:Rehabilitation / Q000379:methods*; D012047:Rehabilitation Centers; D000071939:Stroke Rehabilitation
multidisciplinary team; specialized rehabilitation; stroke