Article

PURPOSE: To conduct a systematic literature review that identifies and summarises
the findings of studies that have compared the outcomes of outpatient, brain
injury rehabilitation programmes conducted in real-life home settings and day
hospital clinic settings. METHOD: A systematic search, using specific inclusion
and exclusion criteria, of English language electronic databases, as well as
manual search of reference lists of identified articles. Each study was evaluated
and rated using 11 methodological criteria.
The findings are summarised. RESULTS:
Database searches, using key terms, initially yielded 4484 articles. Of these
articles, 17 articles were included in the review and rated according to
methodological quality. The majority of studies indicated that the outcomes of
rehabilitation programmes conducted in home settings are at least equivalent to
rehabilitation conducted in day hospital and outpatient settings for people with
acquired brain injury. Most identified studies (15/17) were with groups of people
with a diagnosis of stroke, primarily over the age of 65 years. Assessments of
impairment or activity limitation were primarily used to reflect outcomes and no
studies used participation or goal-based outcome measures. CONCLUSIONS: The
available studies indicate that outcomes of outpatient rehabilitation programmes
delivered at home, of short-term duration (mostly 3 months) for people with
stroke recently discharged from hospital, are at least equivalent to day
hospital-based outpatient rehabilitation programme outcomes. However, there have
been no controlled studies designed to investigate the influence of therapy
context (home and clinic settings) on outcomes for people receiving outpatient
neurological rehabilitation. Furthermore, investigations of the efficacy of
community-based rehabilitation with younger people with brain injuries, caused by
mechanisms other than stroke, are required.

Langue : ANGLAIS