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February 1994

Stroke Rehabilitation Outcome Studies: Selection for Meta-analysis

Author Affiliations

Burke Rehabilitation Hospital 785 Mamaroneck Ave White Plains, NY 10605

Arch Neurol. 1994;51(2):120. doi:10.1001/archneur.1994.00540140022008

Ottenbacher and Jannell1 have used meta-analysis to study the effect of stroke rehabilitation on functional outcome following stroke. The studies that they cite actually address two separate issues: (1) Do patients randomized to focused stroke rehabilitation units do better than those given physical, occupational, and speech therapy on a general medical ward? (2) Is one type of rehabilitation technique better than another in optimizing functional recovery within the stroke rehabilitation unit? Pooling studies addressing these separate issues obscure the primary question: Are focused stroke rehabilitation units advantageous?

There are now six studies that prospectively randomize patients (based on bed availability) to either a focused stroke rehabilitation unit or a general medical unit.2-7 Five of these studies have found significant benefits for those admitted to a focused stroke rehabilitation unit with respect to one or more of the following: higher overall activity of daily living scores, higher walking/transfer activity

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