An international multicenter study of specialized rehabilitation for stroke patients . Protocol of the Sunnaas InterNational (SIN) stroke project

Abstract

Rationale: Stroke is leading cause of serious, long-term disability in adults. Consequently, many individuals with stroke are in need of specialized rehabilitation. However, the content of specialized rehabilitation may vary. Aims: To describe the content of specialized stroke rehabilitation, and possible influence on the physical and social functioning after specialized rehabilitation, in nine rehabilitation institutions representing seven different countries. Design: The design is a prospective, descriptive study of the specialized rehabilitation of stroke patients in rehabilitation institutions in Norway, PR China, the United States, Russia, Israel, Palestine and Sweden. Patients with a primary diagnosis of stroke consecutively attending an institution for specialized rehabilitation will be invited to enroll in the study. Study Outcomes: General descriptive data of the rehabilitation centers, the content of their programs for specialized rehabilitation for stroke patients, and descriptive data of enrolled patients will be registered. Primary outcome measures are the Barthel Index (BI), alternatively, the Functional Independence Measure (FIM), which reflect performance of the activities of daily living. Secondary outcome measures are the Life Satisfaction Scale (LISAT-11), the Modified Rankin Scale (MRS), the National Institutes of Health Stroke Scale (NIHSS) and a semistructured questionnaire with focus on the social situation. Tests will be performed on admission to rehabilitation, 18-22 days into rehabilitation, at discharge, six and twelve months after discharge. Discussion: The study will contribute to the knowledge about the content of specialized stroke rehabilitation with examples from nine clinics in seven different countries. The study will highlight how the different models of specialized rehabilitation may influence patients’ outcomes. Data from all sites will target what physical and psychosocial situations persons with stroke face in different settings. The international aspects of specialized stroke rehabilitation may serve as background for the discussion on the optimal rehabilitation services for stroke patients.