[Physiotherapy after stroke--a randomized controlled trial].

BACKGROUND: This study examines whether two different physiotherapy regimes used in rehabilitation after acute stroke have any differences in outcome. MATERIAL AND METHODS: A double-blind study of patients with acute first-ever stroke. 61 patients were consecutively included, block-randomized into two groups and stratified according to gender and hemispheric location. Group 1 (33 patients) received physiotherapy in the hospital's stroke unit according to the Motor Relearning Programme (MRP), group 2 (28 patients) according to the Bobath method. Supplemental treatment did not differ. The Motor Assessment Scale (MAS), the Sodring Motor Evaluation Scale (SMES), the Barthel ADL (Activities of Daily Living) Index, and the Nottingham Health Profile (NHP) were used as outcome measures. The following variables were also registered: length of stay in hospital, use of assistive devices for mobility, and patients' accommodation after discharge. RESULTS: Patients treated according to the MRP had shorter stays in hospital compared to those treated according to Bobath (mean 21 days vs. 34 days, p < 0.01). Both groups improved on MAS and SMES, but motor functions improved significantly better in the MPP group. Both groups improved on the Barthel Index; there were no significant differences between the groups, though women treated by MRP improved more than women treated by Bobath. There were no differences between the groups in NHP scores, use of assistive devices or accommodation after discharge. INTERPRETATION: This study indicates that physiotherapy according to the MRP is preferable to the Bobath programme in the rehabilitation of stroke patients.