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Rehabilitation Research and Practice
Volume 2013 (2013), Article ID 498014, 9 pages
Clinical Study

Early Physical Activity and Discharge Destination after Stroke: A Comparison of Acute and Comprehensive Stroke Unit Care

1School of Health Sciences, La Trobe University, Melbourne, VIC 3086, Australia
2Physiotherapy Department, Royal Perth Hospital, Perth, WA 6000, Australia
3Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3084, Australia
4Department of Mathematics and Statistics, University of Melbourne, Melbourne, VIC 3010, Australia

Received 27 July 2013; Revised 9 October 2013; Accepted 9 October 2013

Academic Editor: Nam-Jong Paik

Copyright © 2013 Tanya West et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Common models of acute stroke care include the acute stroke unit, focusing on acute management, and the comprehensive stroke unit, incorporating acute care and rehabilitation. We hypothesise that the rehabilitation focus in the comprehensive stroke unit promotes early physical activity and discharge directly home. Methods. We conducted a two-centre prospective observational study of patients admitted to a comprehensive or acute stroke unit within 14 days poststroke. We recruited 73 patients from each site, matched on age, stroke severity, premorbid function, and walking ability. Patient activity was measured using behavioural mapping. Therapy activity was recorded by therapist report. Time to first mobilisation, discharge destination, and length of stay were extracted from the medical record. Results. The comprehensive stroke unit group included more males, fewer partial anterior circulation infarcts, more lacunar infarcts, and more patients ambulant without aids prior to their stroke. Patients in the comprehensive stroke unit spent 14.4% more (95% CI: 8.9%–19.8%; ) of the day in moderate or high activity, 18.5% less time physically inactive (95% CI: 5.0%–32.0%; ), and were more likely to be discharged directly home (OR 3.7; 95% CI 1.4–9.5; ). Conclusions. Comprehensive stroke unit care may foster early physical activity, with likely discharge directly home.