***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Caring for stroke patients in stroke units , compared with other hospital locations , leads to decreased mortality and disability at one year.1 A trial of a combined acute and rehabilitation ward in Trondheim , Norway , showed that hospital care improved survival and functional outcome at five years.2 The benefits were attributed to the treatment provided in the first few weeks after stroke . The purpose of this study was to examine the effects of care in a non-acute stroke unit on outcome at five years . The methods and findings of 315 patients at one year of our r and omised study comparing a non-acute stroke rehabilitation unit with care on conventional medical and geriatric wards  have been published.3 In the present study , we ascertained survival to five years by using hospital records and death certificates . Survivors were traced to establish their residential status and visited by a research er who was Abstract Hemiplegic patients with an average age of 65 years , were r and omly assigned to a rehabilitation center ( the  control group ) and to a general hospital under the management of a nurse trained in rehabilitation procedures  ( the experimental group ) . Patients with severe impairment and aphasia were excluded . The two groups were similar in age , sex , residence accommodation prior to rehabilitation , duration of disability , degree of proficiency in self-care , intelligence , degree of perceptual motor deterioration , and available ‘ ego energy . ’ Minor differences between the two groups are discusssed in detail with reference to their effect on outcome . Improvement in living arrangements and self-care were effected equally by the rehabilitation team and rehabilitation nurse . In locomotion the experimental group did not do as well as the control group . The rehabilitation nurse demonstrated ability to manage the restorative care of hemiplegic patients , but severe grade s of disability require the rehabilitation center . The problems are discussed in respect to rating functional capacity in disability Of the 373 stroke patients 95 were admitted to the feasibility study of stroke rehabilitation . The patients were divided into two groups , an intensive and a normal treatment group . In this study , the functional recovery of stroke , measured by ADL and motor function was significantly better in the intensive treatment group . There was no difference in institutionalization or incidence of death between the groups . The gain of ADL and motor function was greatest during the first three months after stroke in the intensive treatment group . The conclusion is that intensified physiotherapy seems to improve the functional recovery of stroke patients BACKGROUND AND PURPOSE Organized acute stroke treatment reduces mortality , functional deficits , and the need of institutionalization after stroke . It is largely unknown whether the effects of treatment are due to early or subacute efforts . The aim of this r and omized , controlled study was to test the hypothesis that rehabilitation of stroke patients in the subacute phase in a hospital rehabilitation unit is beneficial in reducing death and dependency and increasing health-related quality of life . METHODS 251 patients initially treated in the hospital were r and omized to subacute rehabilitation in a hospital rehabilitation unit ( n = 127 ) or to the health services in the municipality ( n = 124 ) and were followed up for 7 months . RESULTS The combined outcome of patients being dead or dependent ( Barthel Index score of < 75 ) was 23 % in the hospital group and 38 % in the municipality group ( P=.01 ) . Seven-month survival rates were 90.6 % and 83.9 % ( P=.11 ) , respectively . Dependency in activities of daily living was 12.6 % in the hospital group and 25.0 % in the municipality group ( P=.07 ) . Patients with a BI score of < 50 before rehabilitation had significantly better outcome in the hospital rehabilitation unit , with fewer patients becoming dependent ( P=.005 ) and patients having higher Sc and inavian Stroke Scale ( P=.026 ) and BI scores ( P=.005 ) . No significant differences in health-related quality of life were found . Many patients treated in the municipalities ( 30 % ) did not receive any organized rehabilitation in this study . CONCLUSIONS Subacute rehabilitation of stroke patients in a hospital-based rehabilitation unit improves outcome .  Patients with moderate or severe stroke appear to benefit most Background and Purpose Assessment of stroke rehabilitation is complicated by the heterogeneity of patients and setting s and by difficulties in disentangling effects of organization from effects of types and amounts of treatment input . Methods A prospect i ve controlled study was undertaken in 245 stroke patients stratified into three groups according to prognosis and managed on a stroke rehabilitation unit ( n=124 ) or general medical wards ( n=121 ) . Patients were r and omly allocated to either setting 2 weeks after stroke and were comparable for baseline characteristics . Results Patients on general medical wards received more physiotherapy  on average ( 16.2 ± 7.2 versus 14.3 ± 3.2 hours ; P < .05 ) but similar amounts of  occupational therapy  ( 9.3 ± 2.8 versus 9.5 ± 3.2 hours ) compared with stroke unit patients . More time was spent on  individual rehabilitation on the stroke unit compared with general wards ( P < .001 ) . Functional abilities at discharge , destination of discharge , and length of hospital stay in patients with good prognosis were comparable in both setting s. Patients with poor prognosis managed on general wards showed higher mortality ( P < .05 ) and longer hospital stay ( 123.2 ± 48.2 versus 52.3 ± 19.8 days ; P < .001 ) , but functional abilities at discharge in survivors were comparable with those of stroke unit patients . Patients with intermediate prognosis had significantly better outcome on the stroke unit , with more patients being discharged home ( 75 % versus 52 % ; P < .001 ) , shorter average length of hospital stay ( 48.7 ± 17.2 versus 104.6 ± 28.6 days ; P < .001 ) , and better functional abilities at discharge ( P < .05 ) . Conclusions Stroke units improve outcome and reduce hospital stay without increasing therapy time . Their effectiveness may be enhanced by patient selection In S.E. Kent , during 1978 and 1979 , 225 patients , representing 228 occurrences of hemiplegia , were referred to a new 20-bed stroke rehabilitation ward .  These patients were r and omly allocated to treatment in the special ward ( group A 112 strokes ) or to remain in conventional treatment locations ( group C 116 strokes ) ; the two groups were closely similar , except for the initial level of consciousness . Survivors were observed at four-month intervals to one year . There are indications of benefit for patients in group A by comparison with Group C in terms of treatment received ( number treated by remedial therapists , the extent of treatment , and the arrangements for after-care ) , and in outcome ( survival and the proportion returned to the community ) . The direction of the trend of advantage is consistent with another recent controlled trial , although not all modes of improvement are identical in the two trials . It is suggested that every health district should develop a comprehensive policy of stroke management OBJECTIVE To assess whether outcomes and costs differ for elderly patients admitted to rehabilitation hospitals , subacute nursing homes , and traditional nursing homes . DESIGN Inception cohort stratified by provider type and followed prospect ively for 6 months . SETTING A total of 92 hospital-based units and freest and ing facilities from 17 states . PATIENTS A total of 518 r and omly selected patients with hip fracture and 485 stroke patients admitted from November 1991 to February 1994 . MAIN OUTCOME MEASURES At 6 months comparing community residence , recovery to premorbid levels in 5 activities of daily living ( ADLs ) , Medicare costs , and the number of therapy and physician visits . Outcomes were adjusted for premorbid residence and function , caregiver availability , comorbid illness , admission function , cognition , depression , sensory deficits , and mobility impairments . RESULTS On admission , rehabilitation hospital patients were more likely ( P<.001 ) to have caregivers and better cognitive and physical function . Hip fracture patients admitted to rehabilitation hospitals did not differ from patients admitted to nursing homes in returning to the community ( adjusted odds ratio [ OR ] , 1.3 ; 95 % confidence interval [ CI ] , 0.6 - 2.6 ) or in the number of ADLs recovered to premorbid level ( difference , 0.09 ADL ; 95 % CI , -0.27 - 0.44 ) , but stroke patients admitted to rehabilitation hospitals were more likely to return to the community ( adjusted OR , 3.3 ; 95 % CI , 1.5 - 7.2 ) and recover ADLs ( difference , 0.63 ADL ; 95 % CI , 0.20 - 1.07 ) . Subacute nursing home patients with stroke were more likely than traditional nursing home patients to return to the community ( adjusted OR , 6.8 ; 95 % CI , 2.2 - 21.4 ) , there was no difference in return to the community for patients with hip fracture ( adjusted OR , 1.6 ; 95 % CI , 0.7 - 3.6 ) , and there were no differences in recovery of ADLs for either condition . Medicare costs were greater ( P<.001 ) for rehabilitation hospital patients than for subacute nursing home patients , and the costs for subacute nursing home patients were greater ( P=.03 for stroke and .009 for hip fracture ) than for traditional nursing home patients . CONCLUSIONS Study findings are consistent with enhanced outcomes for elderly patients with stroke treated in rehabilitation hospitals but not for patients with hip fracture . Subacute nursing homes were more effective than traditional nursing homes in returning patients with stroke to the community , despite comparable functional outcomes BACKGROUND AND PURPOSE Stroke unit rehabilitation tends to be directed toward stroke patients with moderately severe disabilities ( " the middle group " ) . Data collected on a stroke rehabilitation unit , however , showed improving outcome over 3 years in patients with a poor prognosis ( discharge home : 48 % versus 16 % , P < .02 ; discharge Barthel Index score : 9 versus 6 , P < .05 ) . The hypothesis that stroke rehabilitation units may improve outcome in severely disabled stroke patients was tested in this study . METHODS A r and omized controlled study was undertaken in 71 patients with a poor prognosis who were treated either on a stroke rehabilitation unit ( n = 34 ) or on general wards ( n = 37 ) to compare outcome between the two groups . Data collected were also compared with those from a method ologically similar study undertaken 3 years ago . RESULTS Severe stroke patients treated on the stroke rehabilitation unit had a significantly better outcome compared with general wards ( mortality : 21 % versus 46 % , P < .05 ; discharge home 47 % versus 19 % , P < .01 ; median length of hospital stay : 43 versus 59 days , P < .02 ) . The number of stroke unit patients being discharged home had increased significantly from the previous study , with a trend toward improvement in median discharge Barthel Index score . CONCLUSIONS Stroke rehabilitation units may improve outcome in severe stroke patients . This improvement appears to be due to the development of innovative management strategies that reduce mortality and institutionalization and enable caregivers to support more disabled stroke patients at home 
    Output:
    
The results indicate that there can be substantial benefit from organized inpatient multidisciplinary rehabilitation in the postacute period , which is both statistically significant and clinical ly important