American Speech-Language-Hearing Association

EBP Compendium: Summary of Systematic Review

The Cochrane Collaboration
Is Stroke Unit Care Portable? A Systematic Review of the Clinical Trials

Langhorne, P., Dey, P., et al. (2005).
Age and Ageing, 34(4), 324-330.

Indicators of Review Quality:

The review addresses a clearly focused question Yes
Criteria for inclusion of studies are provided Yes
Search strategy is described in sufficient detail for replication Yes*
Included studies are assessed for study quality Yes
Quality assessments are reproducible Yes*

Description: This is a systematic review and meta-analysis of randomized clinical controlled clinical trials examining the effectiveness of multidisciplinary, mobile stroke teams compared to hospital services. Of particular interest to clinicians is information pertaining to swallowing assessment.

Question(s) Addressed:

  1. Whether treatment provided by a mobile stroke team is more effective than conventional treatment in general hospital wards in improving clinical outcomes of death, the need for institutional care, and dependency.
  2. Whether treatment provided by a mobile stroke team is more effective than treatment by a comprehensive hospital stroke unit in improving clinical outcomes of death, the need for institutional care, and dependency.
  3. Whether treatment provided by a mobile stroke team is more effective than conventional treatment in general hospital wards in improving the processes of care (i.e., assessments and treatments, length of hospital stay), and the patient’s activities of daily living scores, mood/depression scores, and subjective health status scores.
  4. Whether treatment provided by a mobile stroke team is more effective than treatment by a comprehensive hospital stroke unit in improving the processes of care (i.e., assessments and treatments, length of hospital stay), and the patient’s activities of daily living scores, mood/depression scores, and subjective health status scores. 

Population: Patients admitted to hospitals with a clinical history of stroke with or without confirmation on brain imaging.

Intervention/Assessment: Peripatetic stroke care defined as a multi-disciplinary team with an interest in stroke care who provide care for stroke patients in several sites within a hospital (i.e., a mobile stoke team).

Number of Studies Included: 6

Years Included: Not clearly stated; meta-analysis done on trials conducted within the last ten years (about 1994 – 2004)

Findings:

Conclusions:

  • Assessment/Diagnosis
    • Assessment Areas
      • Swallowing
        • The authors found mobile stroke teams to improve the process of care in the area of swallowing. Compared to conventional care, treatment from a mobile stroke team was associated with a greater proportion of patients receiving swallowing assessments. However, length of stay was not significantly altered by stoke team.
        • The authors concluded that there was "no clear evidence that peripatetic care provided by mobile stroke teams can improve patient outcomes compared with conventional care in general wards" (p. 329).

Keywords: Stroke

Access the Review

Note:

*Evaluated with the full Cochrane systematic review. This review includes additional details regarding the search strategy and quality assessments.

Added to Compendium: January 2012

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