Sheffield Institute for Studies on Ageing, University of Sheffield, Samuel Fox House, Northern General Hospital, Sheffield S5 7AU, UK.
Age Ageing. 2011 Sep;40(5):557-62. doi: 10.1093/ageing/afr046. Epub 2011 Jun 17.
to test the hypothesis that older people and their informal carers are not disadvantaged by home-based rehabilitation (HBR) relative to day hospital rehabilitation (DHR).
pragmatic randomised controlled trial.
four geriatric day hospitals and four home rehabilitation teams in England.
eighty-nine patients referred for multidisciplinary rehabilitation. The target sample size was 460.
multidisciplinary rehabilitation either in the home or in the day hospital.
the primary outcome measure was the Nottingham extended activities of daily living scale (NEADL). Secondary outcome measures included EQ-5D, hospital anxiety and depression scale, therapy outcome measures, hospital admissions and the General Health Questionnaire for carers.
at the primary end point of 6 months NEADL scores were not significantly in favour of HBR cf. DHR; mean difference -2.139 (95% confidence interval -6.87 to 2.59, P = 0.37). A post hoc analysis suggested non-inferiority for HBR for NEADL but there was considerable statistical uncertainty.
taken together the statistical analyses and lack of power of the trial outcomes do not provide sufficient evidence to conclude that patients in receipt of HBR are disadvantaged compared with those receiving DHR.
检验假设，即与日间医院康复（DHR）相比，居家康复（HBR）不会使老年人及其非正式照顾者处于不利地位。
实用随机对照试验。
英格兰的 4 家老年日间医院和 4 家居家康复团队。
89 名接受多学科康复治疗的患者。目标样本量为 460 名。
在家庭或日间医院进行多学科康复治疗。
主要结局测量是诺丁汉扩展日常生活活动量表（NEADL）。次要结局测量包括 EQ-5D、医院焦虑和抑郁量表、治疗结局测量、住院情况和照顾者一般健康问卷。
在 6 个月的主要终点时，HBR 组的 NEADL 评分与 DHR 组相比没有显著优势；平均差异-2.139（95%置信区间-6.87 至 2.59，P=0.37）。事后分析表明 HBR 在 NEADL 方面具有非劣效性，但存在相当大的统计不确定性。
综合统计分析和试验结果的功效不足，没有提供足够的证据来得出接受 HBR 的患者与接受 DHR 的患者相比处于不利地位的结论。
