Trial reportHealth technology assessment (Winchester, England)2020
An extended stroke rehabilitation service for people who have had a stroke: the EXTRAS RCT.
Trial report in Health technology assessment (Winchester, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 5 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Application of the integrated rehabilitation-clinical-nutrition management model in geriatric rehabilitation patients: a narrative review.Frontiers in public health · 2026Pooled it
- Do self-management interventions improve self-efficacy and health-related quality of life after stroke? A systematic review.International journal of stroke : official journal of the International Stroke Society · 2025Pooled it
- International Systematic Review of Utility Values Associated with Cardiovascular Disease and Reflections on Selecting Evidence for a UK Decision-Analytic Model.Medical decision making : an international journal of the Society for Medical Decision Making · 2024Pooled it
- Pooled it
- Cost-effectiveness of patient navigation programs for stroke patients-A systematic review.PloS one · 2021Pooled it
- The stroke transitional care intervention for older adults with stroke and multimorbidity: a multisite pragmatic randomized controlled trial.BMC geriatrics · 2023Trial
- From Hospital to Home: Applying a Co-Design Approach to Determine the Key Components of an Intervention to Support Transition-To-Home After Stroke.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Goal Setting for Aging Adults and Care Partners: A Scoping Review.Innovation in aging · 2024Article
- Analysis of the current status of rehabilitation motivation and its influencing factors in older adults with stroke: a cross-sectional study.Frontiers in aging neuroscience · 2023Article
- Review
- Analysis of influencing factors of rehabilitation treatment effect in patients with first-episode stroke.American journal of translational research · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 8 institutions in 2 countries.
Funding
Abstract
backgroundThere is limited evidence about the effectiveness of rehabilitation in meeting the longer-term needs of stroke patients and their carers.
objectiveTo determine the clinical effectiveness and cost-effectiveness of an extended stroke rehabilitation service (EXTRAS).
designA pragmatic, observer-blind, parallel-group, multicentre randomised controlled trial with embedded health economic and process evaluations. Participants were randomised (1 : 1) to receive EXTRAS or usual care.
settingNineteen NHS study centres.
participantsPatients with a new stroke who received early supported discharge and their informal carers.
interventionsFive EXTRAS reviews provided by an early supported discharge team member between 1 and 18 months post early supported discharge, usually over the telephone. Reviewers assessed rehabilitation needs, with goal-setting and action-planning. Control treatment was usual care post early supported discharge.
main outcome measuresThe primary outcome was performance in extended activities of daily living (Nottingham Extended Activities of Daily Living Scale) at 24 months post randomisation. Secondary outcomes at 12 and 24 months included patient mood (Hospital Anxiety and Depression Scale), health status (Oxford Handicap Scale), experience of services and adverse events. For carers, secondary outcomes included carers' strain (Caregiver Strain Index) and experience of services. Cost-effectiveness was estimated using resource utilisation costs (adaptation of the Client Service Receipt Inventory) and quality-adjusted life-years.
resultsA total of 573 patients (EXTRAS,
conclusionsEXTRAS did not improve stroke survivors' performance in extended activities of daily living but did improve their overall satisfaction with services. Given the impact on costs and quality-adjusted life-years, there is a high chance that EXTRAS could be considered cost-effective. FUTURE WORK: Further research is required to identify whether or not community-based interventions can improve performance of extended activities of daily living, and to understand the improvements in health-related quality of life and costs seen by provision of intermittent longer-term specialist review.
trial registrationCurrent Controlled Trials ISRCTN45203373.
fundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.