Methods/design: This study is a multicentre randomised controlled trial with health economic and process evaluations.
It is set within NHS stroke services which provide ESD. Participants are adults who have experienced a new stroke (and
carer if appropriate), discharged from hospital under the care of an ESD team.
The intervention group receives an extended stroke rehabilitation service provided for 18 months following completion
of ESD. The extended rehabilitation service involves regular contact with a senior ESD team member who leads and
coordinates further rehabilitation. Contact is usually by telephone. The control group receives usual stroke care post-ESD.
Usual care may involve referral of patients to a range of rehabilitation services upon completion of ESD in accordance
with local clinical practice. Randomisation is via a central independent web-based service.
The primary outcome is extended activities of daily living (Nottingham Extended Activities of Daily Living Scale) at
24 months post-randomisation. Secondary outcomes (at 12 and 24 months post-randomisation) are health status, quality
of life, mood and experience of services for patients, and quality of life, experience of services and carer stress for carers.
Resource use and adverse events are also collected. Outcomes are undertaken by a blinded assessor.
Implementation and delivery of the extended stroke rehabilitation service will also be described. Semi-structured
interviews will be conducted with a subsample of participants and staff to gain insight into perceptions and
experiences of rehabilitation services delivered or received.
Allowing for 25% attrition, 510 participants are needed to provide 90% power to detect a difference in mean
Nottingham Extended Activities of Daily Living Scale score of 6 with a 5% significance level.