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Background/aims Stroke early supported discharge services were introduced to provide a comprehensive stroke specialist therapy input, while reducing cost of acute care. Early supported discharge services resulted in better health-related outcomes. A consensus has not yet been established regarding specific early supported discharge patient characteristics and clinical profile. The main aim of this study was to establish evidence to support the development of an early supported discharge patient profile (demographics and clinical) and eligibility criteria to enable early supported discharge services achieve their purposes of reducing post-stroke disability and institutionalisation rates. This article outlines the relationship between early supported discharge patients' clinical profiles and clinical outcomes, in terms of disability, goal attainment and institutionalisation rates. Methods A retrospective review of data was implemented to determine whether specific early supported discharge patients' clinical profiles and characteristics correlate with clinical outcomes. Data were collected for patients admitted to the Suffolk Stroke Early Supported Discharge Service between August and October 2016, comprising patients' demographics and clinical profiles, including stroke type, Barthel Index and Modified Rankin Scale. Performance data were collected at the end of the early supported discharge service including therapy frequency and intensity, as well as clinical outcomes including the Goal Attainment Scale. Results Data were collected for 53 patients. Data were analysed for all patients in three groups: goals not achieved; goals achieved; and goals achieved to a higher level), according to the Goal Attainment Scale. A Chi-square test showed no significant difference with regard to sex and stroke side (P=0.27). Analysis of variance revealed no significant difference in age. Conversely, results showed a significant association between goal attainment and the stroke subtype, severity and length of hospital stay. Conclusions Specific clinical characteristics and disease profiles correlate with functional outcomes and could influence goal attainment and functional status. A specific patient cohort seems to benefit the most from early supported discharge services in terms of optimised functional outcomes and recovery.

Background: Parkinson's disease (PD) is an incurable, progressive neurodegenerative disorder that gradually results in accumulating disability. Evidence suggests that specific interventions, for example, physical exercise and movement strategy training, can improve some of the PD-associated problems and enhance quality of life. The aim of this paper is to demonstrate the effect of a tailored rehabilitation programme, comprising of a combination of exercise therapy and movement strategy training, on falls risk, mobility, and quality of life in people with PD. Methods: A prospective longitudinal design, with 1- and 2-year follow-up, was conducted, where fifteen people with idiopathic PD and average age of 76.1 years attended weekly, then biweekly 90-minute rehabilitation sessions that focused on exercise therapy and movement strategy training. Outcome measures were assessed at baseline and at 1- and 2-year, which included self-reported number of falls, Freezing of Gait Questionnaire, Tinetti falls assessment tool, and Parkinson's Disease Questionnaire (PDQ-39). Results: At 1-year, a significant improvement was identified in gait freezing and Tinetti scores, as well as a statistically significant reduction in the number of falls and falls risk. Several aspects of the PDQ-39 have also improved. Some of the effects continued to exist through year two, but the improvement has not been consistent compared to year one. Conclusion: A combination of regular exercise and movement strategy training has the potential for reducing falls risk, and improving mobility (less gait freezing) and quality of life of people with PD.

Freezing of Gait (FOG) is one of the most disturbing symptoms in advanced stage of Parkinson's disease (PD) that is strongly associated with recurrent falls and reduced functional independence. The purpose of the study was to determine the impact of FOG on mobility in terms of risk of falls, walking aids utilization and assistance-seeking behaviour by comparing freezers (FRs) and nonfreezers (NFRs). Clinical and demographic data, including disease duration, stage and characteristics, cognition, edication, history of falls, walking aids utilization, and assistanceseeking behaviour was collected from 102 subjects with PD from three medical centres in Belgium, Israel, and UK. Association between FOG and other disease characteristics, medication, falls, walking aids, and need for carers' assistance was investigated. Comparing FRs and NFRs showed significant difference in history of previous falls, walking aids utilization, and need for carers' assistance. More than half of the FRs reported previous fall and a need for walking aids for mobility compared to 20% in NFRs group. A vicious cycle exists among subjects with PD who experience FOG. Gait freezing induces increased risk and frequency of falls as well as increased fear of falling, which in turn increases the tendency towards higher reliance on carers' assistance and more utilization of walking aids.