In a randomized controlled trial of management of acute stroke in the elderly, a higher proportion of patients was assessed as independent in self-care in a stroke unit compared with patients with similar levels of neurologic impairment treated in medical units. The use of physical therapy and occupational therapy in the stroke unit and medical units was compared. Patients in the stroke unit received less therapy over a shorter period of time; however, a higher proportion had occupational therapy beginning at a much shorter interval after admission. Early introduction of rehabilitation by therapists may be more important than the amount or duration of treatment.