OBJECTIVE: Few community interventions following stroke enhance activity, participation or quality of life. We tested two novel community interventions designed to promote self-directed rehabilitation following stroke. DESIGN: This was a randomized, controlled parallel group 2×2 trial. SETTING: Community. PARTICIPANTS: Maori and Pacific New Zealanders, >15 years old, randomized within three months of a new stroke. INTERVENTIONS: A DVD of four inspirational stories by Maori and Pacific people with stroke and a 'Take Charge Session'--a single structured risk factor and activities of daily living assessment, designed to facilitate self-directed rehabilitation. MAIN MEASURES: Primary outcomes were Health-related Quality of Life (Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the Short Form 36 (SF-36)) 12 months from randomization. Secondary outcomes were Barthel Index, Frenchay Activities Index, Carer Strain Index and modified Rankin score. RESULTS:One hundred and seventy-two people were randomized with 139 (80.8%) followed up at 12 months post randomization. The effect of the Take Charge Session on SF-36 PCS at 12 months was 6.0 (95% confidence interval (CI) 2.0 to 10.0) and of the DVD was 0.9 (95% CI -3.1 to 4.9). Participants allocated to the Take Charge Session were less likely to have a modified Rankin score of >2 (odds ratio (OR) 0.42, 95% CI 0.2 to 0.89) and their carers had lower (better) Carer Strain Index scores (-1.5, 95% CI -2.8 to -0.1). CONCLUSION: A simple, low-cost intervention in the community phase of stroke recovery aiming to promote self-directed rehabilitation improved outcomes.
RCT Entities:
OBJECTIVE: Few community interventions following stroke enhance activity, participation or quality of life. We tested two novel community interventions designed to promote self-directed rehabilitation following stroke. DESIGN: This was a randomized, controlled parallel group 2×2 trial. SETTING: Community. PARTICIPANTS: Maori and Pacific New Zealanders, >15 years old, randomized within three months of a new stroke. INTERVENTIONS: A DVD of four inspirational stories by Maori and Pacific people with stroke and a 'Take Charge Session'--a single structured risk factor and activities of daily living assessment, designed to facilitate self-directed rehabilitation. MAIN MEASURES: Primary outcomes were Health-related Quality of Life (Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the Short Form 36 (SF-36)) 12 months from randomization. Secondary outcomes were Barthel Index, Frenchay Activities Index, Carer Strain Index and modified Rankin score. RESULTS: One hundred and seventy-two people were randomized with 139 (80.8%) followed up at 12 months post randomization. The effect of the Take Charge Session on SF-36 PCS at 12 months was 6.0 (95% confidence interval (CI) 2.0 to 10.0) and of the DVD was 0.9 (95% CI -3.1 to 4.9). Participants allocated to the Take Charge Session were less likely to have a modified Rankin score of >2 (odds ratio (OR) 0.42, 95% CI 0.2 to 0.89) and their carers had lower (better) Carer Strain Index scores (-1.5, 95% CI -2.8 to -0.1). CONCLUSION: A simple, low-cost intervention in the community phase of stroke recovery aiming to promote self-directed rehabilitation improved outcomes.
Authors: William M M Levack; Mark Weatherall; E Jean C Hay-Smith; Sarah G Dean; Kathryn McPherson; Richard J Siegert Journal: Cochrane Database Syst Rev Date: 2015-07-20
Authors: Zhomart Orman; Amanda G Thrift; Muideen T Olaiya; David Ung; Dominique A Cadilhac; Thanh Phan; Mark R Nelson; Velandai K Srikanth; Jason Vuong; Christopher F Bladin; Richard P Gerraty; Sharyn M Fitzgerald; Judith Frayne; Joosup Kim Journal: Qual Life Res Date: 2022-01-24 Impact factor: 4.147
Authors: Anne Forster; Lesley Brown; Jane Smith; Allan House; Peter Knapp; John J Wright; John Young Journal: Cochrane Database Syst Rev Date: 2012-11-14
Authors: Stefania Fugazzaro; Monica Denti; Monia Allisen Accogli; Stefania Costi; Donatella Pagliacci; Simona Calugi; Enrica Cavalli; Mariangela Taricco; Roberta Bardelli Journal: Int J Environ Res Public Health Date: 2021-05-31 Impact factor: 3.390