Jeyaraj D Pandian1, Cynthia Felix1, Paramdeep Kaur1, Deepika Sharma1, Lizzie Julia1, Gagan Toor1, Rajni Arora2, Dorcas B C Gandhi2, Shweta J Verma1, Craig S Anderson3, Peter Langhorne4, G V S Murthy5, Maree L Hackett6,7, Pallab K Maulik8,9, Mohammed Alim8, Lisa A Harvey10, Stephen Jan4, Marion Walker11, Anne Forster12, Richard Lindley6. 1. Stroke Unit, Department of Neurology, Christian Medical College, Ludhiana, Punjab, India. 2. Department of Physiotherapy, Christian Medical College, Ludhiana, Punjab, India. 3. The George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. 4. University of Glasgow, Glasgow, UK. 5. Indian Institute of Public Health Hyderabad, Public Health Foundation of India, Hyderabad, India. 6. The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia. 7. University of Central Lancashire, Preston, UK. 8. The George Institute for Global Health, Hyderabad, India. 9. The George Institute for Global Health, University of Oxford, Oxford, UK. 10. Sydney Medical School/Northern, University of Sydney, Sydney, New South Wales, Australia. 11. University of Nottingham, Nottingham, Nottinghamshire, UK. 12. University of Leeds, Bradford, UK.
Abstract
BACKGROUND: The aim of this pilot study was to determine the feasibility of a multicenter, randomized, controlled trial in India of a family-led, trained caregiver-delivered, home-based rehabilitation intervention vs. routine care. METHODS: A prospective, randomized (within seven-days of hospital admission), blinded outcome assessor, controlled trial of structured home-based rehabilitation delivered by trained and protocol-guided family caregivers (intervention) vs. routine care alone (control) was conducted in patients with residual disability. Key feasibility measures were recruitment, acceptance and adherence to assessment procedures, and follow-up of participants over six-months. CTRI/2014/10/005133. RESULTS: A total of 104 patients from the stroke unit at Christian Medical College, Ludhiana were recruited over nine-months. Recruitment was feasible and accepted by patients and their carers. Important observations were made regarding potential unblinding of the participants, contamination of therapy between the randomized groups, organization of home visits, and resources required for a multicenter study. CONCLUSION: The pilot study established the feasibility of conducting a large-scale study of family-led, trained caregiver-delivered, home-based stroke rehabilitation in a low resource setting. The main phase of the trial 'ATTEND' is currently underway in over 10 centers in India.
BACKGROUND: The aim of this pilot study was to determine the feasibility of a multicenter, randomized, controlled trial in India of a family-led, trained caregiver-delivered, home-based rehabilitation intervention vs. routine care. METHODS: A prospective, randomized (within seven-days of hospital admission), blinded outcome assessor, controlled trial of structured home-based rehabilitation delivered by trained and protocol-guided family caregivers (intervention) vs. routine care alone (control) was conducted in patients with residual disability. Key feasibility measures were recruitment, acceptance and adherence to assessment procedures, and follow-up of participants over six-months. CTRI/2014/10/005133. RESULTS: A total of 104 patients from the stroke unit at Christian Medical College, Ludhiana were recruited over nine-months. Recruitment was feasible and accepted by patients and their carers. Important observations were made regarding potential unblinding of the participants, contamination of therapy between the randomized groups, organization of home visits, and resources required for a multicenter study. CONCLUSION: The pilot study established the feasibility of conducting a large-scale study of family-led, trained caregiver-delivered, home-based stroke rehabilitation in a low resource setting. The main phase of the trial 'ATTEND' is currently underway in over 10 centers in India.
Authors: Judith Dm Vloothuis; Marijn Mulder; Janne M Veerbeek; Manin Konijnenbelt; Johanna Ma Visser-Meily; Johannes Cf Ket; Gert Kwakkel; Erwin Eh van Wegen Journal: Cochrane Database Syst Rev Date: 2016-12-21
Authors: Hueiming Liu; Richard Lindley; Mohammed Alim; Cynthia Felix; Dorcas B C Gandhi; Shweta J Verma; Deepak Kumar Tugnawat; Anuradha Syrigapu; Ramaprabhu Krishnappa Ramamurthy; Jeyaraj D Pandian; Marion Walker; Anne Forster; Craig S Anderson; Peter Langhorne; Gudlavalleti Venkata Satyanarayana Murthy; Bindiganavale Ramaswamy Shamanna; Maree L Hackett; Pallab K Maulik; Lisa A Harvey; Stephen Jan Journal: BMJ Open Date: 2016-09-15 Impact factor: 2.692