Brenda Brouwer1, Dianne Bryant2, S Jayne Garland3. 1. School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada. Electronic address: brouwerb@queensu.ca. 2. School of Physical Therapy, Western University, London, Ontario, Canada. 3. School of Physical Therapy, Western University, London, Ontario, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
Abstract
OBJECTIVE: To explore the effectiveness of a 2-week client-centered rehabilitation intervention (tune-up) delivered 6 months after inpatient discharge on community reintegration at 1 year in people with stroke. DESIGN: A multicenter randomized controlled trial with 2 groups: an intervention ("tune-up") group and a control group having the same exposure to assessment. SETTING: Three research laboratories. PARTICIPANTS: Participants (N=103) with hemiparetic stroke recruited from inpatient rehabilitation units at the time of discharge. INTERVENTIONS: Participants randomized to the tune-up group received 1-hour therapy sessions in their home 3times/wk for 2 weeks at 6 months postdischarge focusing on identified mobility-related goals. A second tune-up was provided at 12 months. MAIN OUTCOME MEASURES: Community reintegration measured by the Subjective Index of Physical and Social Outcome at 12 months and secondary outcomes included the Berg Balance Scale and measures of mobility and health-related quality of life up to 15 months. RESULTS: At 12 months, both groups showed significant improvement in community reintegration (P<.05), a trend evident at all time points, with no difference between groups (mean difference, -0.5; 95% confidence interval, -1.8 to 2.7; P=.68). Similarly, a main effect of time reflected improvement in mobility-related and quality of life outcomes for both groups (P≤.0.5), but no group differences (P≥.30). CONCLUSIONS: All participants in the tune-up group met or exceeded at least 1 mobility-related goal; however, the intervention did not differentially improve community reintegration. The improvements in mobility and quality of life over the 15-month postdischarge period may be secondary to high activity levels in both study groups and exposure to regular assessment. Crown
RCT Entities:
OBJECTIVE: To explore the effectiveness of a 2-week client-centered rehabilitation intervention (tune-up) delivered 6 months after inpatient discharge on community reintegration at 1 year in people with stroke. DESIGN: A multicenter randomized controlled trial with 2 groups: an intervention ("tune-up") group and a control group having the same exposure to assessment. SETTING: Three research laboratories. PARTICIPANTS: Participants (N=103) with hemiparetic stroke recruited from inpatient rehabilitation units at the time of discharge. INTERVENTIONS:Participants randomized to the tune-up group received 1-hour therapy sessions in their home 3times/wk for 2 weeks at 6 months postdischarge focusing on identified mobility-related goals. A second tune-up was provided at 12 months. MAIN OUTCOME MEASURES: Community reintegration measured by the Subjective Index of Physical and Social Outcome at 12 months and secondary outcomes included the Berg Balance Scale and measures of mobility and health-related quality of life up to 15 months. RESULTS: At 12 months, both groups showed significant improvement in community reintegration (P<.05), a trend evident at all time points, with no difference between groups (mean difference, -0.5; 95% confidence interval, -1.8 to 2.7; P=.68). Similarly, a main effect of time reflected improvement in mobility-related and quality of life outcomes for both groups (P≤.0.5), but no group differences (P≥.30). CONCLUSIONS: All participants in the tune-up group met or exceeded at least 1 mobility-related goal; however, the intervention did not differentially improve community reintegration. The improvements in mobility and quality of life over the 15-month postdischarge period may be secondary to high activity levels in both study groups and exposure to regular assessment. Crown
Authors: Axelle Gelineau; Anaick Perrochon; Louise Robin; Jean-Christophe Daviet; Stéphane Mandigout Journal: Int J Environ Res Public Health Date: 2022-07-26 Impact factor: 4.614