Susan Stark1, Marian Keglovits2, Emily Somerville2, Yi-Ling Hu3, Jane Conte4, Yan Yan5. 1. Assistant Professor of Occupational Therapy, Neurology and Social Work, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri. 2. Occupational Therapist, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri. 3. Rehabilitation and Participation Science Program, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri. 4. Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri. 5. Professor, Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
Abstract
INTRODUCTION: Stroke is a leading cause of serious, long-term disability in the US. With shorter inpatient hospital stays, more time in rehabilitation is devoted to medical stabilization and less on skills to regain independence in daily activities. The transition home may be an opportunity for intervention focused on regaining independence. We propose an enhanced rehabilitation transition program called: Community Participation Transition after Stroke (COMPASS). METHOD: A prospective, randomized, single-blinded, parallel-group pilot study was completed to demonstrate feasibility with N=15 participants. FINDINGS: Fidelity to the protocol was achieved: the COMPASS group received 81% of the planned minutes and 83% of the intervention visits. There was no difference between groups for healthcare utilization or falls. Adherence was 85% at 3-months and 71% at 9-months for the home modification intervention. At 6-months, the COMPASS group's reintegration to normal living scores improved by 17.39 points for the COMPASS group, and 1.30 for the control group. Environmental barriers decreased in both groups. CONCLUSION: This pilot study demonstrated that it is feasible to implement a community participation intervention during the period of transitioning home from inpatient rehabilitation for stroke survivors. Additional studies are necessary to determine the efficacy of the intervention.
INTRODUCTION: Stroke is a leading cause of serious, long-term disability in the US. With shorter inpatient hospital stays, more time in rehabilitation is devoted to medical stabilization and less on skills to regain independence in daily activities. The transition home may be an opportunity for intervention focused on regaining independence. We propose an enhanced rehabilitation transition program called: Community Participation Transition after Stroke (COMPASS). METHOD: A prospective, randomized, single-blinded, parallel-group pilot study was completed to demonstrate feasibility with N=15 participants. FINDINGS: Fidelity to the protocol was achieved: the COMPASS group received 81% of the planned minutes and 83% of the intervention visits. There was no difference between groups for healthcare utilization or falls. Adherence was 85% at 3-months and 71% at 9-months for the home modification intervention. At 6-months, the COMPASS group's reintegration to normal living scores improved by 17.39 points for the COMPASS group, and 1.30 for the control group. Environmental barriers decreased in both groups. CONCLUSION: This pilot study demonstrated that it is feasible to implement a community participation intervention during the period of transitioning home from inpatient rehabilitation for stroke survivors. Additional studies are necessary to determine the efficacy of the intervention.
Entities:
Keywords:
community reintegration; feasibility; home modifications; participation; stroke
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