Effectiveness of home-based carer-assisted in comparison to hospital-based therapist-delivered therapy for people with stroke: A randomised controlled trial
Affiliations: [a] Physiotherapy Program, Center for Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan, Malaysia
| [b] Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia | [c] Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia | [d] International Center for Casemix and Clinical Coding, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia | [e] Department of Health Policy and Management, Faculty of Public Health, Kuwait University, Kuwait
Correspondence:
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Address for correspondence: Nor Azlin Mohd Nordin, Physiotherapy Program, Center for Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur Malaysia. Tel.: +603 26810203; Fax: +603 26810200; E-mail: norazlin8@ukm.edu.my.
Abstract: BACKGROUND:The benefits of engaging informal carers or family in the delivery of therapy intervention for people with stroke have not been well researched. OBJECTIVES:To assess the effectiveness of a home-based carer-assisted in comparison to hospital-based therapist-delivered therapy for community-dwelling stroke survivors. METHODS:An assessor blinded randomised controlled trial was conducted on 91 stroke survivors (mean age 58.9±10.6 years, median time post-onset 13.0 months, 76.5% males) who had completed individual rehabilitation. The control group received hospital-based group therapy delivered by physiotherapists as out-patients and the test group was assigned to a home-based carer-assisted therapy. Targeted primary outcomes were physical functions (mobility, balance, lower limb strength and gait speed). A secondary outcome index was health-related quality of life. An intention-to-treat analysis was used to evaluate outcomes at week 12 of intervention. RESULTS:Both therapy groups improved significantly in all the functional measures; mobility (p < 0.01), balance (p < 0.01), lower limb strength (p < 0.01), gait speed (p < 0.05), and in the quality of life score (p < 0.05) at trial completion. No statistical differences were found between the two groups in any outcome indices (all p > 0.05). CONCLUSIONS:The home-based carer-assisted therapy is as effective as the hospital-based therapist-delivered training in improving post-stroke functions and quality of life.
Keywords: Stroke, home-based therapy, carer, functional outcome, quality of life
