Family-led rehabilitation after stroke in India (ATTEND): a randomised controlled trial

Lindley, Richard I.; Anderson, C; Billot, Laurent; Forster, Anne; Hackett, Maree L.; Harvey, L A; Jan, S; Li, Q; Liu, H; Langhorne, Peter; Maulik, Pallab K.; Murthy, Gudlavalleti Venkata Satyanarayana; Walker, Marion F; Pandian, Jeyaraj D.; Alim, Mohammed; Felix, Cynthia; Syrigapu, Anuradha; Tugnawat, Deepak; Verma, Schweta J.; Shamanna, B R; Hankey, Graeme J.; Thrift, Amanda G.; Bernhardt, Julie; Mehndiratta, Man Mohan; Jeyaseelan, Lakshmanan; Donnelly, Patrick; Byrne, Dominic; Steley, S; Santhosh, Varkey Nadakkavukaran; Chilappagari, Shailaja; Mysore, Jayanthi; Roy, Jayanta; Padma, M. V.; John, Lydia; Aaron, Sanjith; Borah, Nomal Chandra; Pamidimukkala, Vijaya; Kaul, Subash; Khurana, Dheeraj; Sylaja, PN; Halprashanth, D S; Madhusudhan, B. Kiran; Nambiar, Vivek; Sureshbabu, Sachin; Khanna, Meeka; Narang, Gaurav; Chakraborty, Debabrata; Chakraborty, Stuti; Biswas, Bijit; Kaura, Surbhi; Koundal, H; Singh, PJ; Andrias, Anjana; Thambu, D S; Ramya, I; George, James; Prabhakar, Anuj; Kirubakaran, P.; Anbalagan, P; Ghose, Manash K.; Bordoloi, Kuki; Gohain, Pankaja; Reddy, Nisha; Reddy, K. Vishnuvardhan; Rao, Ting; Alladi, Suvarna; Jalapu, V R R; Manchireddy, K; Rajan, Amal; Mehta, Saurabh P.; Katoch, C; Das, Biplab; Jangir, A; Kaur, Tanvinder; Sreedharan, SapnaErat; Sivasambath, S.; Dinesh, Sujatha; Shibi, B.S.; Thangaraj, Ajay; Karunanithi, A; Sulaiman, Suziah; Dehingia, K; Das, Kishor Kumar; Nandini, C; Dhanya, T S; Thomas, Nicholas J.; Krishna, Revathi N.; Aneesh, V; Khullar, Shilpa; Thouman, S; Sebastian, Ivy

doi:10.1016/s0140-6736(17)31447-2

Cited by 110 publications

(113 citation statements)

References 27 publications

(22 reference statements)

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“…Training began at the hospital and continued at home for up to 2 months after discharge. In 6 months of follow-up, there was no difference between the groups regarding readmission (89 [14%] IG vs. 82 [13%] CG; p=0.560) (19) . In England, another RCT that also offered an educational intervention in nursing techniques and skills training found no difference in readmission rates between groups at six and 12 months of evaluation (20) .…”

Section: Discussionmentioning

confidence: 96%

Use of health services by elderly people post-stroke: a randomized controlled trial

Bierhals

Day

Mocellin

et al. 2020

Rev. Gaúcha Enferm.

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Aim: To verify the relation of a nursing home care educational intervention in the use of health services by elderly people post-stroke. Methods: A randomized controlled trial conducted with 44 family caregivers of elderly people post-stroke. Data was collected between May/2016 and July/2018 in a hospital in the South of Brazil and at the participants’ homes. The intervention group (IG=21) received home visits by nurses after hospital discharge. The control group (CG=23) had a conventional follow-up in a conventional health services. The Pearson’s Chi-Square Test or the Fisher’s Exact Test was performed for assessment of the outcome at 60 days and 1 year after discharge. Clinical Trial registration NCT02807012. Results: There was a significant difference regarding the use of hospital outpatient service (IG=100%, CG=78.3%, p<0.050) 60 days after discharge. Conclusion: The great use of outpatient service by the IG demonstrates the effectiveness of nursing educational intervention focused on health care network after discharge.

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Section: Discussionmentioning

confidence: 96%

Use of health services by elderly people post-stroke: a randomized controlled trial

Bierhals

Day

Mocellin

et al. 2020

Rev. Gaúcha Enferm.

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“…However, one of the largest randomized controlled trials testing the efficacy of family-led rehabilitation among Indian stroke survivors reported a neutral effect compared with usual care. 21 The authors proposed among other recommendations the evaluation of technology-assisted rehabilitation as another viable option worth pursuing for developing countries.…”

Section: Discussionmentioning

confidence: 99%

“…12–20 However a recently published large study in India failed to show superiority of a family-led stroke rehabilitation intervention compared with usual care. 21 Another potential strategy is the use of tele-rehabilitation where remotely supervised rehabilitation can be administered to stroke survivors in domiciled settings. Again tele-rehabilitation has been evaluated for feasibility and efficacy in HICs and some LMICs outside SSA with moderate level of evidence of its efficacy compared to conventional face-to-face rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Potential role of tele-rehabilitation to address barriers to implementation of physical therapy among West African stroke survivors: A cross-sectional survey

Sarfo

Adamu

Awuah

et al. 2017

Journal of the Neurological Sciences

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Background The greatest burden from stroke-related disability is borne by Low-and-Middle Income countries (LMICs) where access to rehabilitation after stroke is severely challenged. Tele-rehabilitation could be a viable avenue to address unmet rehabilitation needs in LMICs. Objectives To assess the burden of post-stroke physical deficits, rates of utilization of physiotherapy services, and perceptions of tele-rehabilitation among recent Ghanaian stroke survivors. Methods Using a consecutive sampling strategy, 100 stroke survivors attending an outpatient Neurology clinic in a Ghanaian tertiary medical center were enrolled into this cross-sectional study. After collecting basic demographic data, clinical history on stroke type, severity and level of disability, we administered the validated 20-item Functional Independence Measure questionnaire to evaluate functional status of study participants and an 8-item questionnaire to assess participants’ attitudes towards telemedicine administered rehabilitation intervention. Results Mean ± SD age of study participants was 57.2 ± 13.3 years of which 51.0% were males with a mean duration of stroke of 1.3 ± 2.2 years. 53% had Modified Rankin scores of ≥3, 57% were fully independent and only 27% reported utilizing any physiotherapy services. Barriers to access to physiotherapy included financial constraints due to cost of physiotherapy services and transportation as well as premature discharge from physiotherapy to avoid overburdening of available physiotherapy services. These factors led to the limited provision of rehabilitative therapy. Participants held positive views of the potential for tele-rehabilitation interventions (80–93%). However, while 85% owned mobile phones, only 35% had smart phones. Conclusion Despite, a high burden of residual disability, only about 1 out of 4 stroke patients in this Ghanaian cohort was exposed to post-stroke physiotherapy services, largely due to relatively high costs and limited health system resources. These Ghanaian stroke patients viewed the potential role of Tele-rehabilitation as positive, but this promising intervention needs to be formally tested for feasibility, efficacy and cost-effectiveness.

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“…This was needed because the members of the family could not provide the intervention strategies necessary for the intervention but were able to choose activities they needed and that required attention, and similar findings have also been reported by Lawlor and Mattingly (119). However, studies conducted in Nigeria and India have shown that social support which is deeply rooted in culture of strong kinship ties, communal living, did not influence participation positively, and consequently did not enhance good quality of life after stroke (133,134).…”

Section: Family-centredness As a Therapeutic Component For Rehabilitamentioning

confidence: 99%

Experiences of using mobile phones in everyday life among persons with stroke and their families in Uganda – a qualitative study

Kamwesiga

Tham

Guidetti

2016

Disability and Rehabilitation

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Aim The aim of this study was to describe the experiences and meaning of using mobile phones in everyday life after stroke, among persons with stroke and their family members. Methods Qualitative semi-structured interviews were conducted among 11 persons with stroke and 9 family members 2 months to 2 years after the stroke. The interviews were analysed by using constant comparative grounded theory (GT) approach. Results Seven categories were identified from the analysis of the participants' experiences. The mobile phone: (1) as an enabler of communication and connections with other people, (2) a source of inspiration for agency, (3) structuring routine and activities in daily life, (4) as a facilitator of social and economic wellbeing of an individual or family, (5) promoter of belonging and participation in social relationships, (6) facilitator of reintegration to community living and (7) enabler of family members to feel secure. From these categories, a core category emerged: The mobile phone as a "life line" and an extension of the body enabling connection, belonging and agency to act in a complex everyday life situation. Conclusion The study gives support for the possibility of using mobile phones to facilitate change and community integration in the rehabilitation process after stroke. Implications for Rehabilitation Stroke leads to decreased functioning in everyday life due to impairments, activity limitations and participation restrictions as well caregiver burden. Mobile phones seem to be an accessible and affordable technology used in daily life of persons with stroke and family members and connects them to the needed services and social relationships. The mobile phone technology reduces resource and infrastructural challenges and increases accessibility to rehabilitation interventions. The mobile phone was an important instrument that facilitated the quality of life of persons with stroke and their family members and could increase their participation in rehabilitation interventions.

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Family-led rehabilitation after stroke in India (ATTEND): a randomised controlled trial

Abstract: Background: Most people with stroke in India have no access to organised

Cited by 110 publications

References 27 publications

Use of health services by elderly people post-stroke: a randomized controlled trial

Use of health services by elderly people post-stroke: a randomized controlled trial

Potential role of tele-rehabilitation to address barriers to implementation of physical therapy among West African stroke survivors: A cross-sectional survey

Experiences of using mobile phones in everyday life among persons with stroke and their families in Uganda – a qualitative study

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