“Stroke - 65 Plus. Continued Active Life”: a study protocol for a randomized controlled cross-sectoral trial of the effect of a novel self-management intervention to support elderly people after stroke

Abstract

BackgroundElderly people represent the majority of stroke cases worldwide. Post-stroke sequelae frequently lead to a more isolated life. Restricted social relations render older individuals with stroke a vulnerable group, especially in terms of social reintegration. Reintegration into the community after a stroke largely depends on support from the family. However, close relatives are at risk of becoming overburdened. The aim of this study is to investigate the effect of a novel self-management intervention to support elderly people after stroke.Methods/DesignRandomized controlled trial. Two weeks before discharge from a rehabilitation hospital/center, individuals with stroke aged > 65 years will be randomized either to a group receiving conventional neurorehabilitation (control) or to an additional novel self-management intervention. In the intervention group, patients with stroke will be offered eight self-management sessions of 45–60 min duration by a physiotherapist or an occupational therapist during a period of nine months after discharge. Inclusion will continue until at least 35 individuals in each group have been recruited.Study outcome measurements: Stroke Self-efficacy Questionnaire, a short version of Stroke Specific Quality of Life Scale, Impact on Participation and Autonomy and Caregiver Burden Scale. Furthermore, physical activity will be assessed using accelerometers. All outcomes except “impact on participation” and “autonomy” will be assessed at baseline, three months, and nine months after discharge. Impact on participation and autonomy will be assessed at three and nine months after discharge.Patient, informal caregiver, and therapist satisfaction will be examined by way of questionnaires and interviews.DiscussionSelf-management interventions are promising strategies for rehabilitation, potentially increasing self-efficacy, quality of life, as well as participation and autonomy. The introduction of a novel self-management intervention in combination with traditional physical and occupational therapy may enhance recovery after stroke and quality of life and lessen the burden on relatives. This trial “Stroke - 65 Plus. Continued Active Life,” will provide further evidence of self-management strategies to clinicians, patients, and health economists.Trial registrationClinicalTrials.gov, NCT03183960. Registered on 12 June 2017.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-2961-4) contains supplementary material, which is available to authorized users.

Social psychological mechanisms and processes in a novel, health professional-led, self-management intervention for older stroke individuals: a synthesis and phenomenological study

“…The current study was designed using the MRC guidance that recommends evaluating the feasibility and acceptability of a complex intervention before implementing the intervention into an RCT [19]. The results of this study on the feasibility and acceptability of the intervention from the informants’ perspectives will be implemented into the RCT in the larger project ‘Stroke - 65 plus.…”

“…The current study is a preliminary part of the larger project ‘Stroke - 65 plus. Continued Active Life’ [19], which aims to support older stroke individuals and their informal caregivers to maintain their former active lifestyle, or to create a new, meaningful life perspective. This paper describes the evaluation of the mechanisms and processes in a novel, health professional-led, self-management support intervention.…”

“…The larger randomised controlled trial (RCT) ‘Stroke - 65 plus. Continued Active Life’ has been described in detail elsewhere [19]. In the RCT, stroke individuals over the age of 65 will be randomised to either conventional neurorehabilitation or to an integrated, health professional-led, self-management support intervention.…”

Effect of Self-Management Support for Elderly People Post-Stroke: A Systematic Review

“…Jones et al advocate an approach that facilitates people with stroke actively reflecting on, and taking initiative and responsibility for, their activities [17]. In an on-going project, Stroke 65 plus-continued active life [18], this is supplemented by involving social networks and social contexts [19]. A similar approach is recommended in a qualitative meta-synthesis by Walsh et al [20].…”

Cuidadores Familiares Dos Sobreviventes De Acidente Vascular Cerebral: Sobrecarga E Fatores Relacionados

“…Isso signi ca que, após a alta hospitalar, uns maiores números de sobreviventes de AVC retornarão para suas residências dependendo de cuidados, e consequentemente, haverá um maior número de cuidadores familiares responsáveis por sua reintegração na comunidade e por sua adaptação nas atividades básicas. Sem o suporte ou apoio social adequado, a saúde do cuidador estará comprometida, o que favorecerá o surgimento da sobrecarga relacionada ao cuidado (2) . Essa sobrecarga é a tradução do termo em inglês burden e representa um fardo resultante do cuidado contínuo.…”