Methodology of the Stroke Self-Management Rehabilitation Trial: An International, Multisite Pilot Trial

Abstract

Rationale: Stroke is a major cause of long-term adult disability with many survivors living in the community relying on family members for on-going support. However, reports of inadequate understanding of rehabilitation techniques are common. A self-management DVD-based observational learning tool may help improve functional outcomes for survivors of stroke and reduce caregivers' burden.Aims: This article describes the methodology of the stroke self-management rehabilitation trial. The overall aim of this pilot trial is to assess the feasibility and preliminary efficacy of a DVD-based intervention for improving functional outcomes of survivors of stroke 2 months post-randomization to inform the design of a full scale randomised clinical trial.Design: Recruitment of a minimum of 20 survivors of stroke and their informal caregivers (where available) in each of the participating centres will occur across multiple international sites. Following baseline assessments, participants will be randomly assigned to an intervention or standard care group. The intervention comprises a structured DVD observation and practice schedule over 8-weeks. All participants will complete follow-up assessments. Study outcomes:The outcome measures will include a global shift in the modified Rankin Scale scores as well as dichotomised scores, changes in quality of life, general health, depression and caregiver burden at 2 months post-randomization. A qualitative analysis of the effects of the intervention will also be undertaken. Discussion:The results of the pilot study will provide knowledge of whether observational learning techniques delivered via DVD can effectively improve recovery following stroke and reduce caregiver burden.3

Strategies to Improve Stroke Care Services in Low- and Middle-Income Countries: A Systematic Review

“…Weekly phone calls were made to monitor adherence to the therapy and the resulting changes. The control group received only baseline and 2 month follow-up assessment [58]. This trial proves that such self-management strategy is feasible with local and global support.…”

Artesunate suppresses oxidative and inflammatory processes by activating Nrf2 and ROS‑dependent p38 MAPK and protects against cerebral ischemia‑reperfusion injury

“…in patients with stroke and alleviate neuronal damage, thus improving the survival rate of stroke victims (22). However, following the restoration of the blood supply to ischemic tissues, the structure and function of cells undergo further damage caused by reperfusion, thus resulting in the development of CIRI (19).…”

Effects of comparative feedback from a Socially Assistive Robot on self-efficacy in post-stroke rehabilitation

“…In order to provide this type of support with a SAR, a greater understanding of how to motivate a patient is needed, since in the majority of rehabilitation paradigms (e.g., constraint induced movement therapy), it is a critical element of the intervention [2], [3]. Self-efficacy, a person's perception of their own competence at a task, is related to motivation, is thought to mediate motor performance, and may underlie many facets of post-stroke outcomes, including lower extremity performance, balance, and health outcomes [4], [5], [6], as well as upper-extremity limb choice [7], [8]. Because of the role of self-efficacy in motor rehabilitation, SAR coaching strategies that improve self-efficacy may lead to positive long-term outcomes.…”