Stroke Rehabilitation at Home

Mayo, Nancy E.

doi:10.1161/strokeaha.116.011309

Cited by 52 publications

(36 citation statements)

References 45 publications

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“…28 Inadequately supervised home rehabilitation after stroke generally does not improve outcomes. 29 Neither trial, however, planned an examination of their implicit behavioral intervention techniques.…”

Section: Methods For Behavioral Modificationmentioning

confidence: 99%

Behavioral self-management strategies for practice and exercise should be included in neurologic rehabilitation trials and care

Dobkin¹

2016

Current Opinion in Neurology

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Purpose Rehabilitation trials and post-acute care to lessen impairments and disability after stroke, spinal cord injury, and traumatic brain injury almost never include training to promote long-term self-management of skills practice, strengthening and fitness. Without behavioral training to develop self-efficacy, clinical trials and home-based therapy may fail to show robust results. Findings Behavioral theories about self-management and self-efficacy for physical activity have been successfully incorporated into interventions for chronic diseases, but rarely for neurologic rehabilitation. The elements of behavioral training include education about the effects of practice and exercise that are relevant to the person, goal setting, identification of possible barriers, problem solving, feedback about performance, tailored instruction, decision making, and ongoing personal or social support. Mobile health and tele-rehabilitation technologies offer new ways to remotely enable such training by monitoring activity from wearable wireless sensors and instrumented exercise devices to allow real-world feedback, goal setting, and instruction. Summary Motivation, sense of responsibility and confidence to practice and exercise in the home can be trained to increase adherence to skills practice and exercise both during and after formal rehabilitation. To optimize motor learning and improve long-term outcomes, self-management training should be an explicit component of rehabilitation care and clinical trials.

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Section: Methods For Behavioral Modificationmentioning

confidence: 99%

Behavioral self-management strategies for practice and exercise should be included in neurologic rehabilitation trials and care

Dobkin¹

2016

Current Opinion in Neurology

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“…Sophisticated, computer-assisted interventions based on the principles of self-regulatory behavior in social cognitive theory already exist in other industries (e.g., retirement savings plans), 22 and have recently been introduced at a smaller scale in chronic disease self-management for conditions like stroke. 23, 24 These models have the potential to increase healthcare value (i.e., lowering cost while improving quality) by combining a clinically precise and individualized approach to overcoming barriers with population-based public health interventions (Figure 4). 25 …”

Section: What Is Needed Most?mentioning

confidence: 99%

Behavioral Interventions for Stroke Prevention

Salinas

Schwamm

2017

Stroke

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“…Training stroke survivors and caregivers to perform structured home therapy which focuses on therapeutic exercises may be a beneficial strategy to fill these needs. Studies have shown that home-based therapy can be as effective as hospital-based program in preventing functional deterioration of stroke survivors [ 11 , 24 , 25 ] However, evidence on its effectiveness, particularly among post-discharged stroke patients are still limited to inform clinical practice, which warrants more studies on this topic area. Further, past studies have not included psycho-behavioral and emotional aspects, 2 important determinants of quality of life among stroke survivors [ 26 ] in their assessment of intervention outcome.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of home-based therapy on functional outcome, self-efficacy and anxiety among discharged stroke survivors

2020

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Introduction: Stroke survivors are commonly at risk of functional decline following discharge from rehabilitation, which increase their susceptibility to falls, dependency in activities of daily living and emotional disturbances. To combat these, continued therapy is important. Home-based therapy (HBT) has been shown to be useful in maintaining functional performance and quality of life of chronic stroke survivors. However, evidence on its effectiveness remains limited, while no studies are available to date which report the benefit of HBT on stroke survivors self-efficacy and emotional status. Therefore, this study aims to assess the effectiveness of post-discharge HBT in comparison to usual practice on functional outcome (mobility and gait speed), self-efficacy and anxiety level among stroke survivors. Methods: This is an assessor-blinded randomized control trial comparing 2 types of intervention which are HBT (experimental group) and usual practice (UP) (control group). Based on sample size calculation using GPower, a total number of 42 participants will be recruited and allocated into either the HBT or the UP group. Participants in HBT group will receive a set of structured exercise therapy consisting of progressive strengthening, balance and task-related exercises. While participants in UP group will receive a usual “intervention” practised by rehabilitation professional prior to discharging stroke patients from their care. Both groups are advised to perform the given interventions for 3 times per week for 12 weeks under the supervision of their caregiver. Outcomes of interventions will be measured using timed up and go test (for mobility), ten-meter walk test (for gait speed), stroke self-efficacy questionnaire (for self-efficacy) and hospital anxiety and depression scale (for anxiety level). All data will be analyzed using descriptive and inferential statistics. Discussion: This study will provide the information on the effectiveness of HBT in comparison to UP among stroke population who are discharged from rehabilitation. Findings from the study will enable rehabilitation professionals to design effective discharge care plan for stroke survivors in combating functional decline when no longer receiving hospital-based therapy. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12619001182189 (last updated 22/11/2019).

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Stroke Rehabilitation at Home

Cited by 52 publications

References 45 publications

Behavioral self-management strategies for practice and exercise should be included in neurologic rehabilitation trials and care

Behavioral self-management strategies for practice and exercise should be included in neurologic rehabilitation trials and care

Behavioral Interventions for Stroke Prevention

The effectiveness of home-based therapy on functional outcome, self-efficacy and anxiety among discharged stroke survivors

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