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

Abstract

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).

Stroke Rehabilitation for Falls and Risk of Falls in Southeast Asia: A Scoping Review With Stakeholders' Consultation

“…Most of the included studies are from Singapore ( 63 , 65 , 66 , 68 , 71 , 72 , 76 – 78 ), followed by Malaysia ( 57 , 61 , 69 , 70 , 73 – 75 , 80 ), Thailand ( 56 , 60 , 62 , 64 , 67 , 79 ), the Philippines ( 58 , 59 ) and Indonesia ( 81 ) ( Figure 2 ). No articles were found from other Southeast Asia countries.…”

“…Of the total 26 articles, five were observational studies ( 57 , 62 , 64 , 66 , 76 ), 17 were experimental ( 56 , 58 – 61 , 63 , 65 , 67 , 69 , 73 – 75 , 77 – 81 ) and the remaining four were qualitative ( 68 , 70 – 72 ). Meanwhile, 15 were clinical-based studies ( 56 – 59 , 62 – 67 , 70 , 75 , 78 , 79 , 81 ) and 11 studies were conducted in the community ( 60 , 61 , 68 , 69 , 71 – 74 , 76 , 77 , 80 ). Most of the articles were authored by physiotherapists ( n = 14) followed by physicians ( n = 6), occupational therapists ( n = 5), and an engineer ( n = 1).…”

“…Three studies ( 62 , 66 , 76 ) specifically investigated the location and activities when the falls happened and four studies ( 62 , 64 , 66 , 76 ) established the risk and associated factors related to falls. A total of 16 studies investigated the intervention for risk of falls for stroke survivors; three studies ( 67 , 79 , 81 ) were randomized controlled trials, two studies ( 56 , 61 ) were a non-randomized controlled trial, 7 studies ( 60 , 63 , 65 , 69 , 75 , 77 , 78 ) were one-group pre-post experiment, four studies were case reports ( 58 , 59 , 73 , 74 ) and one study was a protocol ( 80 ). The interventions identified from this review can be classified as conventional or technology-based methods.…”

Specific health-related quality of life in Cerebrovascular accident survivors: associated factors

“…Given the above and the scarcity of studies that evaluate the HRQoL specific to stroke and its predictors, the relevance of research on this topic is evident, as it provides crucial inputs for health care planning. In this scenario, the role of the nursing team should be directed to the patient's rehabilitation through an individualized care plan, containing viable and effective interventions that allow the early identification of deficits and the reduction of the impact of sequelae, in order to contribute to the improvement of HRQoL after a stroke (9)(10)(11) .…”

Adherence Rate, Barriers to Attend, Safety, and Overall Experience of a Remote Physical Exercise Program During the COVID-19 Pandemic for Individuals After Stroke

“…Remote physical exercise programs (e.g., telerehabilitation, telemonitoring, or home-based rehabilitation) can offer guided exercises with remote monitoring to people with musculoskeletal and neurological disorders (Hosseiniravandi et al, 2020), who are isolated by social distance. Such remote monitoring allows health professionals to adapt the exercises and physical activities according to the needs of the individuals with neurological diseases (Laver et al, 2020), facilitates access to health services, and improves equity, thus reducing the costs of the rehabilitation programs (Chen et al, 2020;Ghorbel et al, 2020;Han et al, 2020;PUi Kei et al, 2020;Salawu et al, 2020;Zedda et al, 2020).…”