Abstract
Objective
To explore the effectiveness of a 2-week client-centered rehabilitation intervention
(tune-up) delivered 6 months after inpatient discharge on community reintegration
at 1 year in people with stroke.
Design
A multicenter randomized controlled trial with 2 groups: an intervention (“tune-up”)
group and a control group having the same exposure to assessment.
Setting
Three research laboratories.
Participants
Participants (N=103) with hemiparetic stroke recruited from inpatient rehabilitation
units at the time of discharge.
Interventions
Participants randomized to the tune-up group received 1-hour therapy sessions in their
home 3times/wk for 2 weeks at 6 months postdischarge focusing on identified mobility-related
goals. A second tune-up was provided at 12 months.
Main Outcome Measures
Community reintegration measured by the Subjective Index of Physical and Social Outcome
at 12 months and secondary outcomes included the Berg Balance Scale and measures of
mobility and health-related quality of life up to 15 months.
Results
At 12 months, both groups showed significant improvement in community reintegration
(P<.05), a trend evident at all time points, with no difference between groups (mean
difference, −0.5; 95% confidence interval, −1.8 to 2.7; P=.68). Similarly, a main effect of time reflected improvement in mobility-related
and quality of life outcomes for both groups (P≤.0.5), but no group differences (P≥.30).
Conclusions
All participants in the tune-up group met or exceeded at least 1 mobility-related
goal; however, the intervention did not differentially improve community reintegration.
The improvements in mobility and quality of life over the 15-month postdischarge period
may be secondary to high activity levels in both study groups and exposure to regular
assessment.
Keywords
List of abbreviations:
6MWT (6-minute walk test), BBS (Berg Balance Scale), GAS (Goal Attainment Scaling), RCT (randomized controlled trial), SF-36 (36-item Short-Form Health Survey), SIPSO (Subjective Index of Physical and Social Outcome), TUG (timed Up and Go)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 02, 2018
Footnotes
Supported by the Heart and Stroke Foundation of Ontario (grant no. SRA 5974).
Clinical Trial Registration No.: NCT00400712.
Disclosures: none.
Identification
Copyright
Crown Copyright © 2018 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
