Abstract
Objective
We investigated the treatment effects of a home-based rehabilitation program compared
with clinic-based rehabilitation in patients with stroke.
Design
A single-blinded, 2-sequence, 2-period, crossover-designed study.
Setting
Rehabilitation clinics and participant’s home environment.
Participants
Individuals with disabilities poststroke.
Interventions
During each intervention period, each participant received 12 training sessions, with
a 4-week washout phase between the 2 periods. Participants were randomly allocated
to home-based rehabilitation first or clinic-based rehabilitation first. Intervention
protocols included mirror therapy and task-specific training.
Main Outcome Measures
Outcome measures were selected based on the International Classification of Functioning,
Disability and Health. Outcomes of impairment level were the Fugl-Meyer Assessment,
Box and Block Test, and Revised Nottingham Sensory Assessment. Outcomes of activity
and participation levels included the Motor Activity Log, 10-meter walk test, sit-to-stand
test, Canadian Occupational Performance Measure, and EuroQoL-5D Questionnaire.
Results
Pretest analyses showed no significant evidence of carryover effect. Home-based rehabilitation
resulted in significantly greater improvements on the Motor Activity Log amount of
use subscale (P=.01) and the sit-to-stand test (P=.03) than clinic-based rehabilitation. The clinic-based rehabilitation group had
better benefits on the health index measured by the EuroQoL-5D Questionnaire (P=.02) than the home-based rehabilitation group. Differences between the 2 groups on
the other outcomes were not statistically significant.
Conclusions
The home-based and clinic-based rehabilitation groups had comparable benefits in the
outcomes of impairment level but showed differential effects in the outcomes of activity
and participation levels.
Keywords
List of abbreviations:
AOU (amount of use), COPM (Canadian Occupational Performance Measure), EQ-5D (EuroQoL-5D Questionnaire), MAL (Motor Activity Log), UE (upper extremity)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: April 24, 2018
Footnotes
Supported by Chang Gung Memorial Hospital (grant no. CMRPD1E0391) and partly supported by the Healthy Aging Research Center at Chang Gung University (grant no. EMRPD1F0321), Chang Gung Memorial Hospital (grant nos. CMRPD1C0401-403, BMRP553, and BMRPD25), and the National Health Research Institutes (grant no. NHRI-EX106-10604PI) in Taiwan.
Clinical Trial Registration No.: NCT02364232.
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
