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Interprofessional Stroke Rehabilitation for Stroke Survivors Using Home Care

Published online by Cambridge University Press:  02 December 2014

Maureen Markle-Reid*
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Camille Orridge
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Robin Weir
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Gina Browne
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Amiram Gafni
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Mary Lewis
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Marian Walsh
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Charissa Levy
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Stacey Daub
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Heather Brien
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Jacqueline Roberts
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Lehana Thabane
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
*
McMaster University, School of Nursing, 1200 Main Street West, HSC 3N28H, Hamilton, Ontario, L8N 3Z5, Canada
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Abstract

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Objective:

To compare a specialized interprofessional team approach to community-based stroke rehabilitation with usual home care for stroke survivors using home care services.

Methods:

Randomized controlled trial of 101 community-living stroke survivors (<18 months post-stroke) using home care services. Subjects were randomized to intervention (n=52) or control (n=49) groups. The intervention was a 12-month specialized, evidence-based rehabilitation strategy involving an interprofessional team. The primary outcome was change in health-related quality of life and functioning (SF-36) from baseline to 12 months. Secondary outcomes were number of strokes during the 12-month follow-up, and changes in community reintegration (RNLI), perceived social support (PRQ85-Part 2), anxiety and depressive symptoms (Kessler-10), cognitive function (SPMSQ), and costs of use of health services from baseline to 12 months.

Results:

A total of 82 subjects completed the 12-month follow-up. Compared with the usual care group, stroke survivors in the intervention group showed clinically important (although not statistically significant) greater improvements from baseline in mean SF-36 physical functioning score (5.87, 95% CI -3.98 to 15.7; p=0.24) and social functioning score (9.03, CI-7.50 to 25.6; p=0.28). The groups did not differ for any of the secondary effectiveness outcomes. There was a higher total per-person costs of use of health services in the intervention group compared to usual home care although the difference was not statistically significant (p = 0.76).

Conclusions:

A 12-month specialized, interprofessional team is a feasible and acceptable approach to community-based stroke rehabilitation that produced greater improvements in quality of life compared to usual home care. Clinicaltrials.gov identifier: NCT00463229

Type
Original Article
Copyright
Copyright © The Canadian Journal of Neurological 2011

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