Methodology of the Stroke Self-Management Rehabilitation Trial: An International, Multisite Pilot Trial

Well, well, look at that, stroke researchers giving up on solving how to get better rehabilitation results. They want to throw all the responsibility for your rehabilitation on you. As Dr. Steven Wolf writes, a rehabilitation stroke expert and professor at Emory University School of Medicine in Atlanta.  "Stroke patients need to rely more on their own problem solving to regain mobility".
If we had anything resembling a decent stroke association, that president would be reading the riot act to anyone who throws up their hands like this and gives up on doing their job because it is too hard. F*cking hey, try rehabbing from a stroke with NO help from your doctor.

What a bunch of bullcrap, 'You've had this major brain attack and we know nothing about how to get you better.  So deal with this yourself, you will recover just as well without our help.'
But it will save a lot of money and our doctors will never need to read research again, washing their hands of their responsibility to help us get better. 


http://www.strokejournal.org/article/S1052-3057%2814%2900433-9/abstract 

Kelly M. Jones, PhD

,

Rohit Bhattacharjee, MPh

,

Rita Krishnamurthi, PhD

,

Sarah Blanton, PhD

,

Alice Theadom, PhD

,

Suzanne Barker-Collo, PhD

,

Amanda Thrift, PhD

,

Priya Parmar, MSc

,

Annick Maujean, PhD

,

Annemarei Ranta, FRACP, MD, PG Cert Sci (Public Health)

,

Emmanuel Sanya, FWACP, MSc, PhD

,

Valery L. Feigin, MD, PhD

on behalf of the

SMART Study Group

¹SMART Study Group members (additional to the article coauthors): Yogini Ratnasabapathy, Denise Taylor, Elizabeth Kendall, Carolyn Ehrlich, Steven Wolf, Dominique Cadilhac, Marilyn MacKay-Lyons, Man Mohan Mehndiratta, Jeyaraj Durai Pandian, Deepti Arora, Peter Langhorn, Gustavo Saposnik, Narayanaswamy Venketasubramanian, Bo Norrving, Akshay Anand, Dheeraj Kurana, Michael Brainin, Natan Bornstein, Richard Lindley, Foad Abd-Allah, Reginald Obiako, Emmanuel Sanya, Maree O'Connor, Rene Stolwyk, and Peter New.

Received: May 29, 2014; Received in revised form: August 6, 2014; Accepted: August 25, 2014; Published Online: December 09, 2014

DOI: http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2014.08.029

Publication stage: In Press Corrected Proof

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Rationale

Stroke is a major cause of long-term adult disability with many survivors living in the community relying on family members for on-going support. However, reports of inadequate understanding of rehabilitation techniques are common. A self-management DVD-based observational learning tool may help improve functional outcomes for survivors of stroke and reduce caregivers' burden.

Aims

This article describes the methodology of the stroke self-management rehabilitation trial. The overall aim of this pilot trial is to assess the feasibility and preliminary efficacy of a DVD-based intervention for improving functional outcomes of survivors of stroke 2 months postrandomization to inform the design of a full-scale randomized clinical trial.

Design

Recruitment of a minimum of 20 survivors of stroke and their informal caregivers (where available) in each of the participating centers will occur across multiple international sites. After baseline assessments, participants will be randomly assigned to an intervention or standard care group. The intervention comprises a structured DVD observation and practice schedule over 8 weeks. All participants will complete follow-up assessments.

Study outcomes

The outcome measures will include a global shift in the Rankin Scale scores and dichotomized scores, changes in quality of life, general health, depression, and caregiver burden at 2 months postrandomization. A qualitative analysis of the effects of the intervention will also be undertaken.

Discussion

The results of the pilot study will provide knowledge of whether observational learning techniques delivered via DVD can effectively improve recovery after stroke and reduce caregiver burden.