With no place to publicly put stroke protocols, nothing will ever get better.
J'accuse the stroke associations of failing to provide even this minimal help to stroke survivors.
Abstract
BACKGROUND:
Australian guidelines recommend that outdoor mobility be addressed to increase participation after stroke.
AIM:
To
investigate the efficacy of the Out-and-About program at increasing
outings delivered during therapy by community teams, and outings taken
by stroke survivors in real life.
METHOD:
Cluster-randomized
trial involving 22 community teams providing stroke rehabilitation.
Experimental teams received the Out-and-About program (a behavior change
program comprising a training workshop with barrier identification and
booster session, printed educational materials, audit, and feedback).
Control teams received printed clinical guidelines only. The primary
outcome was the percentage of stroke survivors receiving four or more
outings during therapy. Secondary outcomes included the number of
outings received by stroke survivors during therapy and undertaken in
real life.
RESULTS:
At
12 months after implementation of the behavior change program, 9% of
audited experimental group stroke survivors received four or more
outings during therapy compared with 5% in the control group (adjusted
risk difference 4%, 95% CI - 9 to 17, p = 0.54). They received 1.1 (SD
0.9) outings during therapy compared with 0.6 (SD 1.0) in the control
group (adjusted mean difference 0.5, 95% CI - 0.4 to 1.4; p = 0.26).
After six months of rehabilitation, observed experimental group stroke
survivors took 9.0 (SD 3.0) outings per week in real life compared with
7.4 (SD 4.0) in the control group (adjusted mean difference 0.5, 95%
CI - 1.8 to 2.8; p = 0.63).
CONCLUSION:
The Out-and-About program did not change team or stroke survivor behavior.
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