Deans' stroke musings: Rehabilitation of stroke: A summary of the ATTEND study(Family-led Rehabilitation after Stroke in India))

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, November 21, 2017

Rehabilitation of stroke: A summary of the ATTEND study(Family-led Rehabilitation after Stroke in India))

This would seem to contradict all the early supported discharge out there. Mainly being taken for cost savings in the hospital. 6 posts on early supported discharge here.
http://www.cmijournal.org/article.asp?issn=0973-4651;year=2017;volume=15;issue=4;spage=285;epage=287;aulast=Valson

Anna T Valson
Christian Medical College, Vellore, India

Date of Web Publication

17-Nov-2017

Correspondence Address:
Source of Support: None, Conflict of Interest: None

DOI: 10.4103/cmi.cmi_70_17

How to cite this article:
Valson AT. Rehabilitation of stroke: A summary of the ATTEND study. Curr Med Issues 2017;15:285-7

How to cite this URL:
Valson AT. Rehabilitation of stroke: A summary of the ATTEND study. Curr Med Issues [serial online] 2017 [cited 2017 Nov 21];15:285-7. Available from: http://www.cmijournal.org/text.asp?2017/15/4/285/218641

Source: This is a summary of the study: The ATTEND collaborative Group: Family-led rehabilitation after stroke in India (ATTEND): a randomized controlled trial. Lancet. 2017 Aug 5;390. (10094):588-599. Summary prepared by Dr. Anna T. Valson, Christian Medical College, Vellore, India.

Clinical Question: Is family-led rehabilitation superior to usual care for stroke patients in a low-resource setting?

Authors' conclusions: (1) Family-led rehabilitation did not improve outcomes, but did not cause harm such as adding to caregiver burden. (2) The results of the study do not currently support the setting up of stroke rehabilitation services that shift tasks to family caregivers.

Why this Study?

Stroke patients in developing countries such as India have limited the access to a multidisciplinary team of health professionals who can monitor and facilitate their rehabilitation after hospital discharge and provide much needed support to caregivers. Since the development of such multidisciplinary teams across the length and breadth of the country is not economically or logistically feasible, an attractive low-cost alternative is “Task Shifting,”^[1] i.e., training caregivers to provide the needed physiotherapy to patients at home. The importance of this approach has been highlighted by the WHO in its Task Shifting Guidelines.^[2] Although this is an approach that makes eminent practical sense and is scalable, there is very little evidence that it is effective in improving disease outcomes. This study ^[3] aimed to generate evidence regarding whether Task Shifting to family caregivers could reduce death and disability in stroke patients in India. A pilot study was carried out at Christian Medical College, Ludhiana, Punjab, to establish the trial methods,^[4] and the protocol was published before data analysis of this study.^[5]