Sunday, March 15, 2015

FAmily-Led RehabiliTaTion aftEr Stroke in INDia: the ATTEND pilot study

More f*cking stupidity. Lets just push all the work about recovery onto the survivor and family. This way the doctor and therapists have washed their hands of any responsibility of improving the lot of the survivor. This is giving up on the medical teams part.
http://onlinelibrary.wiley.com/doi/10.1111/ijs.12475/abstract;jsessionid=83A9CC168723235DE87F1FA4A6AAEF3F.f02t02?
  1. Jeyaraj D. Pandian1,*,
  2. Cynthia Felix1,
  3. Paramdeep Kaur1,
  4. Deepika Sharma1,
  5. Lizzie Julia1,
  6. Gagan Toor1,
  7. Rajni Arora2,
  8. Dorcas B.C. Gandhi2,
  9. Shweta J. Verma1,
  10. Craig S. Anderson3,
  11. Peter Langhorne4,
  12. G.V.S. Murthy5,
  13. Maree L. Hackett6,7,
  14. Pallab K. Maulik8,9,
  15. Mohammed Alim8,
  16. Lisa A. Harvey10,
  17. Stephen Jan4,
  18. Marion Walker11,
  19. Anne Forster12 and
  20. Richard Lindley4
Article first published online: 9 MAR 2015
DOI: 10.1111/ijs.12475

Additional Information(Show All)
  1. Conflict of interest: None declared.
  2. Funding: Australian NHMRC program (571281) and project (1045391) grants and The George Institute for Global Health, University of Sydney, Australia.
  3. Unique identifier: NCTO2123875.
  4. Clinical trial registration URL: http://www.clinicaltrials.gov.
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Keywords:

  • caregiver;
  • developing countries;
  • early supported discharge;
  • home-based care;
  • quality of life;
  • rehabilitation;
  • stroke;
  • therapy

Background

The aim of this pilot study was to determine the feasibility of a multicenter, randomized, controlled trial in India of a family-led, trained caregiver-delivered, home-based rehabilitation intervention vs. routine care.

Methods

A prospective, randomized (within seven-days of hospital admission), blinded outcome assessor, controlled trial of structured home-based rehabilitation delivered by trained and protocol-guided family caregivers (intervention) vs. routine care alone (control) was conducted in patients with residual disability. Key feasibility measures were recruitment, acceptance and adherence to assessment procedures, and follow-up of participants over six-months. CTRI/2014/10/005133.

Results

A total of 104 patients from the stroke unit at Christian Medical College, Ludhiana were recruited over nine-months. Recruitment was feasible and accepted by patients and their carers. Important observations were made regarding potential unblinding of the participants, contamination of therapy between the randomized groups, organization of home visits, and resources required for a multicenter study.

Conclusion

The pilot study established the feasibility of conducting a large-scale study of family-led, trained caregiver-delivered, home-based stroke rehabilitation in a low resource setting. The main phase of the trial ‘ATTEND’ is currently underway in over 10 centers in India.
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