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.

Showing posts with label family led rehabilitation. Show all posts
Showing posts with label family led rehabilitation. Show all posts

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 Publication17-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?Top


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]

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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.
View Full Article (HTML) Enhanced Article (HTML) Get PDF (269K)

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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