Objective: To assess the added value of caregiver-mediated exercises combined with telerehabilitation in addition to usual care compared to usual care alone on the self-reported mobility outcome after subacute stroke.
Design: Multicentre, observer-blinded, parallel randomised controlled trial. An off-site researcher allocated treatments using minimisation.
Setting: Four rehabilitation centres in the Netherlands.
Participants: Forty-one patient-caregiver dyads within 3 months poststroke.
Intervention: Eight-week blended care program with caregiver-mediated mobility exercises for 2.5 h per week supported by telerehabilitation and four face-to-face sessions in addition to usual care.
Main Measures: Self-reported mobility domain of the Stroke Impact Scale postintervention. Secondary outcomes were functional outcome, dyads' psychosocial wellbeing, care transition to the community postintervention and after 6 months.
Results: Forty-one dyads (21 intervention, 20 control) were randomised, and 37 (N = 18; N = 19) were analysed following intention-to-treat. The Stroke Impact Scale mobility was not significantly different between groups postintervention (B 0.8, 95% CI -6.8-8.5, = 0.826). The secondary outcomes, namely, (a) caregivers' quality of life postintervention (= 0.013), (b) caregivers' symptoms of depression postintervention (= 0.025), and (c) independence in leisurely activities at 6 months (= 0.024), showed significant benefits in favour of caregiver-mediated exercises with telerehabilitation. A significant difference favouring controls was found in self-reported muscle strength at 6 months (= 0.002).
Conclusions: Caregiver-mediated exercises combined with telerehabilitation yielded no differential effect on our primary outcome self-reported mobility. Although the trial is underpowered, current findings are in line with previous trials. Future studies should further explore beneficial effects of caregiver involvement in stroke rehabilitation targeting psychosocial wellbeing.
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http://dx.doi.org/10.1177/02692155241261700 | DOI Listing |
Stroke
January 2025
Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia (W.A., A. Almuwais, S.A., Madawi Alotaibi).
Background: Poststroke fatigue affects half of global patients with stroke, causing early exhaustion, weariness, and dependence. Physiotherapy interventions like exercise and aerobic training are recommended to alleviate symptoms, but their effectiveness is not well supported. This review evaluates physiotherapy's effectiveness in treating poststroke fatigue in adults.
View Article and Find Full Text PDFClin Rehabil
October 2024
Department of Rehabilitation Medicine, Amsterdam University Medical Center, VUmc, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
Pediatr Phys Ther
January 2024
Department of Pediatrics (Ms Lammers), Powell Center for Rare Disease Research and Therapy, University of Florida, Gainesville, Florida; Department of Physical Therapy (Dr Smith), University of Florida, Gainesville, Florida.
Purpose: To describe the feasibility and effect of caregiver-mediated exercise training using a novel Therapeutic Play Gym in 3 neonatal intensive care unit (NICU) graduates with rare neuromuscular diseases.
Summary Of Key Points: Caregivers of 3 medically complex, technology-dependent NICU graduates could not access community-based rehabilitation services after discharging from lengthy initial hospitalizations. These children, diagnosed with spinal muscular atrophy type 0, untreated X-linked myotubular myopathy, and untreated nemaline myopathy 3 (NEM3), completed monthly consultations with a pediatric clinical specialist and 3 assessment appointments.
J Adv Nurs
July 2022
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Aims: This review aims to examine updated evidence to evaluate the effectiveness of caregiver-mediated exercise interventions on basic and extended activities of daily living (ADL), anxiety and depression of post-stroke rehabilitation individuals.
Design: A systematic review and meta-analysis.
Data Sources: Six electronic databases, including CINAHL, CENTRAL, Embase, PubMed, PsycINFO and Scopus, grey literature and trial registry were searched from inception until February 2021.
PLoS One
February 2022
Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, VU University Medical Centre, Amsterdam, The Netherlands.
Background: The evidence for rehabilitation interventions poststroke lack sufficient robustness. However, variation in treatment effects across countries have been given little attention.
Objective: To compare two identically protocolized trials conducted in different western countries in order to identify factors that may have caused variation in secondary trial outcomes.
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