Article

OBJECTIVE: To enhance participation post stroke through a structured,
community-based program. DESIGN: A controlled trial with random allocation to
immediate or four-month delayed entry. SETTING: Eleven community sites in seven
Canadian cities. SUBJECTS: Community dwelling persons within five years of stroke
onset, cognitively intact, able to toilet independently. INTERVENTIONS:
Evidence-based program delivered in three 12-week sessions including exercise and
project-based activities, done as individuals and in groups. MAIN MEASURES: Hours
spent per week in meaningful activities outside of the home and Reintegration to
Normal Living Index; Stroke-Specific Geriatric Depression Scale, Apathy Scale,
gait speed, EuroQuol EQ-5D, and Preference-Based Stroke Index. All measures were
transformed to a scale from 0 to 100. Assessments prior to randomization, after
the first session at three months, six months, 12 months, and 15 months. RESULTS:
A total of 186 persons were randomized. The between-group analysis showed no
disadvantage to waiting and so groups were combined and a within-person analysis
was carried out at three time points. There were statistically significant
increases in all study outcomes on average over all persons. Over 45% of people
met or exceeded the pre-specified target of a three hour per week increase in
meaningful activity and this most often took a full year of intervention to
achieve. Greatest gains were in satisfaction with community integration (mean
4.78; 95% CI: 2.01 to 7.55) and stroke-specific health-related quality of life
(mean 4.14; 95% CI: 2.31 to 5.97). CONCLUSIONS: Community-based programs
targeting participation are feasible and effective, but stroke survivors require
time to achieve meaningful gains.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS