Stroke self-management


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Stroke is a leading cause of death in the world and a major cause of long-term adult disability. The emotional and socioeconomic impact of stroke on patients, families, and health services is enormous. However, the availability of community rehabilitation after hospital discharge is limited. Given the increasing number of stroke survivors, there is an urgent need to develop alternatives to costly face-to-face therapist rehabilitation to support stroke survivors and their families.

One strategy is to maximise the benefits of new technologies, such as instructional DVDs and app development.  Prof. Valery Feigin and colleagues have developed a novel, role model observational learning tool for stroke recovery and coping (in DVD format).

We have now completed an international multi-site pilot trial, entitled ‘Stroke Self-management Rehabilitation Trial’. This study tested the implementation of a DVD intervention with all study processes tested across recruitment sites in New Zealand, Canada, Singapore, United Kingdom, USA, and India. Secondary aims were to collect process measures about strengths of the intervention, barriers to protocol adherence, participant suggestions for improvements, and preliminary efficacy data.

Findings suggest a self-management approach to stroke rehabilitation delivered via DVD is feasible worldwide with global support from stroke clinicians and survivors of stroke. To better meet the individual needs of each patient, and to maximise uptake, self-management programmes require an individualised approach that can be adapted to meet people’s changing needs.

Information from this pilot trial (and subsequent focus group sessions held in in 2016) is now informing the ongoing refinement of the self-management rehabilitation programme delivered via DVD. Future plans include a full-scale randomised controlled trial and the potential development of an app version of the intervention.

If proven to be effective, this unique observational learning tool may have a vital and positive impact on reducing stroke burden within our communities, as well as worldwide. Findings will be relevant to clinicians, rehabilitation specialists, stroke researchers and policy makers involved in maximizing the recovery of stroke survivors and reducing burden for family caregivers.

COLLABORATORS:

  • National Institute for Stroke and Applied Neurosciences, AUT University, Auckland, NZ – Prof. Valery Feigin, Dr R Krishnamurthi, Dr A Theadom, A/Prof. S Barker-Collo, Dr K Jones
  • North Shore Hospital, NZ – Dr Yogini Ratnasabapathy
  • University of Otago, Palmerston North, NZ – Dr Anna Ranta
  • Griffith Health Institute, Griffith University, Queensland, Australia – Prof. E. Kendall, Dr A. Maujean, Dr C. Ehrlich
  • Monash University, Melbourne, Australia – Prof. A. Thrift, A/Prof. D. Cadilhac
  • Emory University, Atlanta, USA – Prof. S. Wolf, Assistant Prof. S. Blanton
  • School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada – Prof. M. MacKay-Lyons
  • Govind Ballabh (G B) Pant Hospital, New Delhi, India – Prof. M. M. Mehndiratta
  • Christian Medical College, Ludhiana, India – Prof. J. Pandian


Funded by:

  • NISAN with support from the New Zealand Stroke Education Charitable Trust.