Effects of Home-Based Versus Clinic-Based Rehabilitation Combining Mirror Therapy and Task-Specific Training for Patients With Stroke: A Randomized Crossover Trial.

Abstract

OBJECTIVE:

We investigated the treatment effects of a home-based rehabilitation program compared with clinic-based rehabilitation in patients with stroke.

DESIGN:

A single-blinded, 2-sequence, 2-period, crossover-designed study.

SETTING:

Rehabilitation clinics and participant's home environment.

PARTICIPANTS:

Individuals with disabilities poststroke.

INTERVENTIONS:

During each intervention period, each participant received 12 training sessions, with a 4-week washout phase between the 2 periods. Participants were randomly allocated to home-based rehabilitation first or clinic-based rehabilitation first. Intervention protocols included mirror therapy and task-specific training.

MAIN OUTCOME MEASURES:

Outcome measures were selected based on the International Classification of Functioning, Disability and Health. Outcomes of impairment level were the Fugl-Meyer Assessment, Box and Block Test, and Revised Nottingham Sensory Assessment. Outcomes of activity and participation levels included the Motor Activity Log, 10-meter walk test, sit-to-stand test, Canadian Occupational Performance Measure, and EuroQoL-5D Questionnaire.

RESULTS:

Pretest analyses showed no significant evidence of carryover effect. Home-based rehabilitation resulted in significantly greater improvements on the Motor Activity Log amount of use subscale (P=.01) and the sit-to-stand test (P=.03) than clinic-based rehabilitation. The clinic-based rehabilitation group had better benefits on the health index measured by the EuroQoL-5D Questionnaire (P=.02) than the home-based rehabilitation group. Differences between the 2 groups on the other outcomes were not statistically significant.

CONCLUSIONS:

The home-based and clinic-based rehabilitation groups had comparable benefits in the outcomes of impairment level but showed differential effects in the outcomes of activity and participation levels.

• Authors: Yu-Wei Hsieh, Ku-Chou Chang, Jen-Wen Hung, Ching-Yi Wu, Mu-Hui Fu, Chih-Chi Chen
• Journal: Archives of physical medicine and rehabilitation (Arch Phys Med Rehabil) Vol. 99 Issue 12 Pg. 2399-2407 (12 2018) ISSN: 1532-821X [Electronic] United States
• PMID: 29702070 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Topics

• Activities of Daily Living
• Aged
• Combined Modality Therapy
• Cross-Over Studies
• Disability Evaluation
• Female
• Functional Laterality
• Home Care Services
• Humans
• International Classification of Functioning, Disability and Health
• Male
• Middle Aged
• Motor Activity
• Patient Participation (statistics & numerical data)
• Recovery of Function
• Rehabilitation Centers
• Single-Blind Method
• Stroke (physiopathology)
• Stroke Rehabilitation (methods)
• Task Performance and Analysis
• Treatment Outcome