258168 Enhancement of Caregiver's Skill as a New Model to Improve the Physical Functional Ability of Home-living Chronic Stroke Rehabilitating Patients

Sunday, October 28, 2012

Tzu Chi Wang , Department of Physical Therapy, Tzu Hui Institute of Technology, Pingtung, Taiwan
Alan C. Tsai, Ph D , Department of Healthcare Administration, Asia University, Taichung, Taiwan
Jiun Jiang Chen , Department of Rehabilitation, Kaohsiung Municipal Min-sheng Hospital, Kaohsiung, Taiwan
Yu De Lin, Ph D , Geriatric Medicine Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
Bang Chuen Liau , Department of physcial therapy, Yong-Chang Rehabilitation Clinic, Kaohsiung, Taiwan
Background: Most stroke patients return home only half-recovered. However, studies have shown that improvement can continue. Objective: To examine the feasibility of improving stroke patients' physical functional recovery and social participation through improving caregiver's care capability. Methods: Forty chronic (>6 m and Brunnstrom Scale III- V) stroke patients recruited from rehabilitation clinics in Taiwan were evaluated and randomly assigned to the control or treatment group for a 12-wk controlled trail after signing an informed consent. Caregivers of the treatment group received weekly home-training by a physical therapist to learn the care skills and plan patient-training schedule. All patients were evaluated with Berg balance scale, physical recovery of stroke impact scale, maximal walking velocity, 6-min walking distance, Activity of Daily Living, social participation, psychological stress and self-perception of overall progress at baseline and endpoint. Caregivers were evaluated for care-burden. Results were analyzed with Student's t-test for independent samples. Result: Caregiver-mediated intervention significantly improved balance control (score 4.46.7 vs. -1.84.9, p<0.01), physical recovery (score 8.111.1 vs. 0.87.5, p<0.05), maximal walking velocity (8.613.8 vs. -1.314.6 cm/sec, p<0.05), 6-min walking distance (31.775.8 vs. -9.928.7 m, p<0.05), Barthel index (5.57.2 vs. -0.38.2, p<0.05), social participation (score 13.319.2 vs. 0.013.4, p<0.05), and self-perception of progress (12.0 13.1 vs. -0.36.7%, p<0.01). No difference in psychological stress or caregivers' burden was observed Conclusion: Caregiver-mediated intervention was effective in improving functional recovery of chronic stroke rehabilitation patients. The model can greatly benefit the long term care system of stroke patients and save on healthcare cost.

Learning Areas:
Administer health education strategies, interventions and programs
Chronic disease management and prevention
Clinical medicine applied in public health
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
Development a new model for community stroke patients to imprvie their functional activity.

Keywords: Strokes, Disability

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: The study is a part of my doctoral research. I was responsible for the design, recruiting, execution, data collection, statistical analysis, result interpretation and preparation of the manuscript
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.