Stark Susan, Keglovits Marian, Somerville Emily, Hu Yi-Ling, Conte Jane, Yan Yan
Assistant Professor of Occupational Therapy, Neurology and Social Work, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri.
Occupational Therapist, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri.
Br J Occup Ther. 2018;81(2):116-124. doi: 10.1177/0308022617736704. Epub 2017 Nov 19.
Stroke is a leading cause of serious, long-term disability in the US. With shorter inpatient hospital stays, more time in rehabilitation is devoted to medical stabilization and less on skills to regain independence in daily activities. The transition home may be an opportunity for intervention focused on regaining independence. We propose an enhanced rehabilitation transition program called: Community Participation Transition after Stroke (COMPASS).
A prospective, randomized, single-blinded, parallel-group pilot study was completed to demonstrate feasibility with N=15 participants.
Fidelity to the protocol was achieved: the COMPASS group received 81% of the planned minutes and 83% of the intervention visits. There was no difference between groups for healthcare utilization or falls. Adherence was 85% at 3-months and 71% at 9-months for the home modification intervention. At 6-months, the COMPASS group's reintegration to normal living scores improved by 17.39 points for the COMPASS group, and 1.30 for the control group. Environmental barriers decreased in both groups.
This pilot study demonstrated that it is feasible to implement a community participation intervention during the period of transitioning home from inpatient rehabilitation for stroke survivors. Additional studies are necessary to determine the efficacy of the intervention.
在美国，中风是导致严重长期残疾的主要原因。随着住院时间缩短，康复时间更多地用于医疗稳定，而用于恢复日常活动独立技能的时间减少。回家过渡阶段可能是一个专注于恢复独立性的干预机会。我们提出了一个强化康复过渡项目，称为：中风后社区参与过渡（COMPASS）。
完成了一项前瞻性、随机、单盲、平行组试点研究，以证明N = 15名参与者的可行性。
达到了方案的保真度：COMPASS组接受了计划分钟数的81%和干预访视的83%。两组在医疗保健利用率或跌倒方面没有差异。家庭改造干预在3个月时的依从率为85%，在9个月时为71%。在6个月时，COMPASS组恢复正常生活的得分提高了17.39分，而对照组提高了1.30分。两组的环境障碍都有所减少。
这项试点研究表明，对中风幸存者从住院康复回家过渡期间实施社区参与干预是可行的。需要进一步的研究来确定该干预的效果。
