Individualized home-based rehabilitation after stroke in France: a pragmatic study of a community stroke rehabilitation team.

BACKGROUND

Community stroke rehabilitation teams (CSRT) provide an individualized home-based rehabilitation service to patients recovering from stroke.

OBJECTIVE

To examine whether there is an improvement in the social participation of patients who received a rehabilitation program provided by CSRT. The secondary objectives were to show if there is an improvement in the patients' quality of life and a reduction in the caregiver burden.

METHODS

Retrospective cohort study, pragmatic in real-care conditions. The rehabilitation program delivered by the CSRT was adapted to the needs of the patients and caregivers. The outcome questionnaires included: the Frenchay Activity Index (FAI), the Minizarit, the EuroQol EQ5D, and the Barthel Index. The primary outcome measure was the FAI.

RESULTS

We included 206 patients followed by the CSRT over the 2018-2020 study period, for whom the primary endpoint was present. The mean age was 66.3 ± 12.7 years, the post-stroke delay was 16.4 ± 32.7 months, and the Barthel index was 66.42 ± 12.6. The duration of the rehabilitation program was on average 162 ± 109 days. We observed a significant improvement in the FAI, from 12.9 ± 10.4 to 17.85 ± 12.4 ( < 0.00001); in the EuroQol, from 57.51 ± 19.96 to 66.36 ± 18.87 ( < 0.00001); in the mini-Zarit, from 2.49 ± 1.75 to 2.06 ± 1.67 ( = 0.0002); and in the Barthel index, from 66.42 ± 12.67 to 84.81 ± 23.70 ( < 0.001).

CONCLUSION

Patients who received a rehabilitation program by the CSRT have an improvement in their social participation, and their informal caregivers have a reduction in their burden.