Original researchEffects of Home-Based Versus Clinic-Based Rehabilitation Combining Mirror Therapy and Task-Specific Training for Patients With Stroke: A Randomized Crossover Trial
Section snippets
Study design and procedure
This study was a single-blinded, 2-sequence, 2-period, crossover design in which each participant received 2 interventions (fig 1). During each period, participants received 12 intervention sessions for 4 weeks. They were randomly assigned to receive home-based rehabilitation first versus clinic-based rehabilitation first. After a 4-week washout period, the group that received home-based rehabilitation first received the clinic-based rehabilitation, and vice versa.
The same trained therapist
Participants’ baseline characteristics
The study initially enrolled 26 patients from December 2014 to November 2016, and the data of the patients who completed each of the 2 study periods of intervention and assessment were analyzed (see fig 2). Table 2 summarizes the baseline characteristics of the 24 participants included in study period 1. No significant differences were found in the baseline characteristics between the 2 treatment groups (P=.21-.94).
During study period 1, 8.3% of patients dropped out of each group; and during
Discussion
In this 2-period, crossover study, we demonstrated that the home-based and clinic-based rehabilitation has differential benefits on different aspects of health outcomes. Patients in the home-based group demonstrated better improvements on the AOU of their affected UE in daily tasks measured by the MAL-AOU and lower extremity force measured by the sit-to-stand test than the clinic-based group. The improved scores on the MAL-AOU and sit-to-stand test also exceeded or approached minimal clinically
Conclusions
The implementation of a home-based stroke rehabilitation intervention with patient-oriented goals resulted in mixed outcomes. The home-based rehabilitation demonstrated better improvements in the amount the affected UE was used in daily tasks and in lower extremity force, whereas the clinic-based rehabilitation enhanced self-perceived health status. Further studies are suggested to investigate how to integrate home-based and clinic-based interventions in patients with different stroke phases,
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Supported by Chang Gung Memorial Hospital (grant no. CMRPD1E0391) and partly supported by the Healthy Aging Research Center at Chang Gung University (grant no. EMRPD1F0321), Chang Gung Memorial Hospital (grant nos. CMRPD1C0401-403, BMRP553, and BMRPD25), and the National Health Research Institutes (grant no. NHRI-EX106-10604PI) in Taiwan.
Clinical Trial Registration No.: NCT02364232.
Disclosures: none.