Feasibility study of an integrated stroke self-management programme: a cluster-randomised controlled trial.

Area of Science:

• Neurology
• Rehabilitation Medicine
• Health Services Research

Background:

• Community-based stroke rehabilitation teams in London were studied.
• A feasibility cluster-randomised design was employed to assess a self-management programme's integration.
• The study involved 78 patients requiring community-based stroke rehabilitation.

Purpose of the Study:

• To determine the feasibility of a controlled trial for a self-management program in stroke rehabilitation.
• To assess the integration of self-management principles into existing rehabilitation services.

Main Methods:

• A cluster-randomised design with community stroke rehabilitation teams as units of randomisation.
• An intervention focused on individualised self-management based on self-efficacy, with clinician training and patient workbooks.
• Outcome measures included quality of life, mood, self-efficacy, functional capacity, and healthcare utilisation, assessed at baseline, 6 weeks, and 12 weeks.

Main Results:

• Four community stroke rehabilitation teams were recruited, enrolling 78 participants.
• All outcome measures were feasible to use, with 85% data completion at 12 weeks.
• While no significant differences in outcomes were found between groups, functional capacity and self-efficacy showed responsiveness; delivery was acceptable and fidelity was confirmed.

Conclusions:

• Integrating a stroke self-management program into community rehabilitation is feasible.
• Despite some data loss, the results support further research and provide data for definitive trial design.
• The study highlights the potential of self-management principles in stroke rehabilitation.