Rehabilitation Transition Program to Improve Community Participation Among Stroke Survivors: A Randomized Clinical...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Public Health

Background:

• Stroke survivors face significant challenges transitioning from inpatient rehabilitation to home environments.
• Environmental barriers in the home and community impede long-term recovery and participation for stroke survivors.
• There is a need for effective interventions to support stroke survivors' community reintegration and daily living post-discharge.

Purpose of the Study:

• To evaluate the efficacy of the Community Participation Transition after Stroke (COMPASS) program compared to an attentional control.
• To assess the program's impact on community participation, activity of daily living (ADL) performance, and reduction of environmental barriers post-stroke.
• To determine if COMPASS improves outcomes for stroke survivors transitioning from inpatient rehabilitation to home.

Main Methods:

• A phase 2b, parallel randomized clinical trial involving 185 stroke survivors aged 50 years and older.
• Participants were randomized to either the COMPASS intervention (home modifications, strategy training) or an attentional control group.
• Outcomes including community participation, ADL performance, and environmental barriers were assessed at various time points up to 12 months post-discharge.

Main Results:

• Both COMPASS and control groups showed similar improvements in community participation over 12 months.
• COMPASS participants demonstrated significantly greater improvements in self-rated performance and satisfaction with daily activities (ADLs).
• The COMPASS intervention led to a significant reduction in environmental barriers in the home compared to the control group, particularly at 6 months.

Conclusions:

• The COMPASS program effectively reduced environmental barriers and improved performance in daily activities for stroke survivors during their home transition.
• While overall community participation improvements were similar between groups, COMPASS offered specific benefits in functional performance and environmental adaptation.
• These findings highlight the importance of targeted interventions addressing environmental and functional challenges for stroke survivors returning home.