Personalized Post-Stroke Rehabilitation in a Rural Community: A Pilot Quasi-Experimental Study on Activities of Daily...

Area of Science:

• Gerontology
• Neurology
• Rehabilitation Medicine

Background:

• Early rehabilitation is vital for post-stroke recovery and predicting outcomes.
• Rural Thailand faces challenges in stroke rehabilitation, including limited access, discontinuous home visits, and fragmented interdisciplinary care.
• Addressing these barriers is crucial for comprehensive stroke patient management.

Purpose of the Study:

• To investigate the effects of personalized intermediate care (IMC) programs on clinical outcomes in rural post-ischemic stroke older adults.
• To evaluate the impact of a physical therapist-led, participatory action research-based pilot quasi-experimental study.
• To assess improvements in activities of daily living and disability levels.

Main Methods:

• A pilot quasi-experimental study involving 34 acute post-stroke patients in rural Thailand.
• Intervention: A 6-month home-based neurorehabilitation and comprehensive treatment program within an IMC framework, followed by a 6-month follow-up.
• Stakeholder collaboration: Physical therapists, physicians, nurses, nutritionists, community leaders, village health volunteers, and family caregivers.

Main Results:

• Significant increase in Barthel Index for Activities of Daily Living (BI-ADL) from baseline (55) to 100 at 6 months (p < 0.05), maintained at 12 months.
• Considerable reduction in modified Rankin Scale (mRS) for disability levels by 6 months post-discharge (p < 0.05).
• Positive trends indicating enhanced functional independence and reduced long-term disability.

Conclusions:

• Early and continuous personalized IMC rehabilitation effectively enhances activities of daily living (ADL) in post-stroke older adults.
• The program significantly reduces disability levels, demonstrating its clinical effectiveness.
• The findings support the dissemination of this IMC rehabilitation model to rural communities.