Application of the information-motivation-behavioral skills model in rehabilitation training for stroke patients

This study aimed to evaluate a multidisciplinary rehabilitation program based on the information-motivation-behavioral skills (IMB) model principles and its association with self-efficacy, functional recovery, quality of life, and caregiver burden among stroke survivors.

A quasi-experimental, non-randomized controlled trial was conducted on 112 stroke patients. The IMB group received a 3-month IMB-based program integrating neurologists, rehabilitation therapists, psychologists, and caregivers, and focusing on information delivery, motivational interviewing, and personalized behavioral training. The usual-care group received standard care. The outcomes included self-efficacy (SSEQ), motor function (Fugl-Meyer Assessment, FMA), daily living ability (Barthel Index, BI), quality of life (SS-QOL), psychological status (Hamilton Depression Rating Scale, HAMD; Hamilton Anxiety Rating Scale, HAMA), and caregiver burden (ZBI), assessed at baseline and post-intervention.

The IMB group achieved higher scores than the usual-care group in the following areas: self-efficacy (+82.5% from baseline; SSEQ: 82.5 ± 7.3 vs. 57.8 ± 8.1; p < 0.001), motor function (+79.4%; FMA: 68.9 ± 10.2 vs. 50.3 ± 9.5; p < 0.001), and quality of life (+71%; SS-QOL: 89.4 ± 11.6 vs. 65.2 ± 10.9; p < 0.001). Anxiety (HAMA: 7.5 ± 2.8 vs. 13.6 ± 3.5) and depression (HAMD: 9.2 ± 3.1 vs. 14.8 ± 4.2) scores were lower in the IMB group and fell within the subclinical range (p < 0.001), and caregiver burden was also lower in the IMB group (-31%; ZBI: 28.4 ± 6.3 vs. 41.2 ± 7.1; p < 0.001).

The IMB-based multidisciplinary intervention was associated with improved stroke recovery outcomes and reduced caregiver stress. This model suggests a potentially scalable approach that warrants further investigation. Its integration of behavioral strategies with neurorehabilitation principles bridges a critical gap in holistic stroke care, emphasizing the importance of self-efficacy and multidisciplinary collaboration.