ABSTRACT
OBJECTIVE: To evaluate the effectiveness of an intervention using video to deliver therapy at home for patients with stroke. DESIGN: Randomized controlled trial. SETTING: The neurology ward and rehabilitation medicine department of a tertiary hospital. PARTICIPANTS: Patients with stroke (N=90). There were 44 patients in the intervention group and 46 patients in the control group. INTERVENTIONS: The intervention group received a combination of at-home rehabilitation guided by a digital videodisk containing therapy techniques and twice-monthly outpatient follow-up for 3 months. The conventional therapy group (control) attended weekly outpatient therapy sessions. MAIN OUTCOME MEASURES: The primary outcome measure was the modified Barthel Index (MBI) score. The secondary measures were the incidence of poststroke complications and the Caregiver Strain Index. RESULTS: At 3 months, there were no significant differences with regard to the number of patients with improved MBI score, complication rate, or Caregiver Strain Index score between the 2 groups. Both groups had significant increases in the MBI score at 3 months (P<.001 for both groups). Regression analysis revealed that only stroke severity significantly influenced the MBI score (P<.001), complication rate (P<.01), and caregiver stress level (P<.05). CONCLUSIONS: Video-based therapy at home for post-acute stroke patients is safe, does not negatively impact independence, and is not stressful for caregivers.
