Effect of individualized coaching at home on walking capacity in subacute stroke patients: A randomized controlled trial (Ticaa'dom).


Journal

Annals of physical and rehabilitation medicine
ISSN: 1877-0665
Titre abrégé: Ann Phys Rehabil Med
Pays: Netherlands
ID NLM: 101502773

Informations de publication

Date de publication:
Jul 2021
Historique:
received: 18 03 2020
revised: 01 11 2020
accepted: 03 11 2020
pubmed: 17 11 2020
medline: 21 10 2021
entrez: 16 11 2020
Statut: ppublish

Résumé

The gains in walking capacity achieved during rehabilitation often plateau, or are lost, when the patient returns home. Moreover, maintaining or increasing the patient's daily physical activity level after a stroke remains challenging. We aimed to evaluate the effectiveness of a six-month individualized coaching program at home on walking capacity, as evaluated by the six-minute walk test in subacute stroke patients. Stroke patients in the physical medicine and rehabilitation service participated in a monocentric observer blinded randomized controlled trial with two groups, intervention versus usual care control. The inclusion criteria were: age≥18 years, first ischemic or hemorrhagic stroke, and stroke within<6 months. Participants were randomly assigned (blocks of variable size) to an intervention group (EG) receiving individualized coaching on physical activity, or to a control group (CG) receiving standard care. The six-month program was composed of monitored physical activity, home visits and a weekly phone call. Participants were evaluated after hospital discharge (T0), at the end of the six-month program (T1) and six months later(follow-up; T2). The primary outcome was the walking distance performance, as evaluated with the six-minute walk test at T1. Eighty-three participants (age: 61y [IQR=22]; time post-stroke: 2.4 month [IQR=1.7]; Barthel index: 100[IQR=5]) were included in the study: (EG, n=41; CG, n=42). The difference between the two groups was not significant at T1(418m [IQR=165] for the EG and 389m [IQR=188] for the CG; P=0.168) and at T2(425m [IQR=121] for the EG vs. 382m [IQR=219] for the CG; P=0.208). Our study shows no difference in the six-minute walk test between the two groups of subacute stroke patients after 6 months of the individualized coaching program, combining home visits, feedback on daily performance and weekly telephone calls. http://ClinicalTrials.gov (NCT01822938).

Sections du résumé

BACKGROUND BACKGROUND
The gains in walking capacity achieved during rehabilitation often plateau, or are lost, when the patient returns home. Moreover, maintaining or increasing the patient's daily physical activity level after a stroke remains challenging. We aimed to evaluate the effectiveness of a six-month individualized coaching program at home on walking capacity, as evaluated by the six-minute walk test in subacute stroke patients.
METHODS METHODS
Stroke patients in the physical medicine and rehabilitation service participated in a monocentric observer blinded randomized controlled trial with two groups, intervention versus usual care control. The inclusion criteria were: age≥18 years, first ischemic or hemorrhagic stroke, and stroke within<6 months. Participants were randomly assigned (blocks of variable size) to an intervention group (EG) receiving individualized coaching on physical activity, or to a control group (CG) receiving standard care. The six-month program was composed of monitored physical activity, home visits and a weekly phone call. Participants were evaluated after hospital discharge (T0), at the end of the six-month program (T1) and six months later(follow-up; T2). The primary outcome was the walking distance performance, as evaluated with the six-minute walk test at T1.
RESULTS RESULTS
Eighty-three participants (age: 61y [IQR=22]; time post-stroke: 2.4 month [IQR=1.7]; Barthel index: 100[IQR=5]) were included in the study: (EG, n=41; CG, n=42). The difference between the two groups was not significant at T1(418m [IQR=165] for the EG and 389m [IQR=188] for the CG; P=0.168) and at T2(425m [IQR=121] for the EG vs. 382m [IQR=219] for the CG; P=0.208).
CONCLUSION CONCLUSIONS
Our study shows no difference in the six-minute walk test between the two groups of subacute stroke patients after 6 months of the individualized coaching program, combining home visits, feedback on daily performance and weekly telephone calls. http://ClinicalTrials.gov (NCT01822938).

Identifiants

pubmed: 33197648
pii: S1877-0657(20)30202-5
doi: 10.1016/j.rehab.2020.11.001
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT01822938']

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

101453

Informations de copyright

Copyright © 2020 Elsevier Masson SAS. All rights reserved.

Auteurs

Stéphane Mandigout (S)

Limoges university, HAVAE laboratory, EA 6310, 123, avenue Albert-Thomas, 87060 Limoges, France. Electronic address: stephane.mandigout@unilim.fr.

David Chaparro (D)

Limoges university, HAVAE laboratory, EA 6310, 123, avenue Albert-Thomas, 87060 Limoges, France.

Benoit Borel (B)

Limoges university, HAVAE laboratory, EA 6310, 123, avenue Albert-Thomas, 87060 Limoges, France.

Benjamin Kammoun (B)

Limoges university, HAVAE laboratory, EA 6310, 123, avenue Albert-Thomas, 87060 Limoges, France.

Jean-Yves Salle (JY)

Limoges university, HAVAE laboratory, EA 6310, 123, avenue Albert-Thomas, 87060 Limoges, France; Department of Medicine and physical rehabilitation service, Limoges university hospital, 87000 Limoges, France.

Maxence Compagnat (M)

Limoges university, HAVAE laboratory, EA 6310, 123, avenue Albert-Thomas, 87060 Limoges, France; Department of Medicine and physical rehabilitation service, Limoges university hospital, 87000 Limoges, France.

Jean-Christophe Daviet (JC)

Limoges university, HAVAE laboratory, EA 6310, 123, avenue Albert-Thomas, 87060 Limoges, France; Department of Medicine and physical rehabilitation service, Limoges university hospital, 87000 Limoges, France.

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