Recovery from disability after stroke as a target for a behavioural intervention: results of a randomized controlled trial.
OBJECTIVE
Disability following stroke is highly prevalent and is predicted by psychological variables such as control cognitions and emotions, in addition to clinical variables. This study evaluated the effectiveness of a workbook-based intervention, designed to change cognitions about control, in improving outcomes for patients and their carers.


METHODS
At discharge, stroke patients were randomly allocated (with their carers) to a 5-week intervention (n = 103) or control (normal care: n = 100). The main outcome (at 6 months) was recovery from disability using a performance measure, with distress and satisfaction as additional outcomes.


RESULTS
The intervention group showed significantly better disability recovery, allowing for initial levels of disability, than those in the control group, F(1,201) = 5.61, p = 0.019. Groups did not differ in distress or satisfaction with care for patients or carers. The only psychological process variable improved by the intervention was Confidence in Recovery but this did not mediate the effects on recovery.


CONCLUSIONS
A large proportion of intervention participants did not complete the workbook tasks. This was perhaps associated with the fairly low level of personal contact with workbook providers. The modest success of this intervention suggests that it may be possible to develop effective behavioural interventions to enhance recovery from disability in stroke patients.
Johnston
Marie
M
University of Aberdeen, Scotland, UK. m.johnston@abdn.ac.uk
Bonetti
Debbie
D
Joice
Sara
S
Pollard
Beth
B
Morrison
Val
V
Francis
Jillian J
JJ
Macwalter
Ron
R
D000368:Aged; D000369:Aged, 80 and over; D032763:Behavior Control / Q000379:methods*; D017028:Caregivers; D006233:Persons with Disabilities / Q000534:rehabilitation; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D017060:Patient Satisfaction; D012648:Self Care / Q000379:methods*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome