title: Interprofessional stroke rehabilitation for stroke survivors using home care.
abstract: OBJECTIVE
  To compare a specialized interprofessional team approach to community-based stroke rehabilitation with usual home care for stroke survivors using home care services.
  
  
  METHODS
  Randomized controlled trial of 101 community-living stroke survivors (<18 months post-stroke) using home care services. Subjects were randomized to intervention (n=52) or control (n=49) groups. The intervention was a 12-month specialized, evidence-based rehabilitation strategy involving an interprofessional team. The primary outcome was change in health-related quality of life and functioning (SF-36) from baseline to 12 months. Secondary outcomes were number of strokes during the 12-month follow-up, and changes in community reintegration (RNLI), perceived social support (PRQ85-Part 2), anxiety and depressive symptoms (Kessler-10), cognitive function (SPMSQ), and costs of use of health services from baseline to 12 months.
  
  
  RESULTS
  A total of 82 subjects completed the 12-month follow-up. Compared with the usual care group, stroke survivors in the intervention group showed clinically important (although not statistically significant) greater improvements from baseline in mean SF-36 physical functioning score (5.87, 95% CI -3.98 to 15.7; p=0.24) and social functioning score (9.03, CI-7.50 to 25.6; p=0.28). The groups did not differ for any of the secondary effectiveness outcomes. There was a higher total per-person costs of use of health services in the intervention group compared to usual home care although the difference was not statistically significant (p=0.76).
  
  
  CONCLUSIONS
  A 12-month specialized, interprofessional team is a feasible and acceptable approach to community-based stroke rehabilitation that produced greater improvements in quality of life compared to usual home care. Clinicaltrials.gov identifier: NCT00463229.
authors.affiliation: School of Nursing, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Maureen
authors.initials: M
authors.lastname: Markle-Reid
authors.forename: Camille
authors.initials: C
authors.lastname: Orridge
authors.forename: Robin
authors.initials: R
authors.lastname: Weir
authors.forename: Gina
authors.initials: G
authors.lastname: Browne
authors.forename: Amiram
authors.initials: A
authors.lastname: Gafni
authors.forename: Mary
authors.initials: M
authors.lastname: Lewis
authors.forename: Marian
authors.initials: M
authors.lastname: Walsh
authors.forename: Charissa
authors.initials: C
authors.lastname: Levy
authors.forename: Stacey
authors.initials: S
authors.lastname: Daub
authors.forename: Heather
authors.initials: H
authors.lastname: Brien
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Roberts
authors.forename: Lehana
authors.initials: L
authors.lastname: Thabane
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006699:Home Care Services; D006801:Humans; D008297:Male; D026761:Physical Therapy Specialty / Q000379:methods*; D011788:Quality of Life; D012047:Rehabilitation Centers; D012111:Residence Characteristics; D012944:Social Support; D020521:Stroke / Q000401:mortality / Q000523:psychology; D000071939:Stroke Rehabilitation; D017741:Survivors; D016896:Treatment Outcome