title: FAmily-Led RehabiliTaTion aftEr Stroke in INDia: the ATTEND pilot study.
abstract: BACKGROUND
  The aim of this pilot study was to determine the feasibility of a multicenter, randomized, controlled trial in India of a family-led, trained caregiver-delivered, home-based rehabilitation intervention vs. routine care.
  
  
  METHODS
  A prospective, randomized (within seven-days of hospital admission), blinded outcome assessor, controlled trial of structured home-based rehabilitation delivered by trained and protocol-guided family caregivers (intervention) vs. routine care alone (control) was conducted in patients with residual disability. Key feasibility measures were recruitment, acceptance and adherence to assessment procedures, and follow-up of participants over six-months. CTRI/2014/10/005133.
  
  
  RESULTS
  A total of 104 patients from the stroke unit at Christian Medical College, Ludhiana were recruited over nine-months. Recruitment was feasible and accepted by patients and their carers. Important observations were made regarding potential unblinding of the participants, contamination of therapy between the randomized groups, organization of home visits, and resources required for a multicenter study.
  
  
  CONCLUSIONS
  The pilot study established the feasibility of conducting a large-scale study of family-led, trained caregiver-delivered, home-based stroke rehabilitation in a low resource setting. The main phase of the trial 'ATTEND' is currently underway in over 10 centers in India.
authors.affiliation: Stroke Unit, Department of Neurology, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Jeyaraj D
authors.initials: JD
authors.lastname: Pandian
authors.affiliation: Stroke Unit, Department of Neurology, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Felix
authors.affiliation: Stroke Unit, Department of Neurology, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Paramdeep
authors.initials: P
authors.lastname: Kaur
authors.affiliation: Stroke Unit, Department of Neurology, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Deepika
authors.initials: D
authors.lastname: Sharma
authors.affiliation: Stroke Unit, Department of Neurology, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Lizzie
authors.initials: L
authors.lastname: Julia
authors.affiliation: Stroke Unit, Department of Neurology, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Gagan
authors.initials: G
authors.lastname: Toor
authors.affiliation: Department of Physiotherapy, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Rajni
authors.initials: R
authors.lastname: Arora
authors.affiliation: Department of Physiotherapy, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Dorcas B C
authors.initials: DB
authors.lastname: Gandhi
authors.affiliation: Stroke Unit, Department of Neurology, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Shweta J
authors.initials: SJ
authors.lastname: Verma
authors.affiliation: The George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Anderson
authors.affiliation: University of Glasgow, Glasgow, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Langhorne
authors.affiliation: Indian Institute of Public Health Hyderabad, Public Health Foundation of India, Hyderabad, India.
authors.forename: G V S
authors.initials: GV
authors.lastname: Murthy
authors.affiliation: The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia.|University of Central Lancashire, Preston, UK.
authors.forename: Maree L
authors.initials: ML
authors.lastname: Hackett
authors.affiliation: The George Institute for Global Health, Hyderabad, India.|The George Institute for Global Health, University of Oxford, Oxford, UK.
authors.forename: Pallab K
authors.initials: PK
authors.lastname: Maulik
authors.affiliation: The George Institute for Global Health, Hyderabad, India.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alim
authors.affiliation: Sydney Medical School/Northern, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Harvey
authors.affiliation: University of Glasgow, Glasgow, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Jan
authors.affiliation: University of Nottingham, Nottingham, Nottinghamshire, UK.
authors.forename: Marion
authors.initials: M
authors.lastname: Walker
authors.affiliation: University of Leeds, Bradford, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Forster
authors.affiliation: The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Lindley
mesh_terms: D017028:Caregivers; D005190:Family; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D018579:Patient Selection; D010865:Pilot Projects; D011446:Prospective Studies; D012648:Self Care / Q000191:economics / Q000379:methods*; D012720:Severity of Illness Index; D016037:Single-Blind Method; D020521:Stroke / Q000191:economics / Q000523:psychology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
keywords: caregiver; developing countries; early supported discharge; home-based care; quality of life; rehabilitation; stroke; therapy