About 1.6 million people suffer strokes in India every year and some 5,00,000 of them are disabled due to lack of rehabilitation services. Given this background, a collaborative group of researchers from India, Australia and the United Kingdom conducted a trial to check whether family-led rehabilitation could help stroke survivors better. Unfortunately, the study has shown that there are not additional benefits from rehabilitation at home.
The Family-led Rehabilitation after Stroke in India trial, also called the ATTEND trial, enrolled 1,250 stroke patients across 14 hospitals in India, making it one of the largest trials of its kind. The patients were aged 18 years or older and had had strokes within one month of the start of the trial. The patients had been left with disabilities and had reasonable expectations of survival. They all had informal family-nominated caregivers to whom the researchers assigned specific rehabilitation interventions or usual care. The family members of participants in the intervention group received structured rehabilitation training that included providing them information, setting goal, training as carers. The training was started at the hospital and then continued at home for up to two months.
The premise of the trial was to find a basis on which to shift the healthcare tasks for stroke rehabilitation from medical professionals to non-trained workers. To the surprise of the research team, the trial revealed that there was no reduction in disability for patients on the trial, compared to those who received no extra care. The researchers say that the findings highlights the need for urgent investment in professional stroke facilities in low-income and middle-income countries.
The study was published in The Lancet.