Effectiveness of a video-based therapy program at home after acute stroke: a randomized controlled trial.

Abstract

To evaluate the effectiveness of an intervention using video to deliver therapy at home for patients with stroke. Randomized controlled trial. The neurology ward and rehabilitation medicine department of a tertiary hospital. Patients with stroke (N=90). There were 44 patients in the intervention group and 46 patients in the control group. The intervention group received a combination of at-home rehabilitation guided by a digital videodisk containing therapy techniques and twice-monthly outpatient follow-up for 3 months. The conventional therapy group (control) attended weekly outpatient therapy sessions. The primary outcome measure was the modified Barthel Index (MBI) score. The secondary measures were the incidence of poststroke complications and the Caregiver Strain Index. At 3 months, there were no significant differences with regard to the number of patients with improved MBI score, complication rate, or Caregiver Strain Index score between the 2 groups. Both groups had significant increases in the MBI score at 3 months (P<.001 for both groups). Regression analysis revealed that only stroke severity significantly influenced the MBI score (P<.001), complication rate (P<.01), and caregiver stress level (P<.05). Video-based therapy at home for post-acute stroke patients is safe, does not negatively impact independence, and is not stressful for caregivers.