Family-led rehabilitation is not effective in aiding the recovery of people who have suffered a stroke, a major international trial involving researchers at the University of Nottingham has suggested.
The results of the study, which was run across 13 centres throughout India and was one of the largest stroke rehabilitation trials ever undertaken, have surprised the researchers who led the work.
The research, published in The Lancet, revealed that there was no reduction in disability for patients on the trial, compared to those who received no extra care.
Professor Marion Walker, in the University’s School of Medicine, was part of the team which conducted the study. She said: “The ATTEND trial was the largest global stroke rehabilitation trial ever to have been conducted and pulled together an impressive team of world-leading stroke researchers.
“It is estimated that around 1.6 million people have a stroke in India each year, yet the vast majority receive little or no formal rehabilitation. Stroke in India affects a much younger population than in high-income countries (on average 15 years younger) which can have a significant impact on an individual’s ability to return to work and generate income.
“Our intervention ensured family members were trained by experts to deliver rehabilitation within the home environment, thereby ensuring patients received much more rehabilitation training than they would normally have received in routine practice.
“Given the limited resources available to stroke survivors in India, we felt this was a hugely important study and were surprised by the results. We now need to find alternative ways of ensuring stroke survivors in India make an optimal recovery.”
The results raise serious questions about the benefit of rehabilitation carried out by family members and highlights the need for urgent investment in professional stroke facilities in low and middle income countries.
The international team was led by Professor Richard Lindley of The George Institute for Global Health, Sydney, and also included leading UK researchers Professor Peter Langhorne at the University of Glasgow and Professor Anne Forster at the University of Leeds.
One of the major successes of this study was the formation of a stroke research network throughout India. Professor Walker is now involved in a £1.9 million National Institute for Health Research (NIHR)-funded stroke research project building further research capacity throughout India.
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