Instrumental Activities of Daily Living Approach in Home Environment for Patients With Stroke

Study Overview
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Brief Summary
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The purpose of this study was to conduct a randomized clinical trial. Implement instrumental daily activities of daily living (A-IADL) in home rehabilitation. To explore the effect of A-IADL on stroke patients' movement, cognition, social participation, daily life function and quality of life.

Detailed Description
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Subjects were randomized to intervention group and control group. The experiment was designed as randomized cross-over control trial. The primary outcome included 11 measures, Fugl-Meyer Assessment, Balance computerized adaptive testing, Mini Mental State Examination, Participation Measure-3 Domains ,4 Dimensions, Canadian Occupational Performance Measure, Barthel Index-based Supplementary Scales, Frenchay Activities Index, Lawnton Instrumental Activities of Daily Living, stroke impact scale, Stroke Self-Efficacy Questionnaire, and Kingston Caregiver Stress Scale.

Official Title
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Investigation of the Effect on Instrumental Activities of Daily Living Approach in Home Environment for Patients With Stroke

Conditions
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Stroke, Activities of Daily Living

Intervention / Treatment
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* Behavioral: Approach-Instrumental Activities of Daily Living
* Behavioral: Home health education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age > 20 years Diagnosis of stroke The modified Rankin Scale : 2 4 Keep sitting for half an hour by himself/herself Follow instructions Willing to sign the subject's consent Exclusion Criteria: Diagnosis of dementia History of orthopedic diseases or peripheral nerve injury

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: A-IADL Group<br>Approach-Instrumental Activities of Daily Living in home | Behavioral: Approach-Instrumental Activities of Daily Living<br>* Individualized instrumental activities of daily living training<br>|
| Active Comparator: Control group<br>Home health education | Behavioral: Home health education<br>* Individualized home health education<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fugl-Meyer Assessment | The Fugl-Meyer Assessment scale is an index to assess the sensorimotor impairment in individuals who have had stroke. The score ranges is 0 to 226. A higher score indicates better body function. | Baseline to 6 weeks | 
| Balance computerized adaptive testing | The Balance computerized adaptive testing is a test about stroke patients, includes movement, balance, activities of daily living. | Baseline to 6 weeks | 
| Mini Mental State Examination | The Mini Mental State Examination general cognitive function. The score ranges is 0 to 30. A higher score indicates better general cognitive function. | Baseline to 6 weeks | 
| Participation Measure-3 Domains ,4 Dimensions | The Participation Measure-3 Domains, 4 Dimensions assesses social participation. A higher score indicates better social participation. | Baseline to 6 weeks | 
| Canadian Occupational Performance Measure | The COPM protocol is divided into three areas: self-care, productivity, and leisure. Patients define important activities and classify them with a score of one to 10. A higher score indicates better occupational performance. | Baseline to 6 weeks | 
| Barthel Index (BI) -based Supplementary Scales | The Barthel Index-based Supplementary Scales assesses basic activities of daily living using three scales:actual performance, ability, and self-perceived difficulty. The score ranges the three scales (i.e., actual performance, ability, and self-perceived difficulty)is 0-20, 0-18, and 0-20, respectively. A higher score indicates better basic activities of daily living. | Baseline to 6 weeks | 
| Frenchay Activities Index | The Frenchay Activities Index is a measure of instrumental activities of daily living for use with patients recovering from stroke. The score ranges is 0 to 45. A higher score indicates better instrumental activities of daily living. | Baseline to 6 weeks | 
| Lawnton Instrumental Activities of Daily Living | The Lawnton Instrumental Activities of Daily Living assesses instrumental activities of daily living.The score ranges is 0 to 8. A higher score indicates better instrumental activities of daily living. | Baseline to 6 weeks | 
| Stroke Impact Scale | The Stroke Impact Scale assesses other dimensions of health-related quality of life: emotion, communication, memory and thinking, and social role function.The score ranges is 59 to 295. A lower score indicates the quality of life less affected by stroke. | Baseline to 6 weeks | 
| Stroke Self-Efficacy Questionnaire | The Stroke Self-Efficacy Questionnaire is a self-report scale measuring self-efficacy judgments in specific domains of functioning post stroke. The score ranges is 0 to 130. A higher score indicates better self-efficacy. | Baseline to 6 weeks | 
| Kingston Caregiver Stress Scale | The Kingston Caregiver Stress Scale is a self-report scale measuring caregiver stress. The score ranges is 10 to 50. A higher score indicates greater stress. | Baseline to 6 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Stroke, Activities of Daily Living, Home Care Services