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A behaviour change program to increase outings delivered during therapy to stroke survivors by community rehabilitation teams : The Out-and-About trial
McCluskey, Annie Ada, Louise Kelly, Patrick J. Middleton, Sandy Goodall, Stephen Grimshaw, Jeremy M. Logan, Pip Longworth, Mark Karageorge, Aspasia
McCluskey, Annie
Ada, Louise
Kelly, Patrick J.
Middleton, Sandy
Goodall, Stephen
Grimshaw, Jeremy M.
Logan, Pip
Longworth, Mark
Karageorge, Aspasia
Abstract
Background: Australian guidelines recommend that outdoor mobility be addressed to increase participation after stroke.
Aim: To investigate the efficacy of the Out-and-About program at increasing outings delivered during therapy by community teams, and outings taken by stroke survivors in real life.
Method: Cluster-randomised trial involving 22 community teams providing stroke rehabilitation. Experimental teams received the Out-and-About program (a behaviour change program comprising a training workshop with barrier identification and booster session, printed educational materials, audit and feedback). Control teams received printed clinical guidelines only. The primary outcome was the percentage of stroke survivors receiving four or more outings during therapy. Secondary outcomes included the number of outings received by stroke survivors during therapy and undertaken in real life.
Results: At 12 months after implementation of the behaviour change program, 9% audited experimental group stroke survivors received four or more outings during therapy compared with 5% in the control group (adjusted risk difference 4%, 95% CI -9 to 17, p=0.54). They received 1.1 (SD 0.9) outings during therapy compared with 0.6 (SD 1.0) in the control group (adjusted mean difference 0.5, 95% CI -0.4 to 1.4; p=0.26). After 6 months of rehabilitation, observed experimental group stroke survivors took 9.0 (SD 3.0) outings per week in real life compared with 7.4 (SD 4.0) in the control group (adjusted mean difference 0.5, 95% CI -1.8 to 2.8; p = 0.63).
Conclusion: The Out-and-About program did not change team or stroke survivor behaviour.
Keywords
physical therapy, occupational therapy, physiotherapy, knowledge translation, walking
Date
2016
Type
Journal article
Journal
International Journal of Stroke
Book
Volume
11
Issue
4
Page Range
425-437
Article Number
ACU Department
Nursing Research Institute
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as green open access
License
File Access
Open
Controlled
Controlled