Abstract
BackgroundFamily carepartner management and support can improve stroke survivor recovery, yet research has placed little emphasis on how to integrate families into the rehabilitation process without increasing negative carepartner outcomes. Our group has developed creative approaches for engaging family carepartners in rehabilitation activities to improve physical and psychosocial health for both the carepartner and stroke survivor. The purpose of this study is to explore a novel, web-based intervention (Carepartner and Constraint-Induced Therapy; CARE-CITE) designed to facilitate positive carepartner involvement during a home-based application of constraint-induced movement therapy (CIMT) for the upper extremity.MethodsThe primary aim of the study is to determine feasibility of CARE-CITE for both stroke survivors and their carepartners. Carepartner mental health, family conflict surrounding stroke recovery, and stroke survivor upper extremity function will be evaluated using an evaluator blinded, two-group experimental design (blocked randomization protocol according to a 2:1 randomization schema) with 32 intervention dyads and 16 control dyads (who will receive CIMT without structured carepartner involvement). CARE-CITE consists of online education modules for the carepartner to review in parallel to the 30-h CIMT that the stroke survivor receives. The intent of CARE-CITE is to enhance the home-based intervention of CIMT, by helping the carepartner support the therapy and create a therapeutic home environment encouraging practice of the weaker arm in functional tasks.DiscussionThe CARE-CITE study is testing the feasibility of a family-integrated rehabilitation approach applied in the home environment, and results will provide the foundation for larger clinical studies. The overall significance of this research plan is to increase the understanding and further development of interventions that may serve as models to promote family involvement in the rehabilitation process.Trial registrationClinicalTrials.gov, NCT02703532. Registered 9 March 2016
Highlights
Carepartner management and support can improve stroke survivor recovery, yet research has placed little emphasis on how to integrate families into the rehabilitation process without increasing negative carepartner outcomes
Creasy et al [9] evaluated the impact of healthcare provider interactions on CP needs during rehabilitation and found that CPs overwhelmingly emphasized the importance of being involved in treatment planning and expressed expectations to have information and rehabilitation training tailored to family needs [10]
Several studies have shown that improving CP coping and life skills surrounding caring for a chronically ill family member benefits the CP leading to a decrease in measures of depression and caregiver burden and improved quality of life (QOL) [5, 11, 12]
Summary
Carepartner management and support can improve stroke survivor recovery, yet research has placed little emphasis on how to integrate families into the rehabilitation process without increasing negative carepartner outcomes. Carepartners (CPs) are key contributors to stroke recovery, but their efforts can lead to a high level of CP burden and depressive symptoms, reduced quality of life (QOL), and increased stress surrounding the recovery process [3,4,5,6,7]. Several studies have shown that improving CP coping and life skills surrounding caring for a chronically ill family member benefits the CP leading to a decrease in measures of depression and caregiver burden and improved QOL [5, 11, 12]. To date, a family-focused approach in rehabilitation therapy that addresses CP needs has not been evaluated in stroke research
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