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In the clinical setting, it is difficult to obtain effective rehabilitation during the acute phase, the reasons may include insufficient awareness of early rehabilitation due mainly to a limitation in number and variety of rehabilitation professionals in Low- and middle-income countries. It is necessary to shift tasks to other healthcare providers who are trained to provide rehabilitation like nurses. The purpose of this study is to examine the feasibility and effectiveness of a modified Barthel Index based rehabilitation nursing program on acute stroke inpatients.
Ischemic stroke is the main cause of disability in the world. More than 70% of stroke patients show various degrees of neural function impairment. Early rehabilitation in acute phase is beneficial for improving patient's activity of daily livings and motor function. However, it is difficult to obtain effective rehabilitation during the acute phase of stroke because of the insufficiency of professional rehabilitation therapists in stroke wards in China. The investigators assume that implementing program based on modified Barthel Index can realize nursing-directed motor rehabilitation during acute phase of ischemic stroke. The present study is to conduct quasi-experimental research to confirm the feasibility and effectiveness of nursing-directed precision rehabilitation in acute stroke patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Modified Barthel Index-based rehabilitation nursing program | Experimental | Patients received the Modified Barthel Index based rehabilitation nursing from qualified nurses. |
|
| Usual care | Other | Patients received the usual care. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| The modified Barthel Index-based rehabilitation nursing program | Behavioral | The intervention with the program based on the MBI classified function of patients into five levels, with every 20 points as a level, Each level corresponds to different training items. Training items included self-care training and training in transfer activities, sitting balance, walking, and sit-to-stand, etc. Each training session lasting at least 30 minutes, two sessions per day, for seven continuous days. During the intervention, the rehabilitation therapist's conventional treatment is not interfered. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline the Modified Barthel Index (MBI) on day 7 | The MBI score ranges from 0 to 100, the higher scores mean a better outcome. | Day 0 and day 7 |
| Change from baseline the motor assessment scale (MAS) on day 7 | The MAS scale excluding general tonus, may be summed to provide an overall score out of a possible 48 points and the higher scores mean a better outcome. | Day 0 and day 7 |
| Change from baseline the National Institute of Health Stroke Scale (NIHSS) on day 7 | The NIHSS scale ranges from 0 to 42, and the higher scores mean a worse outcome. | Day 0 and day 7 |
| Measure | Description | Time Frame |
|---|---|---|
| The completion rate | The completion means participants completed all the study stage and all the data collection. | Day 7 |
| The adverse events rate | The adverse events including pneumonia, stroke progression or recurrent, fall. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jingfen Jin, Master | The Second Affiliated Hospital of Medical College of Zhejiang University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Second Affiliated Hospital, School of Medicine, Zhejiang University | Hangzhou | Zhejiang | 310009 | China |
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| ID | Term |
|---|---|
| D000083242 | Ischemic Stroke |
| ID | Term |
|---|---|
| D020521 | Stroke |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| Usual care | Behavioral | Patients in the control group received clinical usual care including the activities of daily living assessment, early mobilization guide and health education. During the intervention, the rehabilitation therapist's conventional treatment is not interfered. |
|
| Day 7 |
| D009422 |
| Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |