The Impact of Caregiver Support on Symptom Improvement in Post-Stroke Patients

Background: Stroke is a significant global health concern, particularly in countries like Bangladesh experiencing a rise in non-communicable diseases. The impact of stroke disabilities is profound, affecting both patients and their caregivers. Objective: This study aims to evaluate the role of caregivers in alleviating symptoms among post-stroke disabled individuals. Method: A two-arm, single-blind, randomized controlled trial was conducted over 12 weeks (July 2022-july 2023). 51 Participants, recruited from tertiary hospital departments, met specific eligibility criteria. They were assigned to either a control, n=26 or intervention group, n=25, receiving either standard care or a caregiver-mediated rehabilitation program, respectively. Assessments were conducted at baseline and endpoint, evaluating various functional and quality-of-life measures. Results: In the study, 30 out of 51 participants were male, constituting 58% of the sample, while the remaining 41% were female. Among the cohort, 24 individuals, making up 47% of the total sample, experienced right hemiplegia. Furthermore, a significant portion of the participants, 38 out of 51 individuals, accounting for 75%, resided in households featuring mobility obstacles such as raised doorsteps between rooms. Additionally, it was observed that 71% of the caregivers were spouses of the patients. In the intervention group, significant enhancements were observed in various domains of the Stroke Impact Scale (SIS), including strength, mobility, composite physical function, and general recovery, with p-values indicating statistical significance (< 0.001). Marginal improvements were also noted in the domains of activities of daily living (ADL)/instrumental activities of daily living (IADL), hand function, communication, and social participation, albeit with slightly higher p-values (0.022 to 0.030). Conversely, the control group did not exhibit significant within-group effects across these domains. When comparing caregiver burden scores between the control and intervention groups, although there were no statistically significant differences observed in the Total Burden, General Strain, and Disappointment domains, the Intervention Group displayed slight improvements in Isolation, Emotional, and Environment domains compared to the Control Group, despite these differences not reaching statistical significance. These findings indicate the multifaceted impact of the caregiver-mediated, home-based intervention on both post-stroke patients' functional outcomes and caregiver burden. Conclusion: Caregivers are essential in post-stroke care, and supporting them is vital for holistic patient support. The 12-week caregiver-mediated rehabilitation program demonstrated effectiveness in improving physical functional recovery, underscoring its practical value for chronic stroke patients.