TY - JOUR AU - Lindley R. AU - Langhorne P. AU - Maulik P. AU - Walker M. AU - Harvey L. AU - Anderson Craig AU - Alim M. AU - Liu H AU - Hackett M AU - Pandian J. AU - Felix C. AU - Gandhi D. AU - Verma S. AU - Murthy G. AU - Forster A. AU - Tugnawat D. AU - Syrigapu A. AU - Ramamurthy R. AU - Shamanna B. AU - Jan Stephen AB -

BACKGROUND: Globally, most strokes occur in low- and middle-income countries, such as India, with many affected people having no or limited access to rehabilitation services. Western models of stroke rehabilitation are often unaffordable in many populations but evidence from systematic reviews of stroke unit care and early supported discharge rehabilitation trials suggest that some components might form the basis of affordable interventions in low-resource settings. We describe the background, history and design of the ATTEND trial, a complex intervention centred on family-led stroke rehabilitation in India. METHODS/DESIGN: The ATTEND trial aims to test the hypothesis that a family-led caregiver-delivered home-based rehabilitation intervention, designed for the Indian context, will reduce the composite poor outcome of death or dependency at 6 months after stroke, in a multicentre, individually randomized controlled trial with blinded outcome assessment, involving 1200 patients across 14 hospital sites in India. DISCUSSION: The ATTEND trial is testing the effectiveness of a low-cost rehabilitation intervention that could be widely generalizable to other low- and middle-income countries. TRIAL REGISTRATION: Clinical Trials Registry-India CTRI/2013/04/003557 . Australian New Zealand Clinical Trials Registry ACTRN12613000078752 . Universal Trial Number U1111-1138-6707.

AD - Research and Development, George Institute for Global Health India, Unit 301, Second Floor ANR Centre, Road No 1, Banjara Hills, Hyderabad, Telangana, India. malim@georgeinstitute.org.in.
The George Institute for Global Health, Sydney, Australia. rlindley@georgeinstitute.org.au.
Sydney Medical School, University of Sydney, Sydney, Australia. rlindley@georgeinstitute.org.au.
Christian Medical College, Ludhiana, Punjab, India. cfelix@georgeinstitute.org.in.
Christian Medical College, Ludhiana, Punjab, India. dorcasattend@gmail.com.
Christian Medical College, Ludhiana, Punjab, India. sjvmv1947@gmail.com.
Indian Institute of Public Health, Hyderabad, India. deepak.k@iiphh.org.
Indian Institute of Public Health, Hyderabad, India. anuradha.s@iiphh.org.
The George Institute for Global Health, Sydney, Australia. canderson@georgeinstitute.org.au.
Sydney Medical School, University of Sydney, Sydney, Australia. canderson@georgeinstitute.org.au.
Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia. canderson@georgeinstitute.org.au.
Department of Physiotherapy, Father Muller Medical College, Mangalore, India. physioram2002@gmail.com.
University of Glasgow, Glasgow, UK. Peter.Langhorne@glasgow.ac.uk.
Indian Institute of Public Health, Hyderabad, India. murthy.gvs@iiphh.org.
School of Medical Sciences, University of Hyderabad, Gachibowli, Hyderabad, India. brsham@gmail.com.
The George Institute for Global Health, Sydney, Australia. mhackett@georgeinstitute.org.au.
Sydney Medical School, University of Sydney, Sydney, Australia. mhackett@georgeinstitute.org.au.
University of Central Lancashire, Preston, Lancashire, UK. mhackett@georgeinstitute.org.au.
Research and Development, George Institute for Global Health India, Unit 301, Second Floor ANR Centre, Road No 1, Banjara Hills, Hyderabad, Telangana, India. pmaulik@georgeinstitute.org.in.
The George Institute for Global Health, Oxford University, Oxford, UK. pmaulik@georgeinstitute.org.in.
Sydney Medical School, University of Sydney, Sydney, Australia. lisa.harvey@sydney.edu.au.
The George Institute for Global Health, Sydney, Australia. sjan@georgeinstitute.org.
Sydney Medical School, University of Sydney, Sydney, Australia. sjan@georgeinstitute.org.
The George Institute for Global Health, Sydney, Australia. hliu@georgeinstitute.org.au.
Sydney Medical School, University of Sydney, Sydney, Australia. hliu@georgeinstitute.org.au.
University of Nottingham, Nottingham, UK. marion.walker@nottingham.ac.uk.
University of Leeds, Leeds, UK. a.forster@leeds.ac.uk.
Christian Medical College, Ludhiana, Punjab, India. jeyarajpandian@hotmail.com. BT - Trials C2 - PMC4704425 DA - 93562401117 DP - NLM ET - 2016/01/08 LA - eng LB - AUS
INDIA
NMH
PROF
FY16 M1 - 1 N1 - Alim, Mohammed
Lindley, Richard
Felix, Cynthia
Gandhi, Dorcas Beulah Chandramathy
Verma, Shweta Jain
Tugnawat, Deepak Kumar
Syrigapu, Anuradha
Anderson, Craig Stuart
Ramamurthy, Ramaprabhu Krishnappa
Langhorne, Peter
Murthy, Gudlavalleti Venkata Satyanarayana
Shamanna, Bindiganavale Ramaswamy
Hackett, Maree Lisa
Maulik, Pallab Kumar
Harvey, Lisa Anne
Jan, Stephen
Liu, Hueiming
Walker, Marion
Forster, Anne
Pandian, Jeyaraj Durai
England
Trials. 2016 Jan 7;17(1):13. doi: 10.1186/s13063-015-1129-8. N2 -

BACKGROUND: Globally, most strokes occur in low- and middle-income countries, such as India, with many affected people having no or limited access to rehabilitation services. Western models of stroke rehabilitation are often unaffordable in many populations but evidence from systematic reviews of stroke unit care and early supported discharge rehabilitation trials suggest that some components might form the basis of affordable interventions in low-resource settings. We describe the background, history and design of the ATTEND trial, a complex intervention centred on family-led stroke rehabilitation in India. METHODS/DESIGN: The ATTEND trial aims to test the hypothesis that a family-led caregiver-delivered home-based rehabilitation intervention, designed for the Indian context, will reduce the composite poor outcome of death or dependency at 6 months after stroke, in a multicentre, individually randomized controlled trial with blinded outcome assessment, involving 1200 patients across 14 hospital sites in India. DISCUSSION: The ATTEND trial is testing the effectiveness of a low-cost rehabilitation intervention that could be widely generalizable to other low- and middle-income countries. TRIAL REGISTRATION: Clinical Trials Registry-India CTRI/2013/04/003557 . Australian New Zealand Clinical Trials Registry ACTRN12613000078752 . Universal Trial Number U1111-1138-6707.

PY - 2016 SN - 1745-6215 (Electronic)
1745-6215 (Linking) EP - 13 T2 - Trials TI - Family-led rehabilitation after stroke in India: the ATTEND trial, study protocol for a randomized controlled trial VL - 17 Y2 - FY16 ER -