This study aimed to enhance participation following stroke through a structured, community-based program. An evidence-based program was administered in three 12-week sessions including exercise and project-based activities, done as individuals and in groups .
Hours spent per week in meaningful activities outside of the home and Reintegration to Normal Living Index; Stroke-Specific Geriatric Depression Scale, Apathy Scale, gait speed, EuroQuol EQ-5D, and Preference-Based Stroke Index served as main outcome measures. All measures were transformed to a scale from 0 to 100. Assessments before randomization, following the first session at three months, six months, 12 months, and 15 months. A total of 186 persons were randomized. The between-group analysis revealed no disadvantage to waiting and so groups were combined and a within-person analysis was carried out at three time points. There were statistically significant gains in all study outcomes on average over all persons. Over 45% of people met or exceeded the pre-specified target of a three hour per week increase in meaningful activity and this most often took a full year of intervention to achieve. Greatest gains were in satisfaction with community integration (mean 4.78; 95% CI: 2.01 to 7.55) and stroke-specific health-related quality of life (mean 4.14; 95% CI: 2.31 to 5.97).
The study found community-based programs targeting participation to be feasible and effective, although stroke survivors do need time to achieve meaningful gains.