• Matire Harwood, Mark Weatherall, Api Talemaitoga, P Alan Barber, John Gommans, William Taylor, Kathryn McPherson, and Harry McNaughton.
• Medical Research Institute of New Zealand, Wellington, New Zealand.
• Clin Rehabil. 2012 Jun 1; 26 (6): 493-501.

ObjectiveFew community interventions following stroke enhance activity, participation or quality of life. We tested two novel community interventions designed to promote self-directed rehabilitation following stroke.DesignThis was a randomized, controlled parallel group 2×2 trial.SettingCommunity.ParticipantsMaori and Pacific New Zealanders, >15 years old, randomized within three months of a new stroke.InterventionsA DVD of four inspirational stories by Maori and Pacific people with stroke and a 'Take Charge Session'--a single structured risk factor and activities of daily living assessment, designed to facilitate self-directed rehabilitation.Main MeasuresPrimary outcomes were Health-related Quality of Life (Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the Short Form 36 (SF-36)) 12 months from randomization. Secondary outcomes were Barthel Index, Frenchay Activities Index, Carer Strain Index and modified Rankin score.ResultsOne hundred and seventy-two people were randomized with 139 (80.8%) followed up at 12 months post randomization. The effect of the Take Charge Session on SF-36 PCS at 12 months was 6.0 (95% confidence interval (CI) 2.0 to 10.0) and of the DVD was 0.9 (95% CI -3.1 to 4.9). Participants allocated to the Take Charge Session were less likely to have a modified Rankin score of >2 (odds ratio (OR) 0.42, 95% CI 0.2 to 0.89) and their carers had lower (better) Carer Strain Index scores (-1.5, 95% CI -2.8 to -0.1).ConclusionA simple, low-cost intervention in the community phase of stroke recovery aiming to promote self-directed rehabilitation improved outcomes.

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