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Home care for stroke patients ineffective, reveals new study

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Home care

[vc_row][vc_column][vc_column_text]~By Dinesh C Sharma

New Delhi, June 28 (India Science Wire): For years, doctors in Indian hospitals have been recommending home-based care for rehabilitation of stroke patients. But a new study – largest of its kind – has revealed that this does not work.

Stroke patients require continuous care including physiotherapy to recover and minimize life-long disability. In the absence of adequate professional and affordable rehabilitation facilities, doctors often recommend care at home by family members supplemented by physiotherapist visits. Hospital-based care is also offered in various centres but is costly.

In order to study if home-based care results in desired outcomes, a study was done at 14 public, private and district hospitals across the country. A total of 1250 stroke patients were followed up over six months. The study participants were divided in two groups – one received standard package of care given by respective hospital while the other group was given home-based care which included training to family members and weekly visits by physiotherapists for two months. The results revealed that there was no reduction in disability for patients who got care at home, compared to those who received the standard package.

The findings, published in medical journal The Lancet on Tuesday, have surprised medical community because earlier studies carried out in developed countries had indicated that community-based rehabilitation played significant role in recovery of stroke patients. The World Health Organisation (WHO) too recommends such an approach.

“We found that despite extensive training in hospital and during follow up visits in the home, there was no difference in the degree of recovery or quality of life of people who received this extra treatment,” explained Professor Richard Lindley of the George Institute for Global Health and the University of Sydney, who led the study.

The study, supported by the National Health and Medical Research Council (NMHRC) of Australia, was coordinated by Christian Medical College, Ludhiana. Patients in the intervention group had access to physiotherapists who taught the family techniques such as mobility training and communication practice.

“Professional help like training and visits by physiotherapists was provided for first two months only because the intervention needed to be cost effective and sustainable. If family members required more training, then the aspiration of routinely providing rehabilitation through family caregivers might not be feasible,” pointed out Jeyaraj Pandian, neurologist from Christian Medical College, Ludhiana who led the trial. “Our training programme might not have been sufficient (in time and content) to deliver effective family rehabilitation, as we observed only about 30 minutes of daily activities in the intervention group. Conventional western rehabilitation is usually associated with greater daily therapy time.” Accredited Social Health Activist (ASHA) might have been a more effective strategy, but probably more expensive.

Dr Vijaya Nath Mishra, a neurologist at the Sir Sunderlal Hospital at BHU, Varanasi, said the results of the study are surprising. “We will have to carefully examine the evidence because we have so far believed and also observed that caregivers and family members have a major role in outcome of stroke.” Dr Mishra was not associated with the study.

It is estimated that around 1.6 million people have a stroke in India each year, yet the vast majority receive no formal rehabilitation. The whole country has just 35 stroke units, and most are in the cities, despite stroke being the third commonest cause of death in the adult population.

Professor G V S Murthy of the Indian Institute of Public Health, the Co-Chair of the study, commented, “Task shifting is increasingly seen as a solution to targeting chronic diseases in many countries in the world. But our results show it may be ineffective for some conditions and waste already limited resources. We need more rigorous examinations of such family and community led programs before they become commonplace.”

The participating hospitals included Christian Medical College, Ludhiana; Apollo Gleneagles Hospitals, Kolkata; All India Institute of Medical Sciences, New Delhi; Baptist Christian Hospital, Tezpur; Christian Medical College and Hospital, Vellore;  GNRC Hospitals, Dispur; Lalitha Super Specialty Hospital, Guntur; Nizam Institute for Medical Sciences, Hyderabad; Postgraduate Institute for Medical Sciences and Research, Chandigarh; Sree Chitra Tirunal Institute for Medical Sciences and Technology; Global Hospitals, Chennai; BGS Global Hospitals, Bangalore; Amrita Institute of Medical Sciences, Kochi and St Stephen’s Hospital, New Delhi. (India Science Wire) [/vc_column_text][/vc_column][/vc_row]

India News

Amit Shah praises Dharmendra Pradhan’s resignation, says Nation above post

Amit Shah hailed Dharmendra Pradhan’s resignation as Union Education Minister, saying BJP places the nation and students above any position while highlighting the government’s commitment to examination reforms.

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Amit Shah

Union Home Minister Amit Shah on Saturday praised Dharmendra Pradhan’s decision to step down as Union Education Minister, saying the move reflected the Bharatiya Janata Party’s commitment to placing the nation and students above any political position.

In a post on X, Shah said that for BJP workers, the country, its youth and students are more important than any office. He described Pradhan’s resignation as an example of the party’s guiding principle of prioritising national interest over personal ambition.

Shah highlights government’s focus on exam reforms

Amit Shah said the Narendra Modi-led government respects the sentiments of students and remains committed to strengthening the examination system following concerns over alleged paper leaks.

He said the Centre has introduced strict measures to ensure severe punishment for those involved in examination paper leaks and expressed confidence that these steps would deliver justice to students who cleared the National Eligibility-cum-Entrance Test (NEET).

Praises Pradhan’s work as Education Minister

Recalling Dharmendra Pradhan’s tenure, Shah highlighted several initiatives undertaken during his time in the Education Ministry. He credited Pradhan with helping implement the National Education Policy (NEP), expanding PM SHRI schools, promoting digital education, strengthening skill development and improving coordination between industry and academic institutions.

Shah also said Pradhan worked towards making examinations more inclusive and student-centric, adding that his tenure reflected his commitment to the vision of a developed India.

Resignation follows NEET controversy

Dharmendra Pradhan’s resignation comes amid nationwide protests over alleged irregularities in the NEET examination and growing demands for accountability.

The resignation has triggered political reactions across party lines. While opposition parties have described the development as a result of sustained student protests, BJP leaders have projected it as an example of accountability and commitment to national interest.

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India News

Assam flood death toll rises to 66, over 6.5 lakh people still affected

Assam’s flood situation improved slightly on Saturday, but more than 6.54 lakh people remain affected in six districts. Four fresh deaths have pushed the state’s flood toll to 66.

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Assam floods

The flood situation in Assam showed marginal improvement on Saturday, though the disaster continued to impact more than 6.54 lakh people across six districts. Four more deaths were reported during the day, taking the total number of fatalities in this year’s floods to 66.

According to the Assam State Disaster Management Authority (ASDMA), three of the latest deaths were reported from Sivasagar district, while one person lost their life in Charaideo.

The number of affected people declined from over 7.05 lakh across nine districts on Friday to 6,54,800 across six districts on Saturday, indicating a gradual improvement in the overall situation.

Sivasagar remains the worst-hit district

Among the affected districts, Sivasagar continues to be the worst hit, with nearly 2.9 lakh people impacted by the floods. Charaideo follows with around 1.9 lakh affected residents, while more than 1.3 lakh people remain affected in Jorhat.

The other districts still facing flood-related challenges are Dibrugarh, Golaghat and Nagaon.

Relief operations continue across affected areas

The ASDMA said the state administration is operating 274 relief camps and aid distribution centres across the affected districts. Around 18,902 displaced people are currently taking shelter at these facilities.

The latest daily bulletin also stated that floodwaters have inundated 810 villages across the state, while 34,970.8 hectares of agricultural land have suffered damage.

Rivers flowing above danger level

The floods have also damaged embankments, roads, bridges and other public infrastructure in several areas.

Authorities said the Dikhou River in Sivasagar and the Dhansiri River at Numaligarh are flowing above the danger level, and officials continue to closely monitor the situation.

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India News

UP Government forms new SIT led by 3 IPS officers to probe Ayodhya Ram Temple donation theft

The Uttar Pradesh government has formed a new SIT led by three IPS officers to investigate the alleged Ram Temple donation theft case in Ayodhya following Supreme Court directions.

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Ram Mandir

The Uttar Pradesh government has reconstituted a Special Investigation Team (SIT) headed by IG Kiran S, with DIG Somen Verma and SSP Dr Gaurav Grover as members, to investigate the alleged theft of donations meant for the Ram Temple in Ayodhya. 

The move comes after directions from the Supreme Court, which sought a reconstituted investigation team to ensure an independent and comprehensive probe into the allegations.

The newly formed SIT is expected to continue the investigation and submit a status report before the Supreme Court on July 27.

Senior IPS officers to lead the probe

According to the state government, the investigation will now be supervised by senior IPS officers.  The revamped SIT has been tasked with examining all aspects of the alleged embezzlement of temple donations and carrying the investigation forward.

The Supreme Court had observed that criminal investigations and technical examination of theft-related cases are more effectively handled by experienced police officers, leading to the reconstitution of the SIT under senior IPS leadership.

Probe to continue under court supervision

The case relates to the alleged embezzlement of offerings (chadhava) donated by devotees at the Shri Ram Janmabhoomi Temple in Ayodhya.

The Supreme Court is monitoring the investigation and will review the SIT’s status report at the next hearing.

Authorities are expected to continue examining evidence collected during the earlier stages of the investigation as the newly constituted SIT proceeds with the case.

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