Effects of primary caregiver participation in vestibular rehabilitation for unilateral neglect patients with right hemispheric stroke: a randomized controlled trial

Figures & data

Table 1 Study design

	Day 0	1st–2nd week	Day 14	3rd–4th week	Day 28
VR group	Pretest*	RN VR + CT	Follow-up I*	Caregiver VR + CT	Follow-up 2*
Control group	Pretest*	CT	Follow-up I*	CT	Follow-up 2*

Note:

* The outcomes measured included ADL (FIM^®), neglect (BITC), balance (PASS), and falls.

Abbreviations: VR, vestibular rehabilitation; RN, registered nurse; CT, conventional therapy; ADL, activities of daily living; FIM^®, Functional Independence Measure^®; BITC, Behavioral Inattention Test Conventional; PASS, Postural Assessment Scale for Stroke patients.

Figure 1 Flowchart of participants.

Abbreviations: n, number; VR, vestibular rehabilitation; GI, gastrointestinal.

Table 2 Summary of sample characteristics

Characteristics	VR (n = 24)		Control (n = 24)		ta/χ^2b	P
	M ± SD	n (%)	M ± SD	n (%)
Age	57.21 ± 12.23		64.54 ± 14.67		1.881a	0.066
Duration from stroke onset	56.88 ± 38.93		73.88 ± 37.86		1.533a	0.132
MMSE	19.38 ± 4.92		17.38 ± 4.14		−1.525a	0.134
Gender					0.242b	0.380
Male		16 (66.67)		12 (50.00)
Female		8 (33.33)		12 (50.00)
Participant caregiver					0.155b	0.926
Family		8 (33.33)		8 (33.33)
Nursing attendants		12 (50.00) 4		11 (45.84)
Foreign caregivers		(16.67)		5 (20.83)

Note:

a Independent t-test;

b chi-square test.

Abbreviations: VR, vestibular rehabilitation; M, mean; SD, standard deviation; n, number; MMSE, Mini-Mental State Examination.

Table 3 Comparison of the VR and the control groups in the outcome measures

Item	Day 0	Day 14	Day 28	Pa	Post hocb
	M ± SD	M ± SD	M ± SD
Neglect (BITC)
VR	49.71 ± 39.63	76.54 ± 44.04	88.71 ± 44.56	0.000	3 > 2, 1; 2 > 1c
Control	48.79 ± 44.64	60.17 ± 45.95	68.83 ± 44.72	0.000	3 > 2, 1; 2 > 1c
Pd	0.840	0.214	0.130
ADL (FIM^®)
VR	58.08 ± 20.59	71.63 ± 22.70	76.21 ± 23.08	0.000	3 > 2, 1; 2 >1c
Control	56.42 ± 20.10	61.83 ± 21.45	65.17 ± 21.55	0.000	3 > 2, 1; 2 > 1c
Pd	0.778	0.131	0.093
Balance (PASS)
VR	12.88 ± 9.09	19.29 ± 7.88	21.54 ± 7.16	0.000	3 > 2, 1; 2 > 1c
Control	14.00 ± 8.11	16.00 ± 7.43	18.04 ± 7.04	0.000	3 > 2, 1; 2 > 1c
Pd	0.653	0.143	0.094
Fall
VR	0.25 ± 0.53	0.04 ± 0.20	0.04 ± 0.20	0.080
Control	0.29 ± 0.62	0.13 ± 0.34	0.08 ± 0.28	0.123
Pd	0.804	0.306	0.561

Notes:

a One-way repeated measures ANOVA;

b post hoc: Bonferroni method;

c day 0: 1; day 14: 2; day 28: 3;

d independent t-test.

Abbreviations: VR, vestibular rehabilitation; M, mean; SD, standard deviation; BITC, Behavioral Inattention Test Conventional; ADL, activities of daily living; FIM^®, Functional Independence Measure^®; PASS, Postural Assessment Scale for Stroke patients; ANOVA, analysis of variance.

Table 4 GEE model evaluation of comparison between groups and times

Item	βa	SE	95% CI		Wald Chi-square	P
			Lower	Upper
Neglect (BITC)
Intercept	48.79	8.92	31.31	66.28	29.91	0.000
Groupb	0.92	11.93	−22.47	24.30	0.01	0.939
Time (Day 14)b	11.38	3.79	3.94	18.81	9.00	0.003
Time (Day 28)b	20.04	4.00	12.21	27.88	25.14	0.000
VR × Day 14b	15.46	6.10	3.50	27.42	6.42	0.011
VR × Day 28b	18.96	7.28	4.69	33.23	6.78	0.009
ADL (FIM^®)
Intercept	56.42	4.02	48.55	64.29	197.30	0.000
Groupb	1.67	5.75	−9.60	12.94	0.08	0.772
Time (Day 14)b	5.42	1.52	2.44	8.39	12.73	0.000
Time (Day 28)b	8.75	1.87	5.08	12.42	21.87	0.000
VR × Day 14b	8.13	3.19	1.88	14.37	6.50	0.011
VR × Day 28b	9.38	3.67	2.18	16.58	6.51	0.011
Balance (PASS)
Intercept	14.00	1.62	10.82	17.18	74.57	0.000
Groupb	−1.13	2.43	−5.90	3.65	0.21	0.644
Time (Day 14)b	2.00	0.52	0.98	3.02	14.77	0.000
Time (Day 28)b	4.04	0.82	2.44	5.64	24.44	0.000
VR × Day 14b	4.42	1.30	1.88	6.96	11.61	0.001
VR × Day 28b	4.63	1.55	1.60	7.66	8.95	0.003

Note:

a Regression coefficient;

b control group (or Day 0) is the reference.

Abbreviations: GEE, generalized estimating equations; SE, standard error; CI, confidence interval; BITC, Behavioral Inattention Test Conventional; VR, vestibular rehabilitation; ADL, activities of daily living; FIM^®, Functional Independence Measure^®; PASS, Postural Assessment Scale for Stroke patients.