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Title:	Effectiveness of autogenic relaxation training in addition to usual physiotherapy in improving emotional state, functional ability and quality of life of stroke survivors
Authors:	Deepak Thazhakkattu Vasu (P85859)
Supervisor:	Nor Azlin Mohd Nordin, Assoc. Prof. Dr.
Keywords:	Autogenic Training Stroke Anxiety Depression Universiti Kebangsaan Malaysia -- Dissertations Dissertations, Academic -- Malaysia
Issue Date:	29-Aug-2022
Description:	The most common post-stroke emotional dysfunctions are anxiety and depression, are characterized by low motivation, which negatively influence the recovery of functions following stroke. There is a need for an integrated intervention, preferably therapistsmediated during rehabilitation therapy, to actively engage the stroke survivors in the initial stage of the post-stroke phase to enhance the functional recovery. Autogenic Relaxation Training (ART) is a simple, self-administered exercise found to produce positive effects on various conditions; however, very few studies are available on the effects of ART in the stroke population. Thus, this experimental study aimed to evaluate the feasibility and outcomes of ART in addition to usual physiotherapy on stroke survivor's emotional state, functional level, and quality of life. This study has two phases: 1. Evaluation of the feasibility of integrated ART in the physiotherapy rehabilitation program for stroke survivors. This phase consists of a one-group experimental pilot study involving 14 stroke survivors (mean age of 59 ±12.12 years) for a duration of 6 weeks. The intervention's feasibility was assessed via feedback from the participants, physiotherapists, and researchers who were involved in this study. 2. Evaluation of the effect of ART in addition to usual physiotherapy on emotional state, functional level, and quality of life, compared to usual physiotherapy alone. For this phase, a total of 66 stroke survivors (mean age of 49.48 ± 8.54 years) were enrolled, and a block randomization method was used to assign the subjects either into an experimental group (ART-added physiotherapy) or a control group (usual physiotherapy) for 12 weeks. The intervention outcomes were assessed using the Hospital Anxiety and depression scale (HADS-A and HADS-D) for emotional state, Modified Barthel Index (MBI) for functional level, and EuroQol 5 dimensions 5 level (EQ-5D-5L) for the quality of life of the participants. Data analysis was done based on the intention-to-treat approach, using the mixed model ANOVA test. All intervention group participants in both phases received 20 minutes of ART (supervised session) followed by 40 minutes of usual physiotherapy once a week, and they were requested to carry out the intervention at home twice per week. Results of phase 1 shown that the intervention is feasible to both the treating physiotherapists and the stroke survivors with no adverse events reported. In phase two, statistically significant time effects were observed for the HADS-A (p<0.01, ηp2=0.514), HADSD (p<0.01, ηp2=0.817), MBI (p<0.01, ηp2=0.587) and EQ5D5L (p<0.001, ηp2=0.969). The group effects were also significant for all outcomes; HADS-A p<0.01, ηp2=0.286, HADS-D p<0.01, ηp2=0.272, BI, p=0.001, ηp2=0.162 and EQ5D5L, p=0.013, ηp2=0.093. The experimental group showed a greater percentage of improvement than the control group in HADS-A (38.61% versus 16.09%,), HADS-D (45.93% versus 22.21%), EQ5D5L (25% versus 18.18%) except for MBI (6.54% versus 12.29%). The time-group interaction effects in all outcome variables are also statistically significant; with the effect size ranging from 0.08 to 0.24. The study findings suggest that adding ART into usual physiotherapy is a feasible and effective approach in improving stroke survivors' emotional state, functional level, and quality of life,Ijazah Doktor Falsafah
Pages:	145
Publisher:	UKM, Kuala Lumpur
Appears in Collections:	Faculty of Health Sciences / Fakulti Sains Kesihatan

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