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Family-led rehabilitation after stroke in India: the ATTEND trial, study protocol for a randomized controlled trial

Alim, Mohammed; Lindley, Richard; Felix, Cynthia; Gandhi, Dorcas Beulah Chandramathy; Verma, Shweta Jain; Tugnawat, Deepak Kumar; Syrigapu, Anuradha; Anderson, Craig Stuart; Ramamurthy, Ramaprabhu Krishnappa; Langhorne, Peter; Murthy, Gudlavalleti Venkata Satyanarayana; Shamanna, Bindiganavale Ramaswamy; Hackett, Maree Lisa; Maulik, Pallab Kumar; Harvey, Lisa Anne; Jan, Stephen; Liu, Hueiming; Walker, Marion; Forster, Anne; Pandian, Jeyaraj Durai


Mohammed Alim

Richard Lindley

Cynthia Felix

Dorcas Beulah Chandramathy Gandhi

Shweta Jain Verma

Deepak Kumar Tugnawat

Anuradha Syrigapu

Craig Stuart Anderson

Ramaprabhu Krishnappa Ramamurthy

Peter Langhorne

Gudlavalleti Venkata Satyanarayana Murthy

Bindiganavale Ramaswamy Shamanna

Maree Lisa Hackett

Pallab Kumar Maulik

Lisa Anne Harvey

Stephen Jan

Hueiming Liu

Marion Walker

Anne Forster

Jeyaraj Durai Pandian


Background: Globally, most strokes occur in low- and middle-income countries, such as India, with many affected people having no or limited access to rehabilitation services. Western models of stroke rehabilitation are often unaffordable in many populations but evidence from systematic reviews of stroke unit care and early supported discharge rehabilitation trials suggest that some components might form the basis of affordable interventions in low-resource settings. We describe the background, history and design of the ATTEND trial, a complex intervention centred on family-led stroke rehabilitation in India.
Methods/design: The ATTEND trial aims to test the hypothesis that a family-led caregiver-delivered home-based rehabilitation intervention, designed for the Indian context, will reduce the composite poor outcome of death or dependency at 6 months after stroke, in a multicentre, individually randomized controlled trial with blinded outcome assessment, involving 1200 patients across 14 hospital sites in India.
Discussion: The ATTEND trial is testing the effectiveness of a low-cost rehabilitation intervention that could be widely generalizable to other low- and middle-income countries.


Alim, M., Lindley, R., Felix, C., Gandhi, D. B. C., Verma, S. J., Tugnawat, D. K., …Pandian, J. D. (2016). Family-led rehabilitation after stroke in India: the ATTEND trial, study protocol for a randomized controlled trial. Trials, 17(13),

Journal Article Type Article
Acceptance Date Dec 17, 2015
Publication Date Jan 7, 2016
Deposit Date Oct 27, 2016
Publicly Available Date Oct 27, 2016
Journal Trials
Electronic ISSN 1745-6215
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 17
Issue 13
Keywords Caregivers, Costs, Disability, Rehabilitation, Stroke
Public URL
Publisher URL


110 ATTEND Protocol Alim et al Trials 2016.pdf (687 Kb)

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