The Effectiveness of Home-Based Therapy on Functional Outcome, Self-Efficacy and Anxiety Among Discharged Stroke Survivors

INTERVENTION: This is an assessor‐blinded randomized control trial involving two types of intervention which are HBT (experimental group) and UT (control group). Stroke survivor will be randomly allocated into HBT (experimental group) and UT (control group). The duration of the intervention is 12 weeks. Participant and their caregiver in HBT group will be given at least one training session with the researcher at Unit Physiotherapy, Cheras Rehabilitation Hospital. Exercise program consist of a total of 7 exercises which include strengthening exercise, task‐specific exercise, and balance exercise, with a total duration of 70 minutes. Exercise prescription in HBT group is followed FITT principle. FITT principle is the component of exercise prescription which includes frequency, intensity, time and type (or modality) (Billinger et al. 2014). Participants need to perform an exercise program at home 3 times a week for 12 weeks. A logbook containing exercise’s picture, instruction and intensity will be provided to the participant. Participant or caregiver needs to record the frequency of exercise in the given logbook. The researcher will contact the participant weekly to check on the progress (which will alter the intensity of the exercise), any adverse or unexpected events, and any issue(s) raised by participant or caregiver. Baseline outcome measure data will be assessed pre‐intervention and week 13 post‐intervention. caregiver define as the person who is able to provide minimal or moderate assistance to the stroke survivor in daily activities and/ or complex tasks; and able to assist stroke survivor to perform HBT. CONDITION: functional performance of stroke survivors;anxiety of stroke survivors;self efficacy level of stroke survivors; ; functional performance of stroke survivors ; anxiety of stroke survivors ; self efficacy level of stroke survivors Mental Health ‐ Anxiety Physical Medicine / Rehabilitation ‐ Physiotherapy Stroke ‐ Haemorrhagic Stroke ‐ Ischaemic PRIMARY OUTCOME: measure fall risk with Timed up and Go (TUG) Test[Pre‐Intervention, 12 weeks Post‐intervention] measure mobility status with Timed up and Go (TUG) Test[Pre‐Intervention, 12 weeks Post‐intervention] measure walking speed using Ten‐meter walk test (10‐mWT)[Pre‐Intervention, 12 weeks Post‐intervention] SECONDARY OUTCOME: measure caregiver strain level with The Modified Caregiver Strain Index ; Primary outcome[Pre‐Intervention, 12 weeks Post‐intervention] measure self‐efficacy level using The Stroke Self‐Efficacy Questionnaire (SSEQ) ; Primary outcome[Pre‐Intervention, 12 weeks Post‐intervention] screening for anxiety and depression with Hospital Anxiety and Depression Scale ; Primary outcome[Pre‐Intervention, 12 weeks Post‐intervention] INCLUSION CRITERIA: Subjects inclusion criteria in this study include: 1. Subject diagnosed with stroke 2. Stroke patient who was discharged from HOPS for more than 4 months. 3. Subject age between 60 to 85 4. Subject requiring caregiver assistance in the activity of daily living (ADL). The caregiver needs to fulfill the caregiver criteria 5. Functional ambulation categories scale > 3. Subject was able to ambulate on level surface without an assistant or only required supervision from one person. Caregiver inclusion criteria in this study include: 1. Able to read and understand native language newspaper 2. Provide minimal or moderate assistance to the stroke survivor in daily activities, such as transfer, bathing, feeding, dressing, and personal hygiene. 3. Provide moderate or dependent assistance to the stroke survivor in complex tasks, such as shopping, cleaning, driving, cooking, and laundry. 4. Able to assist stroke survivor t