Taking Charge of Stroke Rehabilitation

Stroke is New Zealand’s second most common cause of death and the leading cause of serious adult disability. Each year, New Zealanders experience a stroke at a rate of around one every 45 minutes.

Until recently there have been no proven effective treatments that improve important outcomes such as independence and quality of life once someone is discharged from hospital after a stroke.

The development and testing through large clinical trials of the ‘Take Charge’ intervention — a low-cost high-impact rehabilitation programme that supports a person to control their own stroke recovery — is a major international achievement for the MRINZ. In the programme’s initial clinical trials, all participants and the researchers who delivered the study interventions were Māori and Pacific Peoples. These unique trials show that goal-oriented selfrehabilitation after a stroke makes all the difference, enabling patients to achieve positive recovery outcomes.

The ‘Take Charge’ programme is more effective than standard rehabilitation for improving stroke outcomes, including quality of life and independence. Rehabilitation teams around the world are now using this approach in stroke and other conditions, and in indigenous communities.

Often clinicians are tasked with deciding when to start dialysis therapy. This landmark study gives reassurance that there is no benefit in starting dialysis early and that indeed, starting early may lead to risk of long-term kidney injury. The long-held assumption that starting dialysis early helps critically ill patients with acute kidney injury, should now be laid to rest.