Randomized controlled trial on rehabilitation through caregiver-delivered nurse-organised service programs for disabled stroke patients in rural China (RECOVER)

RECOVER trial is to develop, implement, and evaluate an evidence-based caregiver-delivered “Early Supported Discharge (ESD)” stroke rehabilitation program designed to improve the physical functioning of disabled stroke patients in rural China. 


Stroke is the second leading cause of mortality and disability among adults worldwide. Rehabilitation is an effective treatment for stroke; however rehabilitation services are far from adequate in China, especially in rural China.


Improve the health and functioning of stroke patients, relieve caregiver burden, build capacity and task-shift within the care-delivery system, and potentially guide future programs and policies that can improve health outcomes and reduce inequities for stroke patients in resource-scarce settings.


The study will be conducted in four phases:

  1. Study preparation
  2. Pilot study
  3. Study revision
  4. Main study

The pilot study will test the feasibility of the program in Zhangwu county hospital among 60 patients for three months. The main study will test the program in two county hospitals (one in Zhangwu County, Liaoning and one in Qingtongxia County, Ningxia) among 200 patients for one year. Eligible patients will be randomized to the intervention group or control group within seven days of hospital admission.

Patients in the intervention group will receive stroke care from a family-nominated caregiver, who will be trained in ESD by a specially trained nurse and guided by an easy-to-understand rehabilitation manual.

In the main study, a nurse will monitor patient progress and care up to six times. Baseline assessments of physical functioning, quality of life, and caregiver burden will be assessed for all patients before discharge, with follow-up assessments at three months in the pilot study and three, six, and 12 months in the main study.