Integrating Complementary Practices into Caregiver Training for Community Stroke Rehabilitation: A Pre–Post Study in Thailand

Background: After formal rehabilitation, Thai stroke survivors often depend on community caregivers who may lack training for ongoing recovery. Integrating culturally familiar complementary practices into caregiver education could strengthen home-based rehabilitation. This study aimed to develop a caregiver health program integrating complementary medicine for stroke care and evaluate its effects on caregiver knowledge and patient functional ability in the community. Methods: This two-phase study was conducted in Pathum Thani, Thailand. Phase I involved community-based participatory development, including stakeholder engagement, situational analysis, focus groups, and a workshop. Phase II was a single-group pre–post quasi-experimental trial. Twenty caregivers completed a 5-day training program and implemented the intervention at home for 12 weeks. Patient functional ability (Barthel ADL Index) and caregiver knowledge were assessed pre- and post-intervention. Data were analyzed using descriptive statistics and Wilcoxon Signed Rank Tests. Results: Twenty caregiver-patient pairs enrolled; one pair withdrew; 19 were included in analysis. Caregiver knowledge improved from 3.75 ± 1.48 to 8.20 ± 1.51 (Δ= +4.45; p < 0.001). Patient ADL improved, with mild dependence increasing (68.5 to 73.7%) and total dependence decreasing (10.5 to 5.3%). Significant gains were observed in toileting, stair climbing (p = 0.03) and dressing (p = 0.05). Conclusions: A community-based, integrative caregiver program was feasible and improved caregiver knowledge and several ADL domains in stroke survivors over 12 weeks. Embedding complementary practices within structured training and follow-up may enhance continuity of post-stroke care in community settings. Keywords: Stroke, Caregivers, Integrative medicine, Community-based rehabilitation, Thailand.