CARE4STROKE: Caregiver mediated exercises with E-health support to improve intensity of training after stroke.

The CARE4STROKE programme consists of 8 weeks of complementary exercise therapy done with a caregiver, next to the usual therapy. Thirty-one standardized exercises are available, that can be customized per patient and caregiver to the individual situation. The exercises can be presented in a book version with photos and text or in a smartphone/ tablet app with video's and voiceover. The exercises are aimed at improving skills related to walking ability like sitting, standing and making transfers, or are supporting exercises to improve mobility, strength and balance. The patient and their caregiver are asked to do the exercises for the length of 8 weeks, minimally 5 times a week for 30 minutes. Additionally, participants in the intervention group will wear the fitbit for the length of 8 weeks after randomization. The fitbit activity monitor is a portable lightweight clip-on device which aims to empower and encourage activity by provided real-time feedback on e.g. number of steps taken, distance covered and number of calories burned. During the 8-week intervention period patients and their caregiver will have a weekly session (approximately 30 min) with a trained therapist. In this session, the participating couple will be instructed as to which exercises should be performed safely during the next week and evaluate the exercises done last week. The programme starts when the patient is admitted to hospital. When the discharge date of the patient is earlier than the finishing of the programme, the programme continues at home (up to 8 weeks from randomisation). Tele-rehabilitation services will allow for instructions of the physical therapists including monitoring progress of patients by e-Health services including telephone conferencing based counselling (frequency as required) and weekly visits by a coordinating physical therapist from the setting of discharge.