None listed
Conditions
Brief summary
Stroke is a major cause of disability. Loss of movement is a major part of this. Studies show that high doses of rehabilitation therapy can reduce disability, but many patients do not receive this, e.g., due to obstacles such as difficulty accessing care. Our collaborator (Dr. Steven C. Cramer at the University of California at Cal. Rehab) has previously found that telerehabilitation is an effective way to deliver care and improve outcomes. These prior studies were performed after hospital discharge when patients were already back at home. The current study aims to extend this work by introducing telerehabilitation to the bedside of patients admitted to an inpatient rehabilitation facility (Osborne Park Hospital). In this study, we will measure issues and effects of telerehabilitation that is started during the rehab admission. We hypothesize that telerehabilitation started early after stroke is feasible and that participants will experience an improvement in their function.
Interventions
In this study participants will train for 8 sessions of 45min time on task on a telerehabilitation system (TRCare). The sessions contain upper limb exercises, games and stroke education. Half of the sessions are supervised by a member of the research team. Patients will complete this study whilst being an inpatient. Half of the sessions will be supervised one-on-one either in-person or virtually with a HIPPA compliant video conference software. Half of the sessions will be unsupervised. The res
In this study participants will train for 8 sessions of 45min time on task on a telerehabilitation system (TRCare). The sessions contain upper limb exercises, games and stroke education. Half of the sessions are supervised by a member of the research team. Patients will complete this study whilst being an inpatient. Half of the sessions will be supervised one-on-one either in-person or virtually with a HIPPA compliant video conference software. Half of the sessions will be unsupervised. The research team can monitor online how long patients have been using the system in order to track adherence to the protocol. A therapist will design the treatment schedule online (via the TRCare portal) and revise the schedule after 1 week. The difficulty of the exercises will be set for each patient individually. Difficulty can be changed for example by offering more difficult levels of the games (such as whac-a-mole) on the device, or by using stiffer therabands in the physical exercises. Stroke education will be provided with a set of predetermined multiple choice questions, developed by clinicians working with TRCare.
Sponsors
Edith Cowan University
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age 18 years or older 2. Stroke that has been radiologically verified 3. Arm motor FM score <56 (out of 66) at Visit 1 4. Box & Block Test score with affected arm is at least 3 blocks in 60 seconds at Visit 1 5. Informed consent signed by the subject 6. Admitted to Osborne Park Hospital for stroke rehabilitation
Exclusion criteria
1. A major, active, coexistent neurological or psychiatric disease, e.g., alcohol dependency or dementia 2. A major medical disorder that substantially reduces the likelihood that a participant will be able to comply with all study procedures 3. Significant cognitive impairment, defined as Montreal Cognitive Assessment score < 22 (a lower score is permitted if due to aphasia and if the patient is specifically allowed by study PI)) 4. Deficits in communication that interfere with reasonable study participation 5. Lacking visual acuity, with or without corrective lens, of 20/40 or better in at least one eye 6. Life expectancy < 6 months 7. Pregnant 8. Receipt of Botox to arms, legs, or trunk in the preceding 6 months, or expectation that Botox will be administered to the arm, leg, or trunk within 3 months of study enrolment 9. Unable to successfully perform all 3 of the rehabilitation exercise test examples 10. Unable or unwilling to perform study procedures/therapy or attend study visits, or expectation of noncompliance with study procedures/therapy 11. Does not speak sufficient English to comply with study procedures
Outcome results
None listed