None listed
Conditions
Brief summary
This study aims to compare an individualised, repetitive computer-based therapy program delivered using the AbleX with a conventional therapist-facilitated task-specific practice program on upper limb (UL) function and quality of life (QoL) for patients with acute stroke. To achieve this aim, the following objectives will be considered. 1. To compare change in UL function of patients with UL motor impairment post stroke between the intervention and control groups. 2. To compare change in patient QoL between the intervention and control groups. 3. To compare the amount of completed UL therapy repetitions between the intervention and control groups. 4. To compare the amount of required direct therapist time between the intervention and control groups. Research question: How effective is virtual reality (VR) at improving UL function and patient QoL when delivered as an adjunct to conventional UL therapy in the acute stage of recovery post stroke? Hypothesis: It is hypothesised that UL rehabilitation incorporating the AbleX will improve patient UL function and QoL when compared to conventional upper limb therapy alone.
Interventions
The intervention will be set-up by accredited Occupational Therapists (OTs) working within a regional public hospital and trained in standardisation of the intervention. Therapists will work with participants across both the acute stroke unit and subacute rehabilitation wards. Participants in the experimental group will receive 30 minutes of conventional therapist-facilitated task-specific practice for the upper limb as well as 30 minutes of individualised computer-based upper limb rehabilitatio
The intervention will be set-up by accredited Occupational Therapists (OTs) working within a regional public hospital and trained in standardisation of the intervention. Therapists will work with participants across both the acute stroke unit and subacute rehabilitation wards. Participants in the experimental group will receive 30 minutes of conventional therapist-facilitated task-specific practice for the upper limb as well as 30 minutes of individualised computer-based upper limb rehabilitation using the AbleX. The AbleX is a computer-based therapy tool that consists of games and activities accessed using a handheld controller or armskate for patients with more severe arm weakness. Therapists will engage in collaborative goal setting and functional task analysis to personalise specific rehabilitation routines for their patients based on the available activities and games within the AbleX computer-based program. An example of a game that may be undertaken as part of AbleX includes solitaire with the use of the AbleX handlebar to click, move and release cards appropriately on the computer screen. Therapists will also engage in collaborative goal setting and functional task analysis to set-up personalised conventional upper limb therapy routines as part of the conventional upper limb therapy completed. An example of an activity that may be undertaken as part of conventional task-specific practice includes patients using their affected upper limb to stack cones in order to improve arm coordination and strength. Once participants are appropriately set-up with their programs, these may be subsequently delegated to the Allied Health Assistants (AHA’s) and/or OT students. Both groups will perform their respective programs five days a week (Monday to Friday) via semi-supervised practice for the duration of their inpatient stay. Both 30 minute components can be completed within the same 1 hour period or separated and completed at any time of the day. Both groups will perform their respective programs for the duration of their inpatient stay or until their upper limb function is deemed to have plateaued by an OT. An audit of the participants medical record / chart will be undertaken fortnightly by an OT or research assistant to monitor adherence.
Sponsors
Georgia Parsons - OT Toowoomba Hospital Subacute Rehabilitation Ward
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1) Diagnosis of acute stroke confirmed by magnetic resonance imaging and/or computed tomography brain scan received within less than three months 2) Mild-moderate upper limb motor impairment as determined by a score of 23-53 on the upper extremity subscale of the Fugl-Meyer Assessment of Motor Recovery after Stroke (UE-FMA) completed by an occupational therapist (OT) 3) Score of 24 or greater on the Mini-Mental State Examination indicating adequate cognition and communication for participation
Exclusion criteria
1) Comorbidities that contraindicate upper limb rehabilitation or exercise 2) Pre-existing/chronic upper limb impairment 3) Severe hemispatial neglect identified through completion of the Visual Perceptual Screen 4) Been given a palliative diagnosis
Outcome results
None listed