None listed
Conditions
Brief summary
Having a stroke is a life-changing event. Many survivors are left with significant impairments that affect their long-term independence. For many, this can limit their participation in activities which they enjoyed before their stroke. In metropolitan Australia, stroke patients receive an average of 42 days of therapist-guided stroke rehabilitation. Many people in regional and rural areas receive much less. Environmental enrichment is the combination of physical, cognitive and social activities. Previous experimental models of stroke have shown that this can increase brain plasticity, which is an important process for re-learning skills and function after stroke. Group-based (peer-supported) programs can provide a sense of community through sharing information, providing tools for coping, and creating an outlet for stroke survivors and caregivers. This may contribute to improved physical function and psychological outcomes after stroke. The aim of the project, “ Exercising, Socialising and Thinking: an Environmental Enrichment Model (ESTEEM) After Stroke", is to build a sustainable group program based on environmental enrichment for use in community venues by stroke survivors and their carers. The ESTEEM Program has been co-produced in collaboration with people with lived experience of stroke including stroke survivors, carers, health professionals and service providers. Overall ESTEEM project hypothesis: We hypothesise that, compared to stroke survivors receiving usual care in the community, stroke survivors who receive the model of environmental enrichment will have greater physical function and quality of life.
Interventions
A wait-list randomised controlled-trial (RCT) (n=270) will be employed to test the effectiveness of the ESTEEM Program when delivered by three community-based care providers, across the Hunter New England LHD.
Stroke survivors and their carers recruited to ESTEEM at all sites will be randomly allocated to either the intervention (Program) group, or a wait-list control group.
The intervention is attending the ESTEEM Program: 150mins of activities, twice per week for 10 weeks. The ESTEEM Program
A wait-list randomised controlled-trial (RCT) (n=270) will be employed to test the effectiveness of the ESTEEM Program when delivered by three community-based care providers, across the Hunter New England LHD. Stroke survivors and their carers recruited to ESTEEM at all sites will be randomly allocated to either the intervention (Program) group, or a wait-list control group. The intervention is attending the ESTEEM Program: 150mins of activities, twice per week for 10 weeks. The ESTEEM Program is run through community based care providers at a community venue of their choice, and is delivered in a group setting with 10-12 participants per session. Each session consists of: * 30 minutes of physical activity (for example sit-to-stand, march on the spot, toe taps), * 30 minutes of socialising and sharing experiences over morning tea, and * 90 minutes of creative (art-based) thinking activities (either dancing, or learning visual arts skills). Throughout the 10 weeks, participants will be offered the opportunity to participate in both aspects of the creative thinking activities (dancing or visual arts). All three components are run at each session and participants are encouraged to participate in all activities, though will not be forced. Each component of the Program will be delivered by an appropriately qualified professional, such as a physiotherapist for the exercise component and a qualified instructor of arts or music for the creative thinking activities. The ESTEEM Program service team will include a program coordinator to support administration and coordination of participant experience in the program. Demographics of and the characteristics describing stroke survivor and carer stroke journeys will be collected on entry into the study (baseline). Health outcomes will be collected from consenting stroke survivors and their carers pre (baseline, 0 weeks), immediately after (post, 10 weeks) and then three months after completion of the ESTEEM Program (3 month follow-up (FU) 24 weeks). Adverse events will be monitored during time on trial for stroke survivors.
A wait-list randomised controlled-trial (RCT) (n=270) will be employed to test the effectiveness of the ESTEEM Program when delivered by three community-based care providers, across the Hunter New England LHD.
Stroke survivors and their carers recruited to ESTEEM at all sites will be randomly allocated to either the intervention (Program) group, or a waitlist control group.
The intervention is attending the ESTEEM Program: 150mins of activities, twice per week for 10 weeks (minimum "dosage" of
A wait-list randomised controlled-trial (RCT) (n=270) will be employed to test the effectiveness of the ESTEEM Program when delivered by three community-based care providers, across the Hunter New England LHD. Stroke survivors and their carers recruited to ESTEEM at all sites will be randomly allocated to either the intervention (Program) group, or a waitlist control group. The intervention is attending the ESTEEM Program: 150mins of activities, twice per week for 10 weeks (minimum "dosage" of the intervention is considered to be 16 sessions over the 10 weeks). The ESTEEM Program is run through community based care providers at a community venue of their choice, and is delivered in a group setting with 10-12 participants per session. Each session consists of: * 30 minutes of physical activity (for example sit-to-stand, march on the spot, toe taps), * 30 minutes of socialising and sharing experiences over morning tea, and * 90 minutes of creative (art-based) thinking activities (either dancing, or learning visual arts skills). Throughout the 10 weeks, participants will be offered the opportunity to participate in both aspects of the creative thinking activities (dancing or visual arts). All three components are run at each session and participants are encouraged to participate in all activities, though will not be forced. Each component of the Program will be delivered by an appropriately qualified professional, such as a physiotherapist for the exercise component and a qualified instructor of arts or music for the creative thinking activities. The ESTEEM Program service team will include a program coordinator to support administration and coordination of participant experience in the program. Demographics of and the characteristics describing stroke survivor and carer stroke journeys will be collected on entry into the study (baseline). Health outcomes will be collected from consenting stroke survivors and their carers pre (baseline, 0 weeks), immediately after (post, 10 weeks) and then three months after completion of the ESTEEM Program (3 month follow-up (FU) 24 weeks). Adverse events will be monitored during time on trial for stroke survivors.
Sponsors
University of Newcastle
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
(i) stroke survivors who meet the following inclusion criteria: • Agreeing (and intending) to participate in the 10-week ESTEEM Program; • Community dwelling adults aged 18 years or older who have experienced a stroke event, not living in a residential care facility; • Have the cognitive and communicative capacity to provide informed consent and follow instructions as determined by the referring health professional; • Ability to stand independently or with the assistance of one person; • Ability to use the washroom independently or with a support person who is able to attend the ESTEEM Program; and • Medically fit (i.e., without absolute contraindications to exercise and able to attend and participate in group exercise (i.e., no co-morbidities preventing regular exercise). A medical clearance may be requested by the Chief Investigator to meet this criteria. (ii) carers of stroke survivors participating in the ESTEEM Program research, who assist with activities of the survivors daily living will be asked to participate in the research. A carer is defined according to The Carers (Recognition) Act 2010, No 20. Under this Act, a person is a carer if the person is an individual who provides ongoing personal care, support and assistance to any other individual who needs it because that other individual: (a) Is a person with disability within the meaning of the Disability Inclusion Act 2014, or (b) Has a medical condition (including a terminal or chronic illness), or (c) Has a mental illness, or (d) is frail and aged. Under this act, a person is not a carer if the care, support and assistance that the person provides is: (a) Under a contract of service or a contract for the provision of services, or (b) In the course of doing voluntary work for a charitable, welfare or community organisation, or (c) As part of the requirements of a course of education or training. To avoid doubt, a person is not a carer of another person for the purposes of this Act merely because the person: (a) Is the spouse or de facto partner of the person, or (b) Is the parent, guardian, child or other relative of the other person, or (c) Lives with the other person. (iii) community-based care workers who are employed by NGO's that are delivering or plan to deliver the ESTEEM Program, including but not limited to those who provide/plan to provide the ESTEEM Program as well as program managers, directors of service delivery and CEOs with the NGO.
Exclusion criteria
Exclusion for stroke survivors: * Have not previously participated in any previous phase of the ESTEEM After Stroke Research Program * are not currently participating in another stroke or rehabilitation trial AND i) receiving a stroke recovery intervention or ii) due to commence a stroke recovery intervention within the next 6 months (on trial and awaiting follow-up assessment permitted). * severe comorbid medical illness, neurological condition, psychiatric illness, or other medical diagnosis deemed by the Chief Investigator to make a participant unlikely to be able to fully participate in all study procedures including attendance at the intervention and/or participation in all research assessment procedures.
Outcome results
None listed