Stroke
Conditions
Keywords
Telemedicine, Telerehabilitation, Acute Stroke, Tai Chi, Tai Ji, Rehabilitation, Home care services, Single blind method, Randomized controlled trial
Brief summary
Telerehabilitation is a promising alternative approach that can help improve access to rehabilitation services once patients are discharged home after stroke. The investigators therefore postulate a non-inferiority hypothesis of the telerehabilitation approach compared to home visits to improve balance problem related to stroke. The platform used will be based on a technological infrastructure that was developed and tested in previous telerehabilitation studies. The study is a randomized control trial (RCT).The study population of interest will target individuals who have had a stroke who stayed in a hospital or chronic stroke population. Participants will be recruited during the hospitalization period at each of the three sites or in the community. The investigators expect to recruit 240 participants, 120 per group. The first evaluation will be conducted at recruitment to establish the baseline measures. The two other evaluations will be conducted 2 months (T2) and four months (T3) following recruitment.
Interventions
BEHAVIORALTai Chi based exercise program
A Tai Chi based exercise program that uses movement repetition favoring directional adjustments in space, supervised by a physiotherapist, has been shown to be effective in improving balance in individuals with physical impairments, including those presenting with sequelae following a stroke.
Sponsors
Université de Montréal
University of Toronto
Université de Sherbrooke
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
45 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* have had a stroke with a Rankin score of 2 or 3; * was not referred to an Intensive Functional Rehabilitation Unit (IFRU) and returned home following discharge from hospital; * understands instructions to allow participation in evaluations and interventions; * has a balance problem as evidenced by a score between 46 and 54 on the Berg Balance Scale96; * has a caregiver that would be available during the telerehabilitation sessions to ensure safety during exercises; * live in an area serviced by high speed Internet.
Exclusion criteria
* severe body hemineglect; * significant hemianopsia visual problems accompanied by hemineglect; * uncontrolled medical problems; * moderate to severe aphasia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in mobility at 2 and 4 months | before the intervention, month 2 and month 4 | Community balance and mobility Scale. |
| Change from baseline in Balance at 2 and 4 months | before the intervention, month 2 and month 4 | Community balance and mobility Scale. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline Quality of life at 2 and 4 month | before the intervention, month 2, month 4 | Quality of life: Reintegration ti normal Living Index (RNLI) |
| Change from Baseline Satisfaction with the care received at 2 and 4 months | before the intervention, month 2, month 4 | Satisfaction with the care received = Health care satisfaction questionnaire |
| Change from Baseline Cost of services from the perspective of the health system at 2 and 4 months | before the intervention, month 2, month 4 | Cost of services from the perspective of the health system = Cost-analysis of telemedicine from the Minnesota University |
| Change from baseline walking speed at 2 and 4 months | before the intervention, month 2, month 4 | Speed: Timed up and go (TUG), |
| Change from baseline aptitude for Balance at 2 and 4 months | before the intervention, month 2 and month 4 | Four-Squares Test |
| Change from baseline Strength of lower limbs at 2 and 4 months | before the intervention, month 2 and month 4 | Sit to Stand Test |
| Change from baseline Psychological Attitudes related to mobility at 2 and 4 months | before the intervention, month 2, month 4 | fear of falling: Activities-specific Balance confidence scale |
| Change from baseline walking endurance at 2 and 4 months | before the intervention, month 2 and month 4 | distance in meters walked two minutes |
| Change from baseline Psychological Attitudes related to balance at 2 and 4 months | before the intervention, month 2, month 4 | Self efficacy: General Perceived Self efficacy |
Countries
Canada
Outcome results
None listed