Stroke
Conditions
Keywords
occupational therapy, stroke, adults, environmental modifications
Brief summary
This study evaluates a program designed to help individuals transition from inpatient rehabilitation to home following an ischemic or hemorrhagic stroke. Half of the participants will receive a stroke education program while the other half will receive an environmental modifications program.
Detailed description
A gap in care exists at the point of transition from inpatient rehabilitation (IR) to home, when survivors encounter new environmental barriers due to the cognitive and sensorimotor sequelae of stroke. Resolving these barriers and improving independence in the community have potential to significantly improve stroke survivors' long-term morbidity. Investigators will conduct a randomized, controlled multi-center trial (RCT) and concurrent implementation evaluation and review of process data to examine therapeutic efficacy, cost-effectiveness and implementation potential of a compensatory intervention (COMPASS) designed to improve daily activity performance and participation outcomes in persons transitioning home from inpatient rehabilitation (IR) following a stroke.
Interventions
BEHAVIORALCOMPASS
The data from the baseline assessment will be used to develop an environmental modification intervention plan. Environmental modifications will be installed before discharge if possible. Problem areas addressed are participant specific (tailored), but the process to identify and address the target area is systematic. All participants will receive identical intervention components. The standardized components include assessment, identification of problematic activities (and environmental barriers), identification of solutions for each problem, implementation of solution set selected by the participant, training, and active practice of daily activities in one's own home and community.
BEHAVIORALEducation Program
The control group will experience the same effects of time and attention in the home but no effect on the outcome of interest.
Sponsors
Washington University School of Medicine
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
55 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Aged ≥55 years at the time of screening * Acute stroke diagnosis (IS or ICH) verified by the stroke team or medical record * Independent in activities of daily living (ADLs) prior to stroke (premorbid Modified Rankin Scale score ≤2) * Plan to discharge to home from an IR * Capable of giving informed consent which includes compliance with the requirements and duration of participation as listed in the Informed Consent Form (ICF).
Exclusion criteria
* Life expectancy \<6 months * Cognitive impairment that the participant's stroke team or a research team member believes impairs their ability to provide informed consent or make reasoned choice including the interpretation of the self-rated scales * Any communication problem that would prevent study completion * Residence in a congregate living facility * Not eligible for a therapeutic pass * Residence outside of the designated catchment area (specific catchment distance to be determined by each site) * Site investigator's judgment that the participant would not be able to complete research procedures or interventions * Participation in another research study that in the site investigator's judgment could interfere or conflict with this research study's assessments or interventions
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Admission to SNF (skilled nursing facility) | From enrollment to 12 months post-discharge from inpatient rehabilitation facility | Date and days of admission to a skilled nursing facility |
Countries
United States
Contacts
CONTACTSusan Stark, PhD
CONTACTBrianna Holden, OTR/L
PRINCIPAL_INVESTIGATORSusan Stark, PhD
Washington University School of Medicine
Outcome results
None listed