Virtually Assisted Home Rehabilitation After Acute Stroke-2

The University of Texas Health Science Center, Houston15 enrolled

Overview

The purpose of this study is to assess feasibility of a virtual rehabilitation program in stroke patients and to assess treatment effects, patient goal attainment with self-guided rehabilitation activities, barriers to and facilitators of telerehab, hospital readmission events, and social determinants of health

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Stroke

Interventions

Telerehabilitation (VAST 2)OTHER

The telehealth platform will be available by a web secure link accessible on a home computer or loaded on user friendly tablets that are customized for the patient's impairments. Telerehabilitation services will include 2 out of 3 disciplines: Occupational Therapy, Speech Therapy, Physical Therapy. All therapy interventions will be delivered by licensed therapists and will be based on patients' specific impairments and goals. Therapy intervention will be provided 3x/wk. for each of 2 disciplines. The intervention will be going on for 4 weeks which will total to 24 sessions. Self-management support with trained health coach will be integrated into 1 therapy session each week. An additional individual 30 minute session will occur with the health coach each week.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Informed consent provided by the subject or legally authorized representative. * Diagnosed with hemorrhagic or ischemic stroke * Pre-stroke mRS is less than 3 * Qualifying Stroke Event must be confirmed by CT or MRI * Recommended to participate in self-guided or in-person rehabilitation activities by a physician or rehabilitation therapist * Must have sufficient cognitive and language abilities to comprehend verbal commands and to carry out the study assessments * Able to access the internet * Mild-moderate impairments in motor or cognitive function Exclusion Criteria: * History of neurological or other disease resulting in significant functional impairment (e.g. Parkinson's disease, motor neuron disease, moderate dementia, arthritis, contractures or fixed anatomical abnormality). * Subjects with a severe comorbid disorder that has reasonable likelihood of limiting survival to less than 6 months. * Any other conditions that, in the opinion of the investigators, would preclude safe and/or effective participation.

Locations (1)

The University of Texas Health Science Center at Houston

Houston, Texas, United States

Outcomes

Primary Outcomes

The experience of the participant measured by the participant experience surveys

Time frame: end of study (about 10 weeks after baseline)

Number of participants that completed all scheduled visits.

Time frame: end of study (about 10 weeks after baseline)

Secondary Outcomes

Change in impact of stroke as assessed by the Stroke Impact Scale (SIS)

This is a A 59 item questionnaire whereby subjects identify the impact of treatment on strength, hand function, mobility, activities of daily living, memory, communication, emotion, and handicap. Item responses are scored on a 5-point Likert-style scale. A score of 1 = an inability to complete the item and a score of 5 = no difficulty experienced at all. A standardized score ranging from 0 to 100 is calculated for all domains, with higher scores indicating a higher quality of life

Time frame: Baseline, end of intervention (about 5 weeks after baseline)

Change in quality of life as assessed by the Short Form (SF-12)health questionnaire

This is a health related quality of life questionnaire consisting of twelve questions that measure eight health domains to assess physical and mental health. Scores range from 0 to 100, with higher scores indicating better physical and mental health functioning

Time frame: Baseline, end of intervention (about 5 weeks after baseline)

Change in cognitive impairment as assessed by the Montreal Cognitive Assessment (MoCA)

Total score on the Montreal Cognitive Assessment (MoCA) range from 0 to 30, with a higher score indicating a better outcome.

Time frame: Baseline, end of intervention (about 5 weeks after baseline)

Change in depression as assessed by the Patient Health Questionnaire (PHQ8)

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.

This is an 8 item questionnaire and each is scored from 0-24 a higher number indicating more depression

Time frame: Baseline, end of intervention (about 5 weeks after baseline)

Change in disability as assessed by the Modified Rankin Scale (mRS)

This scale is scored from 0(no symptoms at all) to 6 (dead), with a higher score being the worst outcome

Time frame: Baseline, end of intervention (about 5 weeks after baseline)

Patient goal attainment with self-guided rehabilitation activities as assessed by the Goal Attainment Measure for Stroke (GAMS).

This is a 4-point scale for multiple aspects of goal attainment Total scale scores range from high of 8 to a low of 0, with higher scores indicating goal attainment

Time frame: week 2

Patient goal attainment with self-guided rehabilitation activities as assessed by the Goal Attainment Measure for Stroke (GAMS).

This is a 4-point scale for multiple aspects of goal attainment Total scale scores range from high of 8 to a low of 0, with higher scores indicating goal attainment

Time frame: week 3

Patient goal attainment with self-guided rehabilitation activities as assessed by the Goal Attainment Measure for Stroke (GAMS).

This is a 4-point scale for multiple aspects of goal attainment Total scale scores range from high of 8 to a low of 0, with higher scores indicating goal attainment

Time frame: week 4

Patient goal attainment with self-guided rehabilitation activities as assessed by the Goal Attainment Measure for Stroke (GAMS).

This is a 4-point scale for multiple aspects of goal attainment Total scale scores range from high of 8 to a low of 0, with higher scores indicating goal attainment

Time frame: week 5

Patient goal attainment with self-guided rehabilitation activities as assessed by the Goal Attainment Measure for Stroke (GAMS).

This is a 4-point scale for multiple aspects of goal attainment Total scale scores range from high of 8 to a low of 0, with higher scores indicating goal attainment

Time frame: week 10

Type of technology used by stroke patients as assessed by a questionnaire

Data will be reported categorically as number who use each type of technology, including cell phone, smart phone, tablet, laptop, and desktop.