Cerebrovascular Accident Clinical Trial
Official title:
Home-Based Tele-Health Stroke Care: A Randomized Trial for Veterans
The purpose of the proposed study is to examine a Tele-rehabilitation (TR) intervention that uses tele-health technology to improve outcomes of stroke patients after discharge to home. The primary aim is to determine the effect of TR on physical function, and secondarily to determine the effect on disability, falls-related self-efficacy, and patient satisfaction.
Stroke patients clearly benefit from intensive, coordinated, inpatient care. At the same
time, there is considerable interest in ways to reduce hospital lengths of stay. Early
discharge rehabilitation programs require coordinated, well-organized home-based
rehabilitation, and lack of sufficient information about the home setting impedes successful
rehabilitation. Unfortunately, resources for in-home rehabilitation are limited. The goal of
TR is to improve functional mobility using a multifaceted rehabilitation intervention via
two types of telehealth technology. Tele-video is used to carry out an in-home assessment of
functional mobility, to make treatment recommendations, and to provide periodic
goal-oriented reassessment, modifying the treatment plan as the patient improves. Tele-video
uses a video camera with a home health aide in the patient's home to provide visual and
audio to a therapist located at the base hospital. It is used to carry out an in-home
assessment of functional mobility, to make treatment recommendations, and to provide
periodic goal-oriented reassessment, modifying the treatment plan as the patient improves.
An interactive, in-home messaging device is used to facilitate adherence with treatment
recommendations and to screen for interval problems (depression, falls, and difficulty with
self-care).
This is a Phase II, 2-arm, 3-site Randomized Controlled Trial (RCT). A total of 120 veterans
with recent onset of ischemic or hemorrhagic stroke who are discharged to the community will
be randomly assigned to one of two groups: (a) TR; and (b) Usual Care. Dependent variables
(physical function, disability, falls-related self-efficacy, and patient satisfaction) will
be measured at baseline, 3-, and 6-months via telephone interviews by the study coordinator
located at the CIEBP who will be blinded to the study group assignment of the patient.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Open Label, Primary Purpose: Treatment
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