Stroke Clinical Trial
Official title:
Effectiveness of a Rehabilitation Exercise Plan at Home to Treat Post-stroke Patients in the Chronic Phase
Background: Stroke is the second leading cause of death worldwide and the primary medical cause of disability. It is estimated that 45% of affected individuals will continue to have moderate or severe functional disabilities throughout their lives. According to the American Stroke Association, telerehabilitation has the potential to provide timely and efficient care to stroke survivors, improving patients' functional outcomes while reducing long-term disability and associated costs. Hypothesis: Through the developed application (Muvity), the study aims to contribute to the validity of telerehabilitation and virtual reality as beneficial tools for rehabilitation, specifically for individuals in the post-stroke sequelae phase. Objectives: To evaluate the effectiveness of a non-immersive virtual reality program in telerehabilitation for patients who have experienced a stroke more than 6 months ago. Methodology: Prospective longitudinal study with single blinding. The control group undergoes a conventional intervention, while the experimental group undergoes an innovative intervention (n=25). Variables: The collected variables and measurement tools include upper extremity functionality (Fugl-Meyer scale), balance (Berg), functional independence (Barthel), pain (Brief Pain Inventory), post-stroke quality of life (ECVI-38), emotional health (UCLA Self-Rating Depression Scale), treatment expectations (Expectation for Treatment Scale), treatment adherence (through an APP), and satisfaction (Telehealth Usability Questionnaire). Statistical Analysis: Data will be analyzed per protocol (PP); the normality distribution of the data will be assessed, and results will be analyzed using parametric or non-parametric techniques depending on normality. A bivariate analysis will compare results between the control and intervention groups, considering a statistically significant result when p < 0.05. Expected Results: Similar results are expected between groups or slightly favorable outcomes in the experimental group for the different variables. Applicability and Relevance: The application would facilitate access to motor rehabilitation treatments in an enjoyable and engaging manner, promoting physical activity and contributing to a healthy lifestyle. Upon obtaining the results of this study, a trial implementation of the application in five socio-sanitary or associative centers is planned to verify its final applicability.
Status | Recruiting |
Enrollment | 50 |
Est. completion date | March 2025 |
Est. primary completion date | December 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 85 Years |
Eligibility | Inclusion Criteria: - Age: between 18 and 85 years old. - Stroke duration of more than six months + Discharge from post-stroke rehabilitation. - Moderate physical disability: scoring between 1-3 on the Modified Rankin Scale. - Standing: able to stand safely for 2 minutes without support (maximum score -4- on item 2 of the Berg Scale). - Vision: capable of correctly visualizing a screen at a distance of 2 meters. - Cognitive status: No cognitive impairment or mild cognitive impairment (Mini-Mental State Examination score = 24). Ability to understand and follow verbal instructions in Catalan or Spanish. - Technological skills: capable of basic use of a mobile phone and computer (keyboard, mouse, screen). - Glenohumeral joint mobility: minimum of 30º flexion, abduction, horizontal abduction; and 15º internal and external rotation. - Elbow joint mobility: minimum of 45º flexion. Exclusion Criteria: - Engaging in intense physical therapies. - Severe aphasia: inability or difficulty communicating through speech. - Cognitive impairments affecting short and mid-term memory. - Vision: having visual deficits in either eye that may impair screen visualization. - Vision: experiencing hemispatial neglect, meaning difficulty processing stimuli on the side opposite to the injury. |
Country | Name | City | State |
---|---|---|---|
Spain | Universitat Politècnica de Catalunya | Barcelona | |
Spain | Associació Disminuïts Físics d'Osona | Vic | Barcelona |
Lead Sponsor | Collaborator |
---|---|
Universitat Politècnica de Catalunya | Associació Disminuïts Físics d'Osona, Consorci Hospitalari de Vic, EAP Vic (CAP Remei), Institut Català de la Salut |
Spain,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Fugl-Meyer | Standard Fugl-Meyer score to assess motor functionality. Sections A (upper limbs, up to 36 points), D (coordination, up to 6 points), H (sensation, up to 6 points), I (joint movement (up to 16 points), and J (joint pain, up to 16 points). The total score could be up to 80 points (the higher score, the higher functionality). | Within one week before and within one week after the treatments for both groups. | |
Primary | Berg score | The Standard Berg Balance Scale is used to assess balance control. Scores range from 0 (equilibrium heavily affected) to 56 (excellent equilibrium capacity). | Within one week before and within one week after the treatments for both groups. | |
Primary | Brief Pain Inventory | Standard score to assess joint pain. It consists of 11 questions related to pain intensity. A score of 0 indicates pain absence, and 10 high pain intensity. | Within one week before and within one week after the treatments for both groups. | |
Primary | Ranges of motion | The ranges of motion of upper and lower limb joint angles are computed before and after the treatments for both control and intervention groups during the assessment face-to-face sessions. This information is also gathered for the intervention group during the 12-week treatment. | Within one week before and within one week after the treatment for both groups and during the 12-week treatment for the intervention group. | |
Secondary | Ranges of motion | The ranges of motion of upper and lower limb joint angles are computed before and after the treatments for both control and intervention groups during the assessment face-to-face sessions. This information is also gathered for the intervention group during the 12-week treatment | During the 12-week treatment for the intervention group. | |
Secondary | Time spent for the rehabilitation sessions | The time spent for the rehabilitation sessions is monitored for both groups (by a simple mobile app for the Control group and by Muvity for the intervention group) | During the 12-week treatment for the intervention group. | |
Secondary | ECVI-38 | Quality of life is monitored by the standard test ECVI-38. This stands for "Escala de calidad de vida para el ictus" (ECVI) in Spanish (Quality of Life Scale for Stroke), It ranges between 0 (no impairment) to 100 (maximum impairment). | Within one week before and within one week after the 12-week treatment | |
Secondary | UCLA Self-Rating Depression Scale | Self-rating depression score. It ranges between 3 (low perception of loneliness) to 9 (high perception of loneliness). | Within one week before and within one week after the 12-week treatment |
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