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Telerehabilitation After Stroke Using Readily Available Technology: A Randomized Controlled Trial.


ABSTRACT:

Background

The number of people living with stroke has increased demand for rehabilitation. A potential solution is telerehabilitation for health care delivery to promote self-management. One such approach is the Augmented Community Telerehabilitation Intervention (ACTIV). This structured 6-month program uses limited face-to-face sessions, telephone contact, and text messages to augment stroke rehabilitation.

Objective

To investigate whether ACTIV improved physical function compared with usual care.

Methods

This 2-arm, parallel randomized controlled trial was conducted in 4 New Zealand centers. Inclusion criteria were patients with first-ever stroke, age >20 years, and discharged home. A blinded assessor completed outcome measurement in participants' homes at baseline, postintervention, and 6 months postintervention. Stratified block randomization occurred after baseline assessment, with participants allocated to ACTIV or usual care control.

Results

A total of 95 people were recruited (ACTIV: n = 47; control: n = 48). Postintervention intention-to-treat analysis found a nonsignificant difference between the groups in scores (4·51; P = .07) for physical function (measured by the physical subcomponent of the Stroke Impact Scale). The planned per-protocol analysis (ACTIV: n = 43; control: n = 48) found a significant difference in physical function between the groups (5·28; P = .04). Improvements in physical function were not maintained at the 12-month follow-up.

Conclusions

ACTIV was not effective in improving physical function in the ACTIV group compared with the usual care group. The per-protocol analysis raises the possibility that for those who receive more than 50% of the intervention, ACTIV may be effective in preventing deterioration or even improving physical function in people with stroke, in the period immediately following discharge from hospital.

SUBMITTER: Saywell NL 

PROVIDER: S-EPMC7739128 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Telerehabilitation After Stroke Using Readily Available Technology: A Randomized Controlled Trial.

Saywell Nicola L NL   Vandal Alain C AC   Mudge Suzie S   Hale Leigh L   Brown Paul P   Feigin Valery V   Hanger Carl C   Taylor Denise D  

Neurorehabilitation and neural repair 20201116 1


<h4>Background</h4>The number of people living with stroke has increased demand for rehabilitation. A potential solution is telerehabilitation for health care delivery to promote self-management. One such approach is the Augmented Community Telerehabilitation Intervention (ACTIV). This structured 6-month program uses limited face-to-face sessions, telephone contact, and text messages to augment stroke rehabilitation.<h4>Objective</h4>To investigate whether ACTIV improved physical function compar  ...[more]

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