Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Increasing Access to Community-based Task-oriented Exercise Programs Through Healthcare-recreation Partnerships to Improve Function Post-stroke: Feasibility of a 2-group Randomized Controlled Trial Protocol
Brief Summary: After a stroke, people find it difficult to perform everyday activities independently, like getting dressed, preparing meals, and shopping, limiting their independence and requiring the assistance of a family member, friend or a home care worker. Losing one's independence can decrease quality of life. Functional exercise classes run by physical therapists where people with stroke practice getting in and out of a chair, stepping, and walking, can improve the ability to balance, walk, and do everyday activities. These classes are not commonly available in community centres, mainly because fitness instructors do not receive training in how to run exercise classes for people with stroke. Therefore there is a need to make these functional exercise programs available in local community centres.

The objective of this project is to test procedures for running a large study to see whether people with stroke improve their ability to do everyday activities after participating in functional group exercise classes for 12 weeks in local community centres. If ability to do everyday activities improves, the investigators wish to see if the improvement is still present 3, 6 and 9 months later. Physical therapists at a nearby hospital will teach fitness instructors how to run the exercise class, help out during the classes, and answer questions by email or phone. Before conducting the larger Canada-wide study, it is important to determine the interest in such a program, the acceptability of the evaluations and the costs associated with the program, the degree of improvements resulting from the program, and if fitness instructors are able to run the program as planned.

In Toronto, London and Pembroke, Canada, managers at a hospital and a nearby recreation centre have agreed to help run the exercise program. A recruiter will ask people with stroke who can walk and are being discharged home from the hospital whether they can be called about the study. People with stroke and a caregiver who agree to participate in the study will complete four evaluations when they enter the study, and 3, 6, and 12 months later. At each evaluation, people with stroke will perform tests of balance and walking, and complete questionnaires about their mood, participation in valued activities, and quality of life. After the first evaluation, the investigators will use a process like flipping a coin, to see if the person with stroke will begin the exercise program immediately or 12 months later. The investigators will call people each month to ask if a fall occurred. The investigators will interview exercise participants, family members and hospital/recreation staff at the end of the study to ask about the experiences.

This project is unique because the program combines the expert knowledge and skills of physical therapists and fitness instructors. The exercise program involves practicing everyday movements, making the exercises easy for fitness instructors and people with stroke to learn. Each exercise has multiple levels of difficulty so the instructor can adapt exercises to how the person is feeling. The exercise program does not require expensive equipment (e.g. chairs, stepping stools) and therefore can be offered in most community centres. Finally, an extensive network of hospitals providing stroke care and community centres run by recreation organizations exists in Canada. Thus, if this program is beneficial, it could easily be made widely available.

With the number of Canadians living with the consequences of stroke increasing every year, access to a functional exercise programs in local community centres will improve their ability to function and live independently in the community and reduce the burden on family or caregivers and on the healthcare system.


Options:
A: Arm Label: Experimental Group; Type: EXPERIMENTAL; Interventions: Behavioral: Together in Movement and Exercise (TIME) Program | Arm Label: Wait-listed Control Group; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: BEHAVIORAL; Name: Together in Movement and Exercise (TIME) Program; Assigned to Arm(s): Experimental Group
B: Arm Label: Active tDCS + robotic therapy + physical therapy; Type: ACTIVE_COMPARATOR; Interventions: Device: Robotic Therapy, Device: Active tDCS, Other: Physical Therapy | Arm Label: sham tDCS + robotic therapy + physical therapy; Type: ACTIVE_COMPARATOR; Interventions: Device: Robotic Therapy, Device: Sham tDCS, Other: Physical Therapy | Arm Label: sham tDCS + physical therapy + occupational therapy; Type: EXPERIMENTAL; Interventions: Device: Sham tDCS, Other: Physical Therapy, Other: Occupational Therapy | Intervention Type: DEVICE; Name: Robotic Therapy; Assigned to Arm(s): Active tDCS + robotic therapy + physical therapy, sham tDCS + robotic therapy + physical therapy | Intervention Type: DEVICE; Name: Active tDCS; Assigned to Arm(s): Active tDCS + robotic therapy + physical therapy | Intervention Type: DEVICE; Name: Sham tDCS; Assigned to Arm(s): sham tDCS + physical therapy + occupational therapy, sham tDCS + robotic therapy + physical therapy | Intervention Type: OTHER; Name: Physical Therapy; Assigned to Arm(s): Active tDCS + robotic therapy + physical therapy, sham tDCS + physical therapy + occupational therapy, sham tDCS + robotic therapy + physical therapy | Intervention Type: OTHER; Name: Occupational Therapy; Assigned to Arm(s): sham tDCS + physical therapy + occupational therapy
C: Arm Label: tDCS + robotic arm therapy; Type: EXPERIMENTAL; Interventions: Device: Transcranial Direct Current Stimulation (tDCS) | Arm Label: tDCS sham + robotic arm therapy; Type: PLACEBO_COMPARATOR; Interventions: Device: Placebo sham | Intervention Type: DEVICE; Name: Transcranial Direct Current Stimulation (tDCS); Assigned to Arm(s): tDCS + robotic arm therapy | Intervention Type: DEVICE; Name: Placebo sham; Assigned to Arm(s): tDCS sham + robotic arm therapy
D: Arm Label: Vojta arm; Type: EXPERIMENTAL; Interventions: Other: Vojta therapy | Arm Label: conventional physiotherapy arm; Type: ACTIVE_COMPARATOR; Interventions: Other: conventional physiotherapy | Intervention Type: OTHER; Name: Vojta therapy; Assigned to Arm(s): Vojta arm | Intervention Type: OTHER; Name: conventional physiotherapy; Assigned to Arm(s): conventional physiotherapy arm

Answer: A