Please select the eligibility criteria that correspond to the clinical trial below.
Title: Optimizing Stroke Family Caregiver Support Across the Care Continuum by Improving the Timing of Intervention Delivery
Brief Summary: About 50% of stroke survivors have limitations in their activities of daily living on return to the community. Family caregivers provide invaluable support to these individuals during their recovery and rehabilitation. Unfortunately, there is no standard clinical practice to prepare caregivers for this role and, as a result, many experience stress and poor health that can compromise stroke survivor recovery and threaten the sustainability of the care needed to thrive in their home. To address this gap, the investigators have developed the Timing it Right Stroke Family Support Program that aims to meet the evolving needs of caregivers. The objective of this multi-province randomized controlled trial is to determine if this program delivered across the stroke care continuum improves caregivers' sense of being supported and emotional well-being. Ultimately this program could be used by stroke care programs from across Canada.


Options:
A: Inclusion Criteria:

* age ≥ 18 years
* Stroke onset \> 6 months prior to study enrollment
* upper extremity hemiparesis with impairment of hand and/or arm
* minimal function of the hand (at least 10º active wrist extension, at least 10º active of thumb abduction/extension, and at least 10º of extension two additional fingers)
* non-professional coach (e.g. family member)
* prescription of physical or occupational therapy

Exclusion Criteria:

* lack of knowledge of German
* serious impairment of verbal communication ability (e.g. severe aphasia)
* inability to consent (e.g. dementia)
* severe neuro-cognitive deficits (MMSE \<23)
* terminal illness, life-threatening co-morbidity
* simultaneous participation in another treatment study targeting stroke recovery
* subjects may not have already received constraint induced movement therapy
B: Inclusion Criteria:

* diagnosis of first unilateral stroke
* Patients who score between 3.2 and 5.2 on the Orpington Prognostic Scale
* Patients participating in a physiotherapy programme
* Patients willing to give informed written consent
* Patients with family willing to participate in their assigned physiotherapy intervention programme

Exclusion Criteria:

* hemiplegia of a non-vascular origin
* discharged from hospital less than two weeks following stroke
* pre-existing neurological disorder
* any lower limb orthopaedic condition that may limit exercise capacity
* aphasia
* cognitive impairment
* not willing to give written consent
C: Inclusion Criteria:

1. Age ≥ 40 years;
2. Recent stroke (defined as stroke symptoms occurring within 4 weeks prior to admission into community hospitals);
3. Diagnosis of stroke made by clinician and/or supported by brain imaging;
4. Able to sit unsupported for 30 seconds;
5. Able to stand on the non-paretic leg for \>4 sec;
6. Able to walk at least 2m with maximum of 1 person assist;
7. Able to follow a 3-step command;
8. Living in the community before discharge and expected to be discharged home;
9. Has a caregiver.

Exclusion Criteria:

1. Has a pacemaker in-situ (because of possible interference of pacemakers by wireless electronic signals);
2. Unable to ambulate at least 150 feet prior to stroke, or intermittent claudication while walking less than 200 meters;
3. Serious cardiac conditions (hospitalization for myocardial infarction or heart surgery within 3 months, history of severe congestive heart failure, serious and unstable cardiac arrhythmias, hypertrophic cardiomyopathy, severe aortic stenosis, angina or dyspnea at rest or during activities of daily living);
4. History of serious chronic obstructive pulmonary disease or oxygen dependence;
5. Severe weight bearing pain;
6. Pre-existing neurological disorders such as Parkinson's disease, Amyotrophic Lateral Sclerosis (ALS), Multiple Sclerosis (MS) or severe dementia
7. History of major head trauma with severe residual deficits;
8. Lower extremity amputation;
9. Legal blindness or severe visual impairment;
10. Severe uncontrolled psychiatric illness such as psychosis, schizophrenia or medication refractory depression;
11. Life expectancy less than three months;
12. Severe arthritis or orthopedic problems that limit passive ranges of motion of lower extremity (knee flexion contracture of \> 10°, knee flexion ROM \< 90°, hip flexion contracture \> 25°, and ankle plantar flexion contracture \> 15°);
13. History of sustained alcoholism or drug abuse in the last six months;
14. Hypertension with systolic blood pressure greater than 200 mmHg and diastolic blood pressure greater than 110 mmHg at rest, that cannot be medically controlled into the resting range of 180/100 mmHg.
D: Inclusion Criteria:

* Participants must speak and read English and be the primary family caregiver of a person who is receiving care for their first hospitalization for an ischemic or hemorrhagic stroke and whose anticipated ultimate destination after discharge is a private residence or apartment building.
* Stroke survivors must exhibit at least minimal disability (i.e., are referred to at least one rehabilitation health care professional during acute care). They may be admitted to short or long-duration inpatient (maximum duration of 6 months) or outpatient rehabilitation or return directly home.

Exclusion Criteria:

* Caregivers of terminally ill stroke survivors or of survivors discharged to complex continuing care, long-term care or assisted retirement residences.

Answer: D