iPad Technology for HOME Rehabilitation in Patients After Stroke: iHOME Acute/Chronic
Condition: Fine Motor Function Deficit and Visual Neglect Post-stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      A pilot randomized, two parallel group study comparing an iPad software game application
      versus standard care in post-stroke patients.

      Study hypothesis: Tablet PC technology using the iPad is a feasible and potentially
      efficacious tool which has the potential to promote fine motor recovery of the upper
      extremity after stroke.
    

Detailed description: 
      The standard one hour of out-patient rehabilitation is insufficient in providing the
      repetitive intense training required for rehabilitation of fine motor recovery. There are
      also limited interventions are available for home use after discharge from a rehabilitation
      centre. Hence, there is now a need to determine the feasibility of innovative strategies for
      home use, to cover the gap after discharge from rehabilitation institutions.

      iHOME is an original, low cost, potentially high impact intervention to fulfil this gap. If
      proven to be effective, the use of tablet technology has a broad range of potential outcomes
      and benefits. The anticipated public benefit is for stroke patients to be able to potentially
      employ the iPad, an accessible technological device, as an expansion of rehabilitation in an
      in-home setting.

      iHOME is a pilot randomized controlled trial with a blinded outcome assessment. The trial is
      subdivided into iHOME Acute and iHOME Chronic, where patients have had a stroke less than 3
      months or more than 6 months ago, respectively, at the time of randomization. Participants
      will be randomly allocated in a 1:1 ratio to the interventions arms (i.e. the investigational
      and control group).
    

Intervention name(s): iPad Intervention; Standard/ Usual Care
Intervention type(s): Other; Other
Intervention description(s): Patients are to self-administer 20 minutes of gaming sessions, in any configuration that is preferred. Patients will be instructed to play the iPad game with the more affected arm/hand. Start and stop times of the iPad intervention will be downloaded from the iPad, which will allow calculation of the total "dose" received. Patients may receive outpatient rehabilitation as required as part of usual care.
The 'Stroke Rehab' software for the iPad was specifically designed for patients with either fine motor weakness and/or neglect. It contains 6 stages:
Popping a stationary balloon
Popping a moving balloon
Popping a pair of stationary balloons
Popping a pair of moving balloons
Stretching a balloon to pop
Balloon/Text distraction test; Patients may receive outpatient rehabilitation as required as part of usual care. Patients will be instructed not to play with an iPad during the 2 week intervention period (in case they have one).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Other
Keywords: Stroke Rehabilitation; iPad; Fine Motor Function; Ischemic Stroke; Visual Neglect