Implementation of Comprehensive Stroke Rehabilitation Therapy for Enhanced Quality of Life
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      The purpose of this research study is to implement into clinical practice, the comprehensive
      QualPro protocol for stroke survivors, which includes gait coordination, balance, mobility,
      and fitness training. Feasibility will be tested in the clinical environment by providing the
      intervention, measuring patient outcomes, and identifying the obstacles to insurance payment
      for the QualPro intervention. By productively addressing issues of implementation, the
      hypotheses of this study include proven feasibility in the clinical environment and
      clinically significant gains for stroke patients in the areas of strength, balance, gait
      coordination, endurance, physical function, and increased life role participation.
    

Detailed description: 
      This comprehensive intervention targets the impairments preventing recovery to normal and
      safe gait, mobility, function, and life role participation (quality of life). It has been
      tested in chronic stroke survivors and found efficacious.

      The QualPro protocol will include three phases, all of which contain components previously
      mentioned. The QualPro protocol includes implementation of gait coordination training to
      address weakness, impaired endurance, and dyscoordination. The protocol will include
      implementation of balance training for falls prevention composed of Yang style, 24-posture,
      short-form Tai Chi. Additionally, the QualPro protocol will include implementation of aerobic
      training for fitness, health, and endurance of stroke survivors, which will be composed of
      low-volume, high intensity interval training (HIIT) on a cycle ergometer. Strength exercises
      will also be included. All exercises will address weakness, impaired endurance, and
      dyscoordination.

      The long-range financial goal of this research study is to realize the cost savings of
      implementing the proposed combination of interventions that will preclude much of the very
      costly and downwardly spiraling sequellae currently observed after stroke, and that currently
      costs managed care and insurance companies an exorbitant and unnecessary amount of precious
      resources.
    

Intervention name(s): Experimental Group, Sub-Acute; Experimental Group, Chronic; Standard of Care, Sub-Acute; Standard of Care, Chronic
Intervention type(s): Other; Other; Other; Other
Intervention description(s): For the sub-acute experimental group, the intervention schedule will be as follows: six months of individual therapy five times weekly (1 - 2.5 hours/session); 6 months of 'refresher' individual therapy twice monthly (1 - 2.5 hours/session) + group therapy up to three times weekly (1 hour/session); and 1 year of group therapy, up to three times weekly (1 hour/session) + 1 'refresher' individual therapy session every 3 months for a total study duration of 2 years.; For the chronic experimental group, the intervention schedule will be as follows: six months of individual therapy five times weekly (1 - 2.5 hours/session); 6 months of 'refresher' individual therapy twice monthly (1 - 2.5 hours/session) + group therapy up to three times weekly (1 hour/session); and 1 year of group therapy, up to three times weekly (1 hour/session) + 1 'refresher' individual therapy session every 3 months for a total study duration of 2 years.; This group will receive standard of care stroke rehabilitation therapy.; This group will receive standard of care stroke rehabilitation therapy.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: stroke; stroke rehabilitation; stroke therapy