Virtually Assisted Home Rehabilitation After Acute STroke (VAST-rehab)

Study Overview
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Brief Summary
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The purpose of this study is to investigate the feasibility of a virtual education and virtual visit program in engaging patients with rehabilitation at home after stroke.

Official Title
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Virtually Assisted Home Rehabilitation After Acute STroke (VAST-rehab)

Conditions
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Stroke

Intervention / Treatment
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* Other: Telerehabilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Informed consent provided by the subject or legally authorized representative. Occurrence of a hemorrhagic or ischemic stroke pre-stroke mRS less than 3 Qualifying Stroke Event must be confirmed by CT or MRI Recommended to participate in self-guided or in-person rehabilitation activities by a physician or rehabilitation therapist Must have sufficient cognitive and language abilities to comprehend verbal commands and to carry out the study assessments Able to access the internet via a personal device Exclusion Criteria: . History of neurological or other disease resulting in significant functional impairment (e.g.Parkinson's disease, motor neuron disease, moderate dementia, arthritis,contractures or fixed anatomical abnormality). Subjects with a severe comorbid disorder that has reasonable likelihood of limiting survival to less than 6 months. Any other conditions that, in the opinion of the investigators, would preclude safe and/or effective participation.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Telerehabilitation<br> | Other: Telerehabilitation<br>* Education based telerehab with rehabilitation therapists providing education on home exercises and stroke specific information<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility as assessed by number of participants that completed all scheduled visits. |  | end of study(12 weeks form baseline) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Functional independence as assessed by the Functional Independence Measure (FIM) | This is an 18 item questionnaire and each is scored from 1(complete dependence on helper) to 7(complete independence), a higher number indicating more independence | Baseline, end of study (about 13-14 weeks after baseline) | 
| Patient-Specific Functional Scale | This tool allows for Subjects to self report activities of daily living that have been affected by stroke and rate severity of impact on these activities. This is scored from 0(unable to perform activity) to 10(able to perform activity at the same level as before injury or problem) | Baseline, end of study (about 13-14 weeks after baseline) | 
| Change in impact of stroke as assessed by the Stroke Impact Scale (SIS) | This is a A 59 item questionnaire whereby subjects identify the impact of stroke on strength, hand function, mobility, activities of daily living, memory, communication, emotion, and handicap. Item responses are scored on a 5-point Likert-style scale. A score of 1 = an inability to complete the item and a score of 5 = no difficulty experienced at all. A standardized score ranging from 0 to 100 is calculated for all domains, with higher scores indicating a higher quality of life | Baseline, end of study (about 13-14 weeks after baseline) | 
| Change in quality of life as assessed by the EuroQol-5-5level scale (EQ-5D-5L) | A self reporting, quality of life measurement that asks Subjects to rate their severity of problems related to mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. There are 5 questions in the first section and each question is scored from 0-5,a higher number indicating a worse outcome .There is a visual scale at the end that is scored from 0(worst health) to 100(best health), higher number indicating better outcome . . | Baseline, end of study (about 13-14 weeks after baseline) | 
| Change in cognitive impairment as assessed by the Short Montreal Cognitive Assessment(s-MoCA) | 8 item questionnaire ,with a possible score of 1-5, a lower number indicating higher cognitive impairment | Baseline, end of study (about 13-14 weeks after baseline) | 
| Change in performance in activities of daily living as assessed by the Barthel Index | This is a scoring technique that measures performance in ten activities of daily living including feeding, wheelchair to bed transfers, grooming ,chair to toilet transfers, walking, using stairs, dressing, and continence of bowels and bladder. This is a 10 item questionnaire and is scored from 0-100, a higher score indicating higher level of independence. | Baseline, end of study (about 13-14 weeks after baseline) | 
| Change in symptoms related to stroke as assessed by the National Institute of Health Stroke Scale(NIHSS) | the score for each ability is a number between 0(normal functioning) to 4(completely impaired). The score is calculated by adding the number for each element of the scale with a highest score of 42, a higher score meaning more impairment. | Baseline, end of study (about 13-14 weeks after baseline) | 
| Change in degree of disability or dependence as measured by the Modified Rankin Score(mRS) | mRS is a 6 point disability scale with possible scores from 0(no disability) to 5(disability requiring constant care) a higher score indicating more disability | Baseline, end of study (about 13-14 weeks after baseline) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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rehabilitation