Feedback and Rewards to Increase Motivation for Therapy in Stroke Rehabilitation

Study Overview
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Brief Summary
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High motivation is a predictor for good therapy results in physical therapy [Grahn 2000]. The investigator want to show that it is possible to increase patients motivation for stroke rehabilitation by providing them objective performance feedback about the patients therapy progress.

Detailed Description
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High motivation is a predictor for good therapy results in physical therapy [Grahn 2000]. Additional focus on motivation and rewards has fallen on the topic of stroke rehabilitation since it was shown in an animal model that the brain centers involved with motivation and rewards are crucial to motor learning [Hosp 2011]. The investigators goal is to target the overall motivation for therapy. During the guided therapy sessions the therapists will be the main motivators and the investigators do not want to interfere with that. But the amount of guided therapy sessions is often limited due to economical reason rather than therapeutic ones. Therefore patients are encouraged to do training on their own if possible and to be active during the patients stay in the rehabilitation clinic. The investigators target the patients motivation to train by themselves and be active but also the patients attitude towards the guided therapies. It is known that performance feedback can improve motivation [Harackiewicz 1979]. Therefore the investigators want to use the data about therapy progress to produce feedback for patients visualizing the patients progress and efforts during the patients stay in the clinic. The investigators will compare patients who receive normal therapy to patients who receive normal therapy plus performance feedback regarding a variety of motivation measures.

Official Title
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Feedback and Rewards to Increase Motivation for Therapy in Stroke Rehabilitation

Conditions
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Stroke

Intervention / Treatment
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* Other: Performance Feedback


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: First time Inpatient at the Cereneo rehabilitation clinic Exclusion Criteria: Rey-Figur Kopie <= 25 AND Rechnerisches Denken WIE <=5 Becks Depression Inventar (BDI) > 17 Major aphasia preventing understanding of study materials (according to the treating physician).
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: Health Services Research
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: No intervention group<br>Patients in stroke rehabilitation receiving standard therapy | |
| Active Comparator: Intervention group<br>Patients in stroke rehabilitation receiving standard therapy plus performance feedback | Other: Performance Feedback<br>* Performance Feedback regarding the patients efforts and accomplishments during the patients stay in the rehabilitation clinic, an expected average of 6 weeks. The data available about the patients progress will be analysed and processed to create a visual illustration shown to the patient on a daily bases.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Motivation | Weekly: Intrinsic Motivation Inventory Questionnaire | Weekly for the duration of the participants stay at the hospital an expected average of 6 weeks | 
| Motivation | Motivation rating of patients regarding the foregoing therapy session by therapists | After each therapy session for the duration of the participants stay at the hospital an expected average of 6 weeks | 
| Motivation | Time patient spends on self administered training | Continuous for the duration of the participants stay at the hospital an expected average of 6 weeks | 
| Motivation | Amount of activities (walking, stair climbing) during free time | Continuousfor the duration of the participants stay at the hospital an expected average of 6 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinical scores (e.g. Fugl-Meyer Score) | Standard quality assessments of the study site (rehabilitation clinic) | When decided by therapists for the duration of the participants stay at the hospital an expected average of 6 weeks |