A Randomised Controlled Trial of Family Mediated Exercises (FAME) Following Stroke

Study Overview
=================
Brief Summary
-----------------
The aim of the study is to evaluate the functional recovery in two groups of primary stroke patients presenting with moderate/severe disability over a six month period through the implementation of a randomised controlled trial. The first group or the experimental group will receive routine therapy and additional lower limb exercise therapy in the form of family assisted exercises. The second group or the control group will receive routine therapy with no additional formal input from their family members. A secondary aim of the project is to evaluate the impact of the FAME programme on the person with stroke and the individual (s) assisting in the delivery of exercises.

Detailed Description
-----------------
Participants with primary stroke eligible for inclusion to the study at 2 weeks post stroke will be randomised into either a 'control' group that will receive routine therapy or an 'experimental' group that will receive routine therapy AND additional 'family mediated exercise therapy. Training will be provided to the nominated family member (s)/friends of participants in the 'intervention' group on a weekly basis by the research physiotherapist (R1). Family members/friends will be requested to keep an exercise diary on a daily basis to document completion of exercises. The trial will continue for eight weeks with an expectation that at least 1200 additional minutes of FAME therapy will be delivered over this time period. Each FAME session is expected to last 35-40 minutes. Exercises will include repetitive sit to stand exercises with an emphasis on improving symmetry, weight bearing exercises during standing, bridging, straight leg raises, quadriceps strengthening exercises, active/active assisted range of movement exercises for the lower limb and walking. Outcome will be assessed by a blinded outcome assessor (R2) on entry to the study, at eight weeks (post-intervention) and again three months post-intervention (follow-up) In addition, a semi-structured interview will be carried out with a random sample of the participants and their family member (s)/friends to gain a more qualitative insight into the impact of the programme on those involved. This interview will be completed by a person unknown to the participant. (R3)

Official Title
-----------------
A Randomised Controlled Trial of Family Mediated Exercises (FAME) Following Stroke

Conditions
-----------------
Weakness, Balance

Intervention / Treatment
-----------------
* Other: Family Mediated Exercise Therapy


Participation Criteria
=================
Eligibility Criteria
-----------------
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

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1<br>Exercise Intervention - additional lower limb exercises will be completed by the person with stroke with the assistance of his/her family for 35 minutes daily for a period of 8 weeks. | Other: Family Mediated Exercise Therapy<br>* 35 minutes of lower limb exercises to be completed by the person with stroke on a daily basis with the assistance of their family for a period of 8 weeks.<br>|
| No Intervention: 2<br>Participants in this group will receive routine exercise therapy following stroke | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fugl Meyer (FM) Assessment |  | Baseline, post intervention and 3 month follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Berg Balance Scale (BBS) |  | Baseline, post intervention and 3 month follow-up | 
| Motor Assessment Scale (MAS) |  | Baseline, post-intervention and 3 month follow up | 
| Six Minute Walk Test (SMWT) |  | Baseline, post-intervention and 3 month follow up | 
| Barthel Index (BI) |  | Baseline, post-intervention and 3 month follow up | 
| Re-integration into Normal Living Index (RNLI) |  | Baseline, post-intervention and 3 month follow up | 
| Nottingham Extended Activities of Daily Living (EADL) |  | Baseline, post-intervention and 3 month follow up | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
exercise, frequency, duration