Early-phase Telecare Programs for Minor Stroke
Status: Not yet recruiting

Minor strokes (few acute neurological symptoms ; NIHSS score <5), represent almost 65% of cerebrovascular ischemic events. The increasing incidence of stroke in people under 65, together with advances in diagnostic and revascularization techniques, mean that post-stroke life expectancy is now in the order of decades. Most patients with minor stroke are rapidly discharged from hospital, with follow-up focused on secondary prevention and they are offered little or no rehabilitation.

However, up to 70% of patients with minor stroke experience difficulties resuming their social or professional activities, which can lead to social and economic disruption (delayed/compromised return to work) and an increased risk of depression. While some care recommendations exist for this population, in France there is no consensus nor identified care pathway for follow-up assessment or management of these patients. Furthermore, existing services are unevenly distributed across the country, and research into the effectiveness of rehabilitation is still scarce, leading to uncertainty as to which interventions should be prioritized to decrease difficulties related to cognitive impairment.

Since there are currently no rehabilitation proposals in France for patients with mild cognitive impairment after mild stroke, in this trial the investigaror will investigate the effectiveness of two six-week telerehabilitation programs each consisting of a weekly session supervised by a therapist and a self-rehabilitation session. The aim of this multicenter randomized controlled trial is the evaluate the relevance and feasibility of early identification of patients eligible for a cognition-focused management proposal and the efficacy of two telecare programs, (a) psychoeducation and (b) computerized cognitive rehabilitation.

Eligibility:
- EligibilityCriteria: Inclusion Criteria:  Minor cerebrovascular accident (CVA): NIHSS score < 5 upon discharge from the neurovascular unit Hospitalization for a first stroke Patient over 18 years old and under 65 years old Post-stroke time < 8 weeks Living at home (not institutionalized) Affiliated with social security or benefiting from such a scheme French language Presence of a cognitive complaint (Score on the "perceived cognitive impairments" subscale of the FACT-Cog < 55) and absence of major cognitive disorder Signature of informed consent  Exclusion Criteria:  History of stroke Uncorrected hearing or visual deficit Neurological pathology other than stroke or disabling psychiatric disorder Unstabilized epilepsy Patient following cognitive rehabilitation in another context or having integrated a post-stroke ETP program Patient residing in a white zone that does not allow the implementation of remote rehabilitation Patient unable to connect to the internet Pregnant, parturient or breastfeeding women* (interview data) Persons deprived of liberty by a judicial or administrative decision Persons admitted to a health or social establishment for purposes other than research Adults subject to a legal protection measure (guardianship, curatorship) Subject participating in another interventional research including an exclusion period still ongoing at pre-inclusion,… - HealthyVolunteers: No - Gender: All - MinimumAge: 18 Years - MaximumAge: 65 Years - StdAgeList: Adult, Older Adult