Telerehabilitation for Stroke Survivors

Overseen By Fadi Musfee, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: The University of Texas Health Science Center, Houston

Disqualifiers: Aphasia, Dementia, Psychiatric disorders, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6 weeks

30 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new method for stroke recovery using CHW-supported telerehabilitation, which involves doing rehab exercises at home with the assistance of a community health worker. The researchers aim to assess how well this method improves physical and mental health and to identify any challenges participants encounter. Participants will be divided into groups, with some receiving this new at-home rehab and others receiving usual care. This trial may suit residents of Brownsville, Texas, who have recently experienced their first stroke, are uninsured, and can follow exercise instructions. As an unphased trial, this study offers a unique opportunity to contribute to innovative stroke recovery methods.

Do I need to stop my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What prior data suggests that this telerehabilitation method is safe for stroke survivors?

Research shows that telerehabilitation for stroke survivors is generally safe. Studies have not found any major safety concerns, indicating it is well-tolerated. Telerehabilitation uses technology to deliver therapy to patients at home, aiming to make rehabilitation more accessible and convenient. So far, research supports its use in aiding recovery without significant safety issues. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about CHW-supported telerehabilitation for stroke survivors because it brings professional rehabilitation support directly to patients' homes through technology. Unlike traditional in-person rehab, this method leverages community health workers (CHWs) to guide and motivate patients remotely, making rehab more accessible and personalized. This approach not only promises to reduce barriers like travel and scheduling but also aims to provide consistent and tailored support, which could lead to better recovery outcomes for stroke survivors.

What evidence suggests that CHW-supported telerehabilitation is effective for stroke survivors?

Research has shown that telerehabilitation can help stroke survivors improve arm movement, balance, and daily task performance. One study found that adding telerehabilitation to regular care improved arm movement. Another study demonstrated a 39% increase in knowledge about stroke prevention and lower depression scores after daily education through telerehabilitation. Overall, telerehabilitation greatly enhances recovery and improves the quality of life for stroke survivors. In this trial, participants will receive CHW-supported telerehabilitation plus usual care, which may effectively aid recovery after a stroke. ^{1 3 4 5 6}

Who Is on the Research Team?

Fadi Musfee, MD

Principal Investigator

The University of Texas Health Science Center, Houston

Are You a Good Fit for This Trial?

This trial is for stroke survivors in Brownsville, Texas who can stand (with help if needed), had their first stroke within the last 3 months, and were not severely disabled before the stroke. Participants must be uninsured, speak Spanish or English, able to do basic exercises safely, and follow instructions despite any aphasia.

Inclusion Criteria

Currently uninsured

Safe to perform basic strengthening rehabilitation exercises

I can stand up with or without help.

Exclusion Criteria

I have received outpatient rehab services before joining this study.

Insured patients as insured patients are referred for standard-of-care clinical rehabilitation

I do not have any conditions like aphasia or dementia that make it hard for me to follow instructions.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive CHW-supported telerehabilitation for post-acute stroke care

6 weeks

Weekly virtual check-ins

Follow-up

Participants are monitored for safety and effectiveness after treatment

1 week

What Are the Treatments Tested in This Trial?

Interventions

• CHW-supported telerehabilitation

Trial Overview The study tests a new at-home telerehabilitation service with community health worker support against usual care. It aims to see how well it works for improving physical and mental health of stroke survivors in Rio Grande Valley and understand barriers and facilitators for its use.

How Is the Trial Designed?

Group I: CHW-supported telerehabilitation plus Usual Care Experimental Treatment 2 Interventions

Who Is Running the Clinical Trial?

The University of Texas Health Science Center, Houston

Lead Sponsor

Trials

974

Recruited

361,000+

National Center for Advancing Translational Sciences (NCATS)

Collaborator

Trials

394

Recruited

404,000+

Published Research Related to This Trial

The pilot study involving seven adults with chronic stroke demonstrated that a home-based telerehabilitation program significantly improved upper limb performance over 6 weeks of training, with participants training 5 days a week for 60 minutes each session.

In addition to physical improvements, there were indications of potential cognitive benefits, suggesting that telerehabilitation may enhance overall recovery in stroke patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Home-based telerehabilitation shows improved upper limb function in adults with chronic stroke: a pilot study. Langan, J., Delave, K., Phillips, L., et al.[2021]

In a study involving ten chronic post-stroke subjects, the telerehabilitation system Muvity showed potential benefits, with four out of six participants improving their ability to perform daily activities and five reporting less pain compared to conventional therapy.

While the results were promising, indicating that Muvity could be a motivating and effective complement to traditional rehabilitation, the differences were not statistically significant, highlighting the need for further research with a larger sample size.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A feasibility study to assess the effectiveness of Muvity: A telerehabilitation system for chronic post-stroke subjects. Garcia, A., Mayans, B., Margelí, C., et al.[2022]

Telerehabilitation programs after stroke showed equivalent or improved functional outcomes compared to traditional face-to-face therapy, particularly in motor function and mobility assessments, based on a systematic review of 13 studies and a meta-analysis of 10 trials.

Patient adherence to telerehabilitation was high, ranging from 75% to 100%, indicating that patients are willing to engage with these programs, although satisfaction levels varied and highlight the need for better standardization in therapy protocols.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Telerehabilitation service impact on physical function and adherence compared to face-to-face rehabilitation in patients with stroke: A systematic review and meta-analysis. Sharififar, S., Ghasemi, H., Geis, C., et al.[2023]

Telerehabilitation has a small but statistically significant effect on improving balance and functional mobility in stroke survivors, based on a systematic review of 14 studies involving 594 patients.

Despite these positive findings, the overall quality of evidence is low, indicating a need for more rigorous research to confirm the effectiveness of telerehabilitation in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effectiveness of Telerehabilitation on Balance and Functional Mobility in Patients with Stroke: A Systematic Review and Meta-Analysis. Alayat, MS., Almatrafi, NA., Almutairi, AA., et al.[2023]

Telerehabilitation (TR) applications show promise, with 71% of the 61 reviewed studies reporting successful outcomes, particularly in cardiac and neurological rehabilitation.

However, only 51% of the applications demonstrated clinically significant results, and further high-quality research is needed to establish TR as a standard practice in routine rehabilitation programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evidence of benefit from telerehabilitation in routine care: a systematic review. Hailey, D., Roine, R., Ohinmaa, A., et al.[2022]

A study involving 49 subacute stroke survivors indicated that telerehabilitation using a guided app for core stability exercises may improve balance and gait compared to usual care, although the differences were not statistically significant.

The findings suggest that home-based telerehabilitation could be a feasible option for enhancing recovery in post-stroke patients, but further research is needed to confirm these effects and improve adherence to the program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Telerehabilitation for balance rehabilitation in the subacute stage of stroke: A pilot controlled trial. Salgueiro, C., Urrútia, G., Cabanas-Valdés, R.[2022]

A study involving 4 stroke survivors using the Tele-REINVENT system for 6 weeks revealed that factors like biofeedback, customization, gamification, and predictability significantly influenced the acceptability of this telerehabilitation tool.

Participants preferred features that provided them with agency and control, suggesting that enhancing user experience can improve the effectiveness and acceptance of at-home EMG biofeedback interventions for stroke rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptability of a Telerehabilitation Biofeedback System Among Stroke Survivors: A Qualitative Analysis. Donnelly, MR., Phanord, CS., Marin-Pardo, O., et al.[2023]

Tele-rehabilitation for stroke survivors shows promise in improving recovery from motor deficits, cognitive dysfunction, and post-stroke depression, based on a systematic review of 22 studies.

While most studies indicated positive effects of tele-rehabilitation, only 8 out of 22 showed significant differences favoring tele-rehabilitation over standard care, suggesting that while effective, results may vary.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tele-Rehabilitation after Stroke: An Updated Systematic Review of the Literature. Sarfo, FS., Ulasavets, U., Opare-Sem, OK., et al.[2023]

Citations

1. withpower.com withpower.com/trial/phase-stroke-8-2024-15a8a

Telerehabilitation for Stroke Survivors Research shows that telerehabilitation can help improve upper limb function, balance, and independence in daily activities for stroke survivors. Studies have ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5734923/

A Home-Based Telerehabilitation Program for Patients with ... Daily stroke education via the telerehabilitation system was associated with a 39% increase in stroke prevention knowledge (p=0.0007). Depression scores ...

3. clinicaltrials.gov clinicaltrials.gov/study/NCT06682429

Telerehabilitation In The Home After Stroke (TR-2) The purpose of this research study is to evaluate whether telerehabilitation targeting arm movement, when added to usual care, improves arm function and ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0967586825002176

A randomized controlled Trial of telerehabilitation ... The findings of this study support telerehabilitation interventions as an effective rehabilitation method, significantly improving the rehabilitation outcomes ...

5. tandfonline.com tandfonline.com/doi/full/10.1080/10833196.2024.2400425

Effectiveness of telerehabilitation on quality of life in stroke ... Overall, the current review provides positive results that suggests telerehabilitation is effective, adding to the findings of previous systematic reviews ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6464866/

Telerehabilitation services for stroke - PMC - PubMed Central Telerehabilitation is an alternative way of delivering rehabilitation services. Information and communication technologies are used to facilitate communication.