Telerehabilitation in the Home versus Therapy In-Clinic for Patients with Stroke
ID Number 16-2025Principal Investigator(s)
Department(s) or Division(s)
Substantial evidence indicates that occupational and physical therapy improves outcomes after stroke, and that larger doses are associated with superior outcomes. However, many patients receive sub-optimal doses of therapy for reasons that include cost, access, and difficulty with travel. This problem is likely to increase with time given the aging of the population and the increased rate with which patients survive stroke. Telehealth, defined as the delivery of health related services and information via telecommunication technologies, has enormous potential to address this unmet need.
The current study will test the effectiveness of a novel home-based telehealth system designed to improve motor recovery and patient education after stroke.
A minimum of 124 subjects (the number may be larger depending on the rate of subject dropout) with arm motor deficits 4-36 weeks after a stroke due to ischemia or to intracerebral hemorrhage will be randomized to receive 6 weeks of intensive arm motor therapy
(a) in a traditional in-clinic setting or
(b) via in-home telerehabilitation (rehabilitation services delivered to the subject’s home via an internet-connected computer).
The intensity, duration, and frequency of this therapy will be identical across the two groups, with subjects in both treatment arms receiving 36 sessions (18 supervised and 18 unsupervised), 80 minutes each (including a 10 minute break), over 6 weeks.
The primary endpoint is within-subject change in the arm motor Fugal-Meyer (FM) score from the Baseline Visit to 30 Day Follow-Up Visit. Arm motor status is the focus here, because it is commonly affected by stroke, is of central importance to many human functions, and is strongly linked to disability and well being after stroke.
Recruiting Patients: Yes