Virtually Assisted Home Rehabilitation After Stroke for Underserved Texas Communities
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: VAST, PASUC alone.
- Кому может быть актуально
- Состояния в реестре: Stroke. Базовые параметры: от 18 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- США
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Обзор
The purpose of this study is to evaluate the clinical effectiveness of Virtually Assisted Home Rehabilitation After Acute STroke (VAST) + post-acute stroke usual care (PASUC) compared to PASUC alone and examine how social determinants of health (SDOH) influence access to and utilization of PASUC rehabilitation.
Вмешательства
- Поведенческое VAST
Participants will receive a planned 4-week, home-based telerehabilitation (TR) intervention that integrates discipline-specific rehabilitation therapy with embedded self management health coaching - Поведенческое PASUC alone
Participants will receive physical therapy, occupational therapy, speech and language therapy, and medical/nursing care aimed at improving functional mobility, activities of daily living, communication, and overall independence. Rehabilitation is individualized based on patient needs and delivered in a supervised clinical setting.
Первичные конечные точки
- Change in perceived ability to perform activities of daily living and functional mobility as assessed by the Stroke Impact Scale (SIS)-Activity subscale [Срок оценки: Baseline, 6 weeks, 18 weeks]
Вторичные конечные точки (5)
- Change in impact of stroke as assessed by the Stroke Impact Scale (SIS)SIS domains (strength, mobility, hand function, communication, emotion, memory/thinking, and participation roles) [Срок оценки: baseline, 6 weeks, 18 weeks]
- Change in degree of disability or dependence as measured by the Modified Rankin Score(mRS) [Срок оценки: Baseline, 6 weeks, 18 weeks]
- Change in functional arm movements as assessed by the Fugl Meyer-Upper Extremity Assessment [Срок оценки: Baseline, 6 weeks,18 weeks]
- Change in lower extremity functional strength as assessed by the Five Times Sit-to-Stand Test (5xSTS) [Срок оценки: Baseline, 6 weeks, 18 weeks]
- Change in functional mobility as assessed by the Timed Up and Go (TUG) test [Срок оценки: Baseline, 6 weeks, 18 weeks]
Критерии участия
Критерии включения
- Hospital admission with primary ICD-10 discharge diagnosis of Acute Ischemic Stroke (AIS) or Intracerebral Hemorrhage (ICH)
o those being referred from the community settings must be within 60 days of post-acute discharge.
- Post-stroke functional deficits warranting PASUC rehabilitation
- Clinically stable and appropriate for discharge per acute care facility
- Completion of a rehabilitation evaluation within the acute setting
- Planned discharge to home (with or without Home Health (HH)/Outpatient Rehabilitation (OPR), Inpatient Rehabilitation Facility (IRF), or Skilled Nursing Facility (SNF)
- Ability to speak and read English or Spanish
- Ability to provide informed consent (patient or LAR)
o If LAR is consenting, patient must be able to follow simple commands
- Access to a video-capable device and internet
Критерии исключения
- Clinically unstable medical condition
- Poorly controlled severe mental illness
- Planned discharge to a long-term care facility (LTACH)
- Inability to complete follow-up (psychiatric hospitalization, hospice, incarceration, homelessness)
- Discharge against medical advice
- Significant language impairment (NIHSS Commands >1 or Best Language >2)- Cognitive impairment (Six-Item, PROMIS) -Severe depression (PHQ-8 >20 or psychiatric hospitalization previous 30 days)- Pre-stroke mRS >3
- Other neurological or musculoskeletal conditions substantially limiting participation o Patients excluded for one of these criteria may be reassessed at 60-days to see if improvement has occurred.
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Параллельные группы
- Маскирование
- Простое слепое
- Основная цель
- Лечение
Центры проведения
США · 1 центр
- The University of Texas Health Science Center at Houston — Houston
Идентификаторы
NCT: NCT07597226 · HSC-MS-26-0119