Telerehabilitation for Patients with Stroke

中风患者的远程康复

• 批准号: 8738482
• 负责人: Steven C. Cramer
• 金额: $ 56.65万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-15 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8738482
• 关键词: Address; Adherence; Adult; Ambulatory Care Facilities; Blinded; Body Weight; Clinic; Communication; Dedications; Education; Educational Materials; Effectiveness; Enrollment; Frequencies; Goals; Health Personnel; Home environment; Inferior; Influentials; Interview; Knowledge; Leg; Life Style; Link; Literature; Measures; Methods; Motivation; Motor; Outcome; Outpatients; Patients; Perception; Personal Satisfaction; Pilot Projects; Population; Prevention; Qualitative Research; Randomized; Recovery; Recurrence; Rehabilitation therapy; Research Design; Research Methodology; Risk Factors; Site; Solutions; Stroke; Stroke prevention; Survival Rate; Survivors; System; Testing; Treatment outcome; Uncertainty; Weight; active comparator; arm; base; blind; blood pressure regulation; compliance behavior; cost; design; disability; disability burden; experience; improved; insight; interest; motor deficit; novel; post stroke; prevent; programs; public health relevance; sensor; sound; stroke education; stroke recovery; stroke rehabilitation; telehealth; telehealth systems; telerehabilitation

DESCRIPTION (provided by applicant): Stroke is a major cause of disability, and the burden of stroke is increasing given increasing survival rates. Rehabilitation therapy after stroke therefore remains a major national concern, with an annual cost of several billion dollars. While rehabilitation therapy of increased intensity and duration have been firmly linked with improved patient outcomes, many patients do not receive this due to issues such as cost and access. Methods are needed to deliver stroke rehabilitation in a maximally efficient manner. A telehealth solution might be useful to address these issues. This study aims to determine if telerehabilitation is comparably efficacious with outpatient clinic therapy, using a single-blind, randomized, non-inferiority study design. The primary endpoint is the change in arm motor status from baseline to 1 month post-therapy. A pilot study found that telerehab performed well at increasing patient knowledge on stroke prevention and risk factor control. The current study will confirm this result and will determine whether these gains in knowledge extend to real world improvement in two hard endpoints relevant to stroke patient outcomes: body weight and blood pressure control. Because compliance with many forms of therapy is often limited, hypotheses related to inter-subject differences in compliance will be tested. The long-term goal of this program is to develop a comprehensive system for delivery of telerehabilitation in the home that increases access to high intensity therapy using an economically sound approach, and thereby improves patient outcomes. The current proposal is a major step in this direction.

描述（由申请人提供）：中风是导致残疾的主要原因，并且随着生存率的提高，中风的负担也在增加。因此，中风后的康复治疗仍然是全国关注的主要问题，每年花费数十亿美元。虽然增加强度和持续时间的康复治疗与改善患者预后密切相关，但许多患者由于成本和获取等问题而没有接受这种治疗。需要以最有效的方式提供中风康复的方法。远程医疗解决方案可能有助于解决这些问题。本研究旨在采用单盲、随机、非劣效性研究设计，确定远程康复是否与门诊治疗相当有效。主要终点是手臂运动状态从基线到治疗后 1 个月的变化。一项试点研究发现，远程康复在增加患者对中风预防和危险因素控制的了解方面表现良好。目前的研究将证实这一结果，并将确定这些知识的进步是否会延伸到现实世界中与中风患者结局相关的两个硬终点的改善：体重和血压控制。由于许多形式的治疗的依从性通常是有限的，因此将测试与受试者间依从性差异相关的假设。该计划的长期目标是开发一个用于在家中提供远程康复的综合系统，使用经济合理的方法增加高强度治疗的机会，从而改善患者的治疗效果。当前的提案是朝这个方向迈出的重要一步。