Virtually Assisted Home Rehabilitation After Stroke for Underserved Texas Communities (VAST TX)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Sean Savitz, MD
- Phone Number: (713) 500-7083
- Email: Sean.I.Savitz@uth.tmc.edu
Study Contact Backup
- Name: Tolulope Fashina
- Phone Number: 713-500-7914
- Email: tolulope.fashina@uth.tmc.edu
Study Locations
-
-
Texas
-
Houston, Texas, United States, 77030
- The University of Texas Health Science Center at Houston
-
Contact:
- Sean Savitz, MD
- Phone Number: (713) 500-7083
- Email: Sean.I.Savitz@uth.tmc.edu
-
Contact:
- Emily Stevens
- Phone Number: 713-500-7914
- Email: emily.a.stevens@uth.tmc.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
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
Exclusion Criteria:
- 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.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: VAST + PASUC
|
Participants will receive a planned 4-week, home-based telerehabilitation (TR) intervention that integrates discipline-specific rehabilitation therapy with embedded self management health coaching
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.
|
|
Active Comparator: 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.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in perceived ability to perform activities of daily living and functional mobility as assessed by the Stroke Impact Scale (SIS)-Activity subscale
Time Frame: Baseline, 6 weeks, 18 weeks
|
This is scored from ange 0-100, with higher scores indicating better function
|
Baseline, 6 weeks, 18 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
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)
Time Frame: baseline, 6 weeks, 18 weeks
|
This is a A 59 item questionnaire whereby subjects identify the impact of stroke on strength, mobility, hand function, communication, emotion, memory/thinking, and participation roles.
Item responses are scored on a 5-point Likert-style scale.
A score of 1 = an inability to complete the item and a score of 5 = no difficulty experienced at all.
A standardized score ranging from 0 to 100 is calculated for all domains, with higher scores indicating a higher quality of life
|
baseline, 6 weeks, 18 weeks
|
|
Change in degree of disability or dependence as measured by the Modified Rankin Score(mRS)
Time Frame: Baseline, 6 weeks, 18 weeks
|
mRS is a 6 point disability scale with possible scores from 0(no disability) to 5(disability requiring constant care) a higher score indicating more disability
|
Baseline, 6 weeks, 18 weeks
|
|
Change in functional arm movements as assessed by the Fugl Meyer-Upper Extremity Assessment
Time Frame: Baseline, 6 weeks,18 weeks
|
This is a 66 item questionnaire and each is scored from 0(cannot perform)-2(performs fully) a higher score indicating better outcome
|
Baseline, 6 weeks,18 weeks
|
|
Change in lower extremity functional strength as assessed by the Five Times Sit-to-Stand Test (5xSTS)
Time Frame: Baseline, 6 weeks, 18 weeks
|
Participants will be instructed to rise from a seated position to standing and return to sitting five consecutive times as quickly as possible without using their upper extremities, if able.
Shorter completion times indicate better functional performance and lower extremity strength.
|
Baseline, 6 weeks, 18 weeks
|
|
Change in functional mobility as assessed by the Timed Up and Go (TUG) test
Time Frame: Baseline, 6 weeks, 18 weeks
|
Participants will be instructed to stand up from a standard chair, walk 3 meters, turn around, walk back to the chair, and sit down.
Shorter completion times indicate better functional mobility and dynamic balance.
|
Baseline, 6 weeks, 18 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Sean Savitz, MD, The University of Texas Health Science Center, Houston
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- HSC-MS-26-0119
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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