Reaching the Unreached: Home-Based Telerehabilitation for Stroke Survivors

June 2, 2026 updated by: University of Alberta

Reaching the Unreached: Randomized Trial of Home-Based Telerehabilitation for Stroke Without Outpatient Care

After a stroke, many people have trouble using their arms and hands. This can make daily tasks-like eating, dressing, or writing-very hard. In Alberta, especially in small towns and rural areas, many stroke survivors go home from the hospital without being referred to rehabilitation. As a result, they miss out on therapy that could help them get better.

This project will test a new way to bring rehabilitation directly into people's homes using telerehabilitation. We will work with 200 stroke survivors across Alberta who did not get regular outpatient rehab. Participants will use the clinically validated Tenzr system-a set of fun, game-like exercises with wearable sensors. Therapists will check in and guide them remotely.

When participants are enrolled in the study, they will be randomized (1:1) into two groups. The Immediate group will receive 8 weeks of home-based telerehabilitation using the Tenzr platform immediately after baseline, while the Delayed group will receive 8 weeks of observation (usual care) followed by 8 weeks of the same telerehabilitation intervention. Everyone in the study will be tested at the baseline, 8 weeks, and 16 weeks. At 16 weeks, we will also interview them to gather their feedback on the telerehabilitation. We want to learn if this program helps people improve arm and hand movement, if it's easy to use, and if people like it. We also want to see if it could be offered more widely across Alberta in the future.

The goal is to give more people access to stroke rehabilitation, no matter where they live.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

200

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Jessica M D'Amico, Scientific Program Lead and Assistant Professor, PhD
  • Phone Number: 780-203-9478
  • Email: damico1@ualberta.ca

Study Contact Backup

Study Locations

  • Canada
    • Alberta
      • Edmonton, Alberta, Canada, T5G 0B7
        • Recruiting
        • Glenrose Rehabilitation Hospital
        • Principal Investigator:
          • Jessica M D'Amico, PhD
        • Contact:
        • Contact:
          • Jessica M D'Amico, Scientific Program Lead, Assistant Professor, PhD
          • Email: damico1@ualberta.ca

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Not currently referred to, or participating in, upper extremity outpatient rehabilitation.
  2. A confirmed stroke diagnosis (ischemic or hemorrhagic)
  3. Have moderate-to-severe upper limb impairment
  4. Live at home
  5. Have access to internet and appropriate devices to have a virtual assessment with clinicians.
  6. ≥ 18 years of age

Exclusion Criteria:

  1. Referred to or currently participating in upper extremity outpatient rehabilitation.
  2. Severe cognitive, communication, or medical comorbidities that would preclude safe home-based exercise
  3. Don't have access to internet and appropriate devices to have a virtual assessment with clinicians.
  4. < 18 years of age

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Immediate Group
The Immediate group will receive 8 weeks of home-based telerehabilitation using the Tenzr platform immediately after baseline clinical assessments.
Other: Standard of Care (SOC)
8 weeks of standard of care for patients discharged from hospital without referrals to outpatient rehabilitation.
Other: Telerehabilitation with Tenzr
8 weeks of telerehabilitation at home supported by a remote therapist utilizing the Tenzr application.
Active Comparator: Delayed Group
Delayed group will receive 8 weeks of observation (usual care) following the baseline clinical assessment; followed by 8 weeks of the same telerehabilitation intervention.
Other: Standard of Care (SOC)
8 weeks of standard of care for patients discharged from hospital without referrals to outpatient rehabilitation.
Other: Telerehabilitation with Tenzr
8 weeks of telerehabilitation at home supported by a remote therapist utilizing the Tenzr application.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Upper Extremity Fugl-Meyer Assessment for Upper Extremity (FM-UE)
Time Frame: Baseline, 8 weeks and 16 weeks.
The Fugl-Meyer Assessment (FMA) is a stroke-specific, performance-based impairment index. It is designed to assess motor functioning, balance, sensation and joint functioning in patients with post-stroke hemiplegia. We will be obtaining and reporting the Upper Extremity subscore. It is a score without units.
Baseline, 8 weeks and 16 weeks.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Nine-hole Peg Test (NHPT) (sec)
Time Frame: Baseline, 8 weeks, 16 weeks
The NHPT requires participants to repeatedly place and then remove nine pegs into nine holes, one at a time, as quickly as possible.
Baseline, 8 weeks, 16 weeks
Change in Box and Blocks Test (number of blocks)
Time Frame: Baseline, 8 weeks, 16 weeks
The Box and Block Test (BBT) measures unilateral gross manual dexterity. It is a quick, simple and inexpensive test. It can be used with a wide range of populations, including clients with stroke.
Baseline, 8 weeks, 16 weeks
Change in Stroke Impact Scale Score
Time Frame: Baseline, 8 weeks, 16 weeks
The Stroke Impact Scale (SIS) is a patient-reported outcome measure that evaluates the biopsychosocial aspects of life after stroke. No units.
Baseline, 8 weeks, 16 weeks
Change in PROMIS Upper Extremity Short Form
Time Frame: Baseline, 8 weeks, 16 weeks
PROMIS® stands for Patient Reported Outcomes Measurement Information System, which is a system of highly reliable, precise measures of patient-reported health status for physical, mental, and social well-being. PROMIS® tools measure what patients are able to do and how they feel by asking a number of questions. The PROMIS v1. 2 UE item bank is a useful clinical assessment tool with good psychometric properties that can be implemented in clinical settings and is focused on upper extremity items.
Baseline, 8 weeks, 16 weeks

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
System Usability Scale (Tech eval)
Time Frame: At completion of Tenzr-supported rehab phase (either 8 or 16 weeks dependent on randomization).
The system usability scale (SUS) is a simple, ten-item attitude Likert scale giving a global view of subjective assessments of usability.
At completion of Tenzr-supported rehab phase (either 8 or 16 weeks dependent on randomization).
Client Satisfaction Questionnaire (CSQ-8)
Time Frame: At completion of trial (16 weeks)
The Client Satisfaction Questionnaire (CSQ-8) is one of a limited number of standardised satisfaction measures that have been used widely.
At completion of trial (16 weeks)
Participant adherence (%, rate of planned sessions completed)
Time Frame: Collected continuously using the Tenzr application during the telerehabilitation phase of the trial (either baseline-8week block or 8week-16week block dependent on randomization).
Using the Tenzr application we will report the rate of completed sessions by recording the # rehab sessions completed by the participants using the application versus the planned # rehab sessions and expressed as a percentage.
Collected continuously using the Tenzr application during the telerehabilitation phase of the trial (either baseline-8week block or 8week-16week block dependent on randomization).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Alberta

Collaborators

Alberta Innovates Health Solutions
Glenrose Hospital Foundation

Investigators

  • Principal Investigator: Jessica M D'Amico, PhD, University of Alberta and Alberta Health Services

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 2, 2026

Primary Completion (Estimated)

December 1, 2027

Study Completion (Estimated)

August 1, 2028

Study Registration Dates

First Submitted

November 25, 2025

First Submitted That Met QC Criteria

March 11, 2026

First Posted (Actual)

March 12, 2026

Study Record Updates

Last Update Posted (Actual)

June 3, 2026

Last Update Submitted That Met QC Criteria

June 2, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Pro00157166

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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