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Stroke Canada Optimization of Rehabilitation by Evidence Implementation Trial SCORE-IT)

19. marts 2008 opdateret af: Toronto Rehabilitation Institute

Stroke Canada Optimization of Rehabilitation by Evidence Implementation Trial (SCORE IT)

The aim of this project is to evaluate whether using an implementation intervention promotes use of best practices by rehabilitation professionals and leads to improvements in patient outcomes for individuals with stroke.

Studieoversigt

Status

Ukendt

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Stroke is a leading cause of disability in Canada and frequently causes hemiparesis (upper limb and lower limb weakness on one side of the body). Approximately one third of stroke survivors require physical rehabilitation to improve their motor and functional recovery (1). Although many strategies have been shown to be effective in promoting recovery after stroke, the uptake of evidence-based practice by rehabilitation professionals across Canada is variable. The aim of this project is to evaluate whether using an implementation intervention promotes use of best practices by rehabilitation professionals and leads to improvements in patient outcomes for individuals with stroke.

This project is a cluster randomized implementation trial for upper and lower limb interventions. Rehabilitation centres across Canada will be randomized to receive either an outcome-oriented implementation strategy (OOI) to facilitate implementation of the EIPRs or a process-oriented implementation strategy (POI). At the onset, rehabilitation professionals practicing in all centres will receive education in using best practice outcome measures related to stroke rehabilitation. All centres will be assessed for baseline adherence to the EIPRs. Centres in the OOI will receive "usual care" (i.e. passive dissemination of the written protocols and information about outcome measures). Centres in the POI arm will receive a combination of strategies to facilitate EIPR uptake (i.e., use of a local facilitator, practice audits with feedback, reminder systems and educational sessions). Following exposure to the EIPRs, all centres will document adherence to the EIPRs, and patient outcomes as assessed by the measures. An analysis of the costs associated with rehabilitation interventions and the incremental expense of a POI strategy will be undertaken. These data will be used to compare the OOI and POI centres with respect to the level of uptake and implementation of EIPRs and related expenses.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

2000

Fase

  • Fase 2
  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Canada
    • Ontario
      • Toronto, Ontario, Canada, M5G 2A2
        • Rekruttering
        • Toronto Rehabilitation Institute
        • Kontakt:
        • Ledende efterforsker:
          • Mark T Bayley, MD
    • Quebec
      • Montreal, Quebec, Canada, H3G 1Y5
        • Ikke rekrutterer endnu
        • McGill University
        • Kontakt:
        • Ledende efterforsker:
          • Sharon Wood-Dauphinee, PhD

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Rehabilitation Hospitals/Research Sites:

Inclusion Criteria:

  • hospital with designated rehabilitation beds;
  • regularly treats stroke patients;
  • has access to at least one physical (PT) and one occupational (OT) therapist on the health professional team

Exclusion Criteria:

  • Inadequate staffing to administer the outcome measures consistently

Patients:

Inclusion Criteria:

  • medically stable;
  • stroke with residual disability;
  • requires complex rehabilitation interventions from at least 3 health care professionals, one of them being an OT or a PT;
  • admitted to rehabilitation centre within 90 days of stroke onset;
  • and age >18 years

Exclusion Criteria:

  • having a medical condition that is expected to result in death within 6 months;
  • presence of a serious chronic disabling condition that impacts on either the rehabilitation process or rehabilitation outcomes such as severe arthritis, dementia, Parkinson's disease;
  • active suicidal ideation or symptoms of psychosis

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Arm function as measured by the Box and Block test
Walking speed as measured by the 6 minutes walk test

Sekundære resultatmål

Resultatmål
Arm function as measured by the Chedoke Arm and Hand Activity Inventory (CAHAI- 9)
Impairment as measured by the Chedoke-McMaster Stroke Assessment Scale (CMSA)
Independence of daily living as measured by the 3. Functional Independence Measure (FIM)
Economic outcomes measured by the Quality Adjusted Life Years (QALY)

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Toronto Rehabilitation Institute

Samarbejdspartnere

McGill University

Efterforskere

  • Ledende efterforsker: Mark T Bayley, MD, Toronto Rehabilitation Institute
  • Ledende efterforsker: Sharon Wood-Dauphinee, PhD, McGill University

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Hjælpsomme links

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. september 2006

Studieafslutning (Forventet)

1. april 2008

Datoer for studieregistrering

Først indsendt

31. juli 2006

Først indsendt, der opfyldte QC-kriterier

31. juli 2006

Først opslået (Skøn)

2. august 2006

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

20. marts 2008

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

19. marts 2008

Sidst verificeret

1. juli 2006

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • CSNscore

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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