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Home-based virtual reality training after discharge from hospital-based stroke rehabilitation: a parallel randomized feasibility trial

BACKGROUND: Virtual reality training (VRT) uses computer software to track a user’s movements and allow him or her to interact with a game presented on a television screen. VRT is increasingly being used for the rehabilitation of arm function, balance and walking after stroke. Patients often require...

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Autores principales: Sheehy, Lisa, Taillon-Hobson, Anne, Sveistrup, Heidi, Bilodeau, Martin, Yang, Christine, Welch, Vivian, Hossain, Alomgir, Finestone, Hillel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555916/
https://www.ncbi.nlm.nih.gov/pubmed/31174579
http://dx.doi.org/10.1186/s13063-019-3438-9
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author Sheehy, Lisa
Taillon-Hobson, Anne
Sveistrup, Heidi
Bilodeau, Martin
Yang, Christine
Welch, Vivian
Hossain, Alomgir
Finestone, Hillel
author_facet Sheehy, Lisa
Taillon-Hobson, Anne
Sveistrup, Heidi
Bilodeau, Martin
Yang, Christine
Welch, Vivian
Hossain, Alomgir
Finestone, Hillel
author_sort Sheehy, Lisa
collection PubMed
description BACKGROUND: Virtual reality training (VRT) uses computer software to track a user’s movements and allow him or her to interact with a game presented on a television screen. VRT is increasingly being used for the rehabilitation of arm function, balance and walking after stroke. Patients often require ongoing therapy post discharge from inpatient rehabilitation. Outpatient therapy may be limited or inaccessible due to waiting lists, transportation issues, distance etc.; therefore, home-based VRT could provide the required therapy in a more convenient and accessible setting. The objectives of this parallel randomized feasibility trial are to determine (1) the feasibility of using VRT in the home post stroke and (2) the feasibility of a battery of quantitative and qualitative outcome measures of stroke recovery. METHODS: Forty patients who can stand for at least 2 min and are soon to be discharged from inpatient or outpatient rehabilitation post stroke are being recruited in Ottawa, Canada and being randomized to control and experimental groups. Participants in the experimental group use home-based VRT to do rehabilitative exercises for standing balance, stepping, reaching, strengthening and gentle aerobic fitness. Control group participants use an iPad with apps selected to rehabilitate cognition, hand fine motor skills and visual tracking/scanning. Both groups are instructed to perform 30 min of exercise 5 days a week for 6 weeks. VRT intensity and difficulty are monitored and adjusted remotely. Weekly telephone contact is made with all participants. Ability to recruit participants, ability to handle the technology and learn the activities, compliance, safety, enjoyment, perceived efficacy and cost of program delivery will be assessed. A battery of assessments of standing balance, gait and community integration will be assessed for feasibility of completion within this population and potential for improvement following the intervention. Effect sizes will be calculated. DISCUSSION: The results of this study will be used to support the creation of a definitive randomized controlled trial on the efficacy of home-based VRT for rehabilitation post stroke. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03261713. Registered on 21 August 2017. Registration amended on 1 June 2018 to decrease enrollment from 40 to 20 due to a cut in study funding and difficulty recruiting participants. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13063-019-3438-9) contains supplementary material, which is available to authorized users.
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spelling pubmed-65559162019-06-10 Home-based virtual reality training after discharge from hospital-based stroke rehabilitation: a parallel randomized feasibility trial Sheehy, Lisa Taillon-Hobson, Anne Sveistrup, Heidi Bilodeau, Martin Yang, Christine Welch, Vivian Hossain, Alomgir Finestone, Hillel Trials Study Protocol BACKGROUND: Virtual reality training (VRT) uses computer software to track a user’s movements and allow him or her to interact with a game presented on a television screen. VRT is increasingly being used for the rehabilitation of arm function, balance and walking after stroke. Patients often require ongoing therapy post discharge from inpatient rehabilitation. Outpatient therapy may be limited or inaccessible due to waiting lists, transportation issues, distance etc.; therefore, home-based VRT could provide the required therapy in a more convenient and accessible setting. The objectives of this parallel randomized feasibility trial are to determine (1) the feasibility of using VRT in the home post stroke and (2) the feasibility of a battery of quantitative and qualitative outcome measures of stroke recovery. METHODS: Forty patients who can stand for at least 2 min and are soon to be discharged from inpatient or outpatient rehabilitation post stroke are being recruited in Ottawa, Canada and being randomized to control and experimental groups. Participants in the experimental group use home-based VRT to do rehabilitative exercises for standing balance, stepping, reaching, strengthening and gentle aerobic fitness. Control group participants use an iPad with apps selected to rehabilitate cognition, hand fine motor skills and visual tracking/scanning. Both groups are instructed to perform 30 min of exercise 5 days a week for 6 weeks. VRT intensity and difficulty are monitored and adjusted remotely. Weekly telephone contact is made with all participants. Ability to recruit participants, ability to handle the technology and learn the activities, compliance, safety, enjoyment, perceived efficacy and cost of program delivery will be assessed. A battery of assessments of standing balance, gait and community integration will be assessed for feasibility of completion within this population and potential for improvement following the intervention. Effect sizes will be calculated. DISCUSSION: The results of this study will be used to support the creation of a definitive randomized controlled trial on the efficacy of home-based VRT for rehabilitation post stroke. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03261713. Registered on 21 August 2017. Registration amended on 1 June 2018 to decrease enrollment from 40 to 20 due to a cut in study funding and difficulty recruiting participants. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13063-019-3438-9) contains supplementary material, which is available to authorized users. BioMed Central 2019-06-07 /pmc/articles/PMC6555916/ /pubmed/31174579 http://dx.doi.org/10.1186/s13063-019-3438-9 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Study Protocol
Sheehy, Lisa
Taillon-Hobson, Anne
Sveistrup, Heidi
Bilodeau, Martin
Yang, Christine
Welch, Vivian
Hossain, Alomgir
Finestone, Hillel
Home-based virtual reality training after discharge from hospital-based stroke rehabilitation: a parallel randomized feasibility trial
title Home-based virtual reality training after discharge from hospital-based stroke rehabilitation: a parallel randomized feasibility trial
title_full Home-based virtual reality training after discharge from hospital-based stroke rehabilitation: a parallel randomized feasibility trial
title_fullStr Home-based virtual reality training after discharge from hospital-based stroke rehabilitation: a parallel randomized feasibility trial
title_full_unstemmed Home-based virtual reality training after discharge from hospital-based stroke rehabilitation: a parallel randomized feasibility trial
title_short Home-based virtual reality training after discharge from hospital-based stroke rehabilitation: a parallel randomized feasibility trial
title_sort home-based virtual reality training after discharge from hospital-based stroke rehabilitation: a parallel randomized feasibility trial
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555916/
https://www.ncbi.nlm.nih.gov/pubmed/31174579
http://dx.doi.org/10.1186/s13063-019-3438-9
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