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Remote constraint induced therapy of the upper extremity (ReCITE): A feasibility study protocol

BACKGROUND: Difficulty using the upper extremity in everyday activities is common after stroke. Constraint-induced movement therapy (CIMT) has been shown to be effective in both sub-acute and chronic phases of stroke recovery and is recommended in clinical practice guidelines for stroke internationa...

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Autores principales: Christie, Lauren J., Fearn, Nicola, McCluskey, Annie, Lannin, Natasha A., Shiner, Christine T., Kilkenny, Anna, Boydell, Jessamy, Meharg, Annie, Howes, Ella, Churilov, Leonid, Faux, Steven, Doussoulin, Arlette, Middleton, Sandy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9715749/
https://www.ncbi.nlm.nih.gov/pubmed/36468055
http://dx.doi.org/10.3389/fneur.2022.1010449
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author Christie, Lauren J.
Fearn, Nicola
McCluskey, Annie
Lannin, Natasha A.
Shiner, Christine T.
Kilkenny, Anna
Boydell, Jessamy
Meharg, Annie
Howes, Ella
Churilov, Leonid
Faux, Steven
Doussoulin, Arlette
Middleton, Sandy
author_facet Christie, Lauren J.
Fearn, Nicola
McCluskey, Annie
Lannin, Natasha A.
Shiner, Christine T.
Kilkenny, Anna
Boydell, Jessamy
Meharg, Annie
Howes, Ella
Churilov, Leonid
Faux, Steven
Doussoulin, Arlette
Middleton, Sandy
author_sort Christie, Lauren J.
collection PubMed
description BACKGROUND: Difficulty using the upper extremity in everyday activities is common after stroke. Constraint-induced movement therapy (CIMT) has been shown to be effective in both sub-acute and chronic phases of stroke recovery and is recommended in clinical practice guidelines for stroke internationally. Despite reports of equivalence of outcome when stroke rehabilitation interventions are delivered using telehealth, there has been limited evaluation of CIMT when using this mode of delivery. ReCITE will (a) evaluate the feasibility and acceptability of CIMT when delivered via telehealth to stroke survivors (TeleCIMT) and (b) explore therapists' experiences and use of an online support package inclusive of training, mentoring and resources to support TeleCIMT delivery in clinical practice. METHODS: A prospective single-group, single blinded, study design with embedded process evaluation will be conducted. The study will be conducted at three outpatient services in Sydney, Australia. A multi-faceted therapist support package, informed by the Capabilities, Opportunity, Motivation- Behaviour model (COM-B), will be used to support occupational therapists to implement TeleCIMT as part of routine care to stroke survivors. Each service will recruit 10 stroke survivor participants (n = 30) with mild to moderate upper extremity impairment. Upper extremity and quality of life outcomes of stroke survivor participants will be collected at baseline, post-intervention and at a 4 week follow-up appointment. Feasibility of TeleCIMT will be evaluated by assessing the number of stroke participants who complete 80% of intensive arm practice prescribed during their 3 week program (i.e., at least 24 h of intensive arm practice). Acceptability will be investigated through qualitative interviews and surveys with stroke survivors, supporter surveys and therapist focus groups. Qualitative interviews with therapists will provide additional data to explore their experiences and use of the online support package. DISCUSSION: The COVID-19 pandemic resulted in a rapid transition to delivering telehealth. The proposed study will investigate the feasibility and acceptability of delivering a complex intervention via telehealth to stroke survivors at home, and the support that therapists and patients require for delivery. The findings of the study will be used to inform whether a larger, randomized controlled trial is feasible.
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spelling pubmed-97157492022-12-03 Remote constraint induced therapy of the upper extremity (ReCITE): A feasibility study protocol Christie, Lauren J. Fearn, Nicola McCluskey, Annie Lannin, Natasha A. Shiner, Christine T. Kilkenny, Anna Boydell, Jessamy Meharg, Annie Howes, Ella Churilov, Leonid Faux, Steven Doussoulin, Arlette Middleton, Sandy Front Neurol Neurology BACKGROUND: Difficulty using the upper extremity in everyday activities is common after stroke. Constraint-induced movement therapy (CIMT) has been shown to be effective in both sub-acute and chronic phases of stroke recovery and is recommended in clinical practice guidelines for stroke internationally. Despite reports of equivalence of outcome when stroke rehabilitation interventions are delivered using telehealth, there has been limited evaluation of CIMT when using this mode of delivery. ReCITE will (a) evaluate the feasibility and acceptability of CIMT when delivered via telehealth to stroke survivors (TeleCIMT) and (b) explore therapists' experiences and use of an online support package inclusive of training, mentoring and resources to support TeleCIMT delivery in clinical practice. METHODS: A prospective single-group, single blinded, study design with embedded process evaluation will be conducted. The study will be conducted at three outpatient services in Sydney, Australia. A multi-faceted therapist support package, informed by the Capabilities, Opportunity, Motivation- Behaviour model (COM-B), will be used to support occupational therapists to implement TeleCIMT as part of routine care to stroke survivors. Each service will recruit 10 stroke survivor participants (n = 30) with mild to moderate upper extremity impairment. Upper extremity and quality of life outcomes of stroke survivor participants will be collected at baseline, post-intervention and at a 4 week follow-up appointment. Feasibility of TeleCIMT will be evaluated by assessing the number of stroke participants who complete 80% of intensive arm practice prescribed during their 3 week program (i.e., at least 24 h of intensive arm practice). Acceptability will be investigated through qualitative interviews and surveys with stroke survivors, supporter surveys and therapist focus groups. Qualitative interviews with therapists will provide additional data to explore their experiences and use of the online support package. DISCUSSION: The COVID-19 pandemic resulted in a rapid transition to delivering telehealth. The proposed study will investigate the feasibility and acceptability of delivering a complex intervention via telehealth to stroke survivors at home, and the support that therapists and patients require for delivery. The findings of the study will be used to inform whether a larger, randomized controlled trial is feasible. Frontiers Media S.A. 2022-11-18 /pmc/articles/PMC9715749/ /pubmed/36468055 http://dx.doi.org/10.3389/fneur.2022.1010449 Text en Copyright © 2022 Christie, Fearn, McCluskey, Lannin, Shiner, Kilkenny, Boydell, Meharg, Howes, Churilov, Faux, Doussoulin and Middleton. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Christie, Lauren J.
Fearn, Nicola
McCluskey, Annie
Lannin, Natasha A.
Shiner, Christine T.
Kilkenny, Anna
Boydell, Jessamy
Meharg, Annie
Howes, Ella
Churilov, Leonid
Faux, Steven
Doussoulin, Arlette
Middleton, Sandy
Remote constraint induced therapy of the upper extremity (ReCITE): A feasibility study protocol
title Remote constraint induced therapy of the upper extremity (ReCITE): A feasibility study protocol
title_full Remote constraint induced therapy of the upper extremity (ReCITE): A feasibility study protocol
title_fullStr Remote constraint induced therapy of the upper extremity (ReCITE): A feasibility study protocol
title_full_unstemmed Remote constraint induced therapy of the upper extremity (ReCITE): A feasibility study protocol
title_short Remote constraint induced therapy of the upper extremity (ReCITE): A feasibility study protocol
title_sort remote constraint induced therapy of the upper extremity (recite): a feasibility study protocol
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9715749/
https://www.ncbi.nlm.nih.gov/pubmed/36468055
http://dx.doi.org/10.3389/fneur.2022.1010449
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