Pilot RCT examining feasibility and disability outcomes of a mobile health platform for strategy training in inpatient stroke rehabilitation (iADAPT)

 

You're putting the cart before the horse. First you create 100% recovery protocols, then you do the training to deliver those protocols. GET THERE!

Pilot RCT examining feasibility and disability outcomes of a mobile health platform for strategy training in inpatient stroke rehabilitation (iADAPT)

Jessica Kersey

,

Emily Kringle

,

I Made Agus Setiawan

,

Bambang Parmanto

&

Elizabeth R. Skidmore

Received 09 Nov 2021, Accepted 07 May 2022, Published online: 18 May 2022

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• https://doi.org/10.1080/10749357.2022.2077522
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ABSTRACT

Background

Strategy training is an intervention that may reduce disability when delivered in inpatient rehabilitation following stroke. However, shorter lengths of stay and challenges with continuity of care following discharge results in difficulties in achieving adequate intervention dosage and carryover of training.

Objective

We examined whether strategy training using a mobile health platform (iADAPT) is feasible during inpatient stroke rehabilitation and following discharge.

Methods

In this RCT, participants were randomized to receive strategy training using either the iADAPT application (n = 16) or a workbook (n = 15). Participants in both groups received 7 in-person sessions during inpatient rehabilitation and 3 remote sessions following discharge. We calculated descriptive statistics to examine acceptance, attendance, and adherence, and within-group effect sizes on satisfaction and disability.

Results

Participants in the iADAPT group attended fewer total intervention sessions (n = 5.5, workbook n = 9.0) but attempted a similar number of goals (n = 7.6, workbook n = 8.2). Both groups reported similar satisfaction with in-person intervention (Treatment Expectancy: iADAPT d = 0.60, workbook d = 0.47; Patient Provider Connection: iADAPT d = 0.18, workbook d = 0.31), but the mobile health group reported greater satisfaction with remote intervention (Treatment Expectancy: iADAPT d = −0.91, workbook d = −0.97; Patient Provider Connection: iADAPT d = 0.85, workbook d = −1.80).     

Conclusions

Considering these promising feasibility metrics and the benefits of mobile health, it is worth continuing to explore the efficacy of strategy training using a mobile health platform.

 

EMS1 Poll Results: How do you assess and treat stroke?

The results of this should lead immediately to a training program put together by the ASA and NSA to make sure all strokes are treated appropriately  on the way to the hospital. What is your hospital doing to make sure their EMS responders are properly trained?
http://www.ems1.com/ems-products/Ambulance-Disposable-Supplies/articles/2179388-EMS1-Poll-Results-How-do-you-assess-and-treat-stroke

Post-Stroke Spasticity: A Case-Based Series Stroke Clinical Updates

Training for your doctors or yourself if you think you will do a better job.
From the NSA, I refuse to waste my time on stuff like this from them, nothing they put out prior has given me any useful information at all.

The goal of the Post-Stroke Spasticity: A Case-Based Series Stroke Clinical Updates activity is to increase clinician knowledge, diagnosis, and treatment of post-stroke spasticity. 
Part One: Upper Limb Post-Stroke Spasticity: Evidence and Opportunities
Part Two: Post-Stroke Lower Extremity Spasticity: Evidence and Opportunities
Part Three: Post-Stroke Diffuse Spasticity: Evidence and Opportunities

Medical Education Resources designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credit™ and ANCC credit. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Practical Stroke Rehabilitation Care: Staying on the Cutting Edge

An RIC course, the most interesting would be
Management of the Neurological Hand at Various Stages of
Recovery
- Marilyn Harvey, OTR/L
Molly Listenberger, OTD, OTR/L
Kim Eberhardt Muir, MS, OTR/L
Katie Polo, MHS, OTR/L, CLT-LANA
That would be worth sitting in on.

Practical Stroke Rehabilitation Care: Staying on the Cutting Edge

COURSE OBJECTIVES
Upon completion of this course, participants will be able to:
• Summarize the research published over the past year(Thats all?) in stroke recovery and rehabilitation, discuss their implications to future research and apply them to clinical practice
• Describe a model of care for stroke rehabilitation that integrates clinical practice and research
• Discuss the purpose and use of commonly prescribed medications in stroke patients during rehabilitation
• Develop evidence-based outcomes for therapeutic management of attentional, perceptual and cognitive-communication interventions for right hemisphere stroke.(What about left hemisphere?)
• Summarize the research related to using non-invasive brain stimulation for neurorehabilitation of motor recovery (upper limb, lower limb and speech) following stroke
• Discuss strategies for increasing the number of steps in gait training for persons with stroke
• Apply various modalities and treatment options for persons post-stroke with mild-moderate levels of upper extremity recovery
• Summarize how families cope and adapt after stroke
• Describe the survivor’s perspective on returning to and maintaining work after stroke and provide recommendations to clinicians as to how to address these issues with their patients
• Demonstrate awareness and knowledge of the barriers and facilitators associated with limitations in access to exercise and physical activity in people with stroke