Saturday, January 09, 2016

Musing: iPad Technology for Home Rehabilitation after Stroke (iHOME): A Proof-of-concept Randomized Trial

Dean Reinke
Deans' Stroke Musing
Thursday, July 17, 2014

Don't you know enough to search for existing research on your topic of choice? My god are these people obtuse. Like this:

iPad Technology for Home Rehabilitation after Stroke (iHOME): A Proof-of-concept Randomized Trial

Gustavo Saposnik, Chi-Ming Chow, David Gladstone, Donna Cheung, Edward Brawer, Kevin E. Thorpe, Avon Saldanha, Alice Dang, Mark Bayley, Tom A. Schweizer and on behalf of the iHOME Research Team for the Stroke Outcomes Research Canada Working Group†

Article first published online: 7 JUL 2014
DOI: 10.1111/ijs.12328
© 2014 World Stroke Organization
Cover image for Vol. 9 Issue 5
INTERNATIONAL JOURNAL OF STROKE

Clinicaltrials.gov registration: NCT01836159

Funding: This study is supported by the Ontario Stroke Network, funded by the Ontario Ministry of Health and Long-Term Care, and by the Canadian Partnership for Stroke Recovery, funded by the Heart and Stroke Foundation of Canada. No support is received from Apple. Dr Saposnik is supported by the Heart and Stroke Foundation of Canada (HSFC) Distinguished Clinician Scientist Award. Dr Schweizer is supported by the HSFC New Investigator Award.
Principal investigators: Dr Saposnik and Dr Chow are the co-PIs of iHOME Acute. Dr Saposnik, Dr Gladstone, and Dr Schweizer are the co-PIs of iHOME Chronic. Dr Bayley is the site PI at Toronto Rehabilitation.

Keywords: outcomes; rehabilitation; stroke; tablet technology

Background

Tablets are a novel line of computers controlled by a multitouch screen. Fine motor movements are captured on the tablet computer through electrical fields and can be qualitatively and quantitatively assessed. Evidence is limited on tablet use for stroke rehabilitation.

Methods

iHOME is an investigator-initiated randomized controlled pilot trial with a single-blinded outcome assessment. The intervention consists of iPad use (investigational group) vs. usual care (control group) among patients receiving conventional outpatient rehabilitation. Eligibility includes aged 18–85 years who experienced a mild ischemic or hemorrhagic stroke (as diagnosed on neuroimaging and determined by the Chedoke–McMaster score ≥3. The STROKE REHAB® software for the iPad was specifically designed for patients with fine motor weakness and/or neglect. Of the total 30 patients, 20 will be in iHOME Acute (enrolled within three-months of stroke onset) and 10 patients in iHOME Chronic (enrolled more than six-months from onset).

Outcome Measures

The primary feasibility outcome is the proportion of the scheduled iPad time used (more than 70% (≥140 mins) of the total ‘dose’ of intervention intended will be considered successful). Efficacy in fine motor movements will be assessed using the nine-hole peg test; time to magnify and pop the balloons in the iPad software application, and improvement in Wolf Motor Function Test.

Conclusions

iHOME is a randomized controlled trial assessing the feasibility, safety, and efficacy of tablet technology for home use in stroke rehabilitation. The results of this study will serve as the basis for a larger multicenter trial.



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