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An Innovative STRoke Interactive Virtual thErapy (STRIVE) Online Platform for Community-Dwelling Stroke Survivors: A Randomized Controlled Trial

  • Liam Johnson
    Affiliations
    The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia

    Faculty of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia

    National Health and Medical Research Council Stroke Rehabilitation and Brain Recovery Centre of Research Excellence, The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
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  • Marie-Louise Bird
    Affiliations
    College of Health and Medicine, University of Tasmania, Launceston, Australia

    Department of Physical Therapy, University of British Columbia, Vancouver, Canada
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  • Makii Muthalib
    Affiliations
    Silverline Research, Brisbane, Australia

    EuroMov, University of Montpellier, Montpellier, France
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  • Wei-Peng Teo
    Correspondence
    Corresponding author Wei-Peng Teo, PhD, CSCS, Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, NIE05-03-18, Singapore 637616.
    Affiliations
    Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia

    Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore
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Published:April 10, 2020DOI:https://doi.org/10.1016/j.apmr.2020.03.011

      Objective

      To investigate the STRoke Interactive Virtual thErapy (STRIVE) intervention on upper-extremity clinical outcomes in community-dwelling stroke survivors.

      Design

      Assessor-blinded randomized controlled trial.

      Setting

      Study screening and testing was conducted in a university clinic. Participants completed the virtual therapy (VT) intervention in a community-based stroke support group setting.

      Participants

      Of 124 stroke survivors initially assessed, 60 participants were recruited (time poststroke, 13.4±8.9 y). Participants were allocated to either VT or control group using a block randomization design and were stratified by sex.

      Interventions

      Participants were randomized to receive 8 weeks of VT or usual care. The intervention consisted of approximately 45 minutes of twice weekly VT training on the Jintronix Rehabilitation System.

      Main Outcome Measures

      Between-group differences in the Fugl-Meyer Upper Extremity scale and Action Research Arm Test score were joint primary outcomes in this study.

      Results

      Significant between-group differences for the Fugl-Meyer Upper Extremity scale were seen at the end of the intervention (F1, 1=5.37, P=.02, d=0.41). No significant differences were observed with the Action Research Arm Test. No adverse events were reported.

      Conclusions

      We demonstrated clinically meaningful improvements in gross upper extremity motor function and use of the affected arm after a VT intervention delivered via a community-based stroke support group setting. This data adds to the contexts in which VT can be used to improve upper limb function. Use of VT in community-based rehabilitation in chronic stroke recovery is supported.

      Keywords

      List of abbreviations:

      ARAT (Action Research Arm Test), BBT (Box and Block Test), EQ-5D-5L (European Quality of Life-5 Dimension-5 Level), ES (effect size), FMUE (Fugl-Meyer Upper Extremity), MAL-28 (Motor Activity Log-28), MAS (Modified Ashworth scale), MMSE (Mini-Mental State Examination), QOM (quality of movement), QSUL (Queen Square Upper Limb), UC (usual care), UE (upper extremity), VT (virtual therapy)
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