权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Interdisciplinary Comprehensive Arm Rehab Evaluation (I-CARE) Stroke

跨学科综合手臂康复评估 (I-CARE) 中风

基本信息

批准号：
7696279
负责人：
Carolee J Winstein
金额：
$ 229.38万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-08-01 至 2011-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7696279
关键词：
Acute Address Adult Aftercare Bilateral Caring Chronic Phase Class Classification Clinical Clinical Trials Community Trial Complex Daily Development Dose Effectiveness Elements End Point Environment Evaluation Evidence based treatment Exercise Family Future Gait Goals Hand Hand functions Home environment Hour Household Hybrids Impairment Inpatients Intervention Kinesiology Laboratories Learning Leg Leisure Activities Level of Evidence Limb structure Lower Extremity Masks Measures Medicare Modality Monitor Motor Movement Numbers Occupational Therapy Outcome Outcome Measure Outpatients Paresis Participant Patient Self-Report Patients Performance Phase Protocols documentation Quality of life Randomized Randomized Controlled Trials Recommendation Recovery Recovery of Function Rehabilitation therapy Residual state Resolution Reversal Learning Review, Systematic (PT)Score Secondary to Self Care Self Perception Services Site Solutions Stroke Subgroup Testing Time Training Translations Travel Upper Extremity Upper arm Walking Week Wolves abstracting acute stroke base constraint induced therapy cost design disability experience functional outcomes improved instrument motor control motor impairment motor learning muscle strength post stroke programs remediation skill acquisition skills stroke recovery stroke rehabilitation tool trend

项目摘要

Project Summary/Abstract Residual disability after stroke is substantial, with about 65% of patients at 6 months unable to incorporate the paretic hand effectively into daily activities. In turn, this degree of functional deficit contributes to a reduced quality of life after stroke. The primary objective of I-CARE (Interdisciplinary Comprehensive Arm Rehabilitation Evaluation) is to improve outpatient therapy for arm paresis after stroke. We will conduct a Phase III, singleblind, multi-center, randomized control trial to investigate the effectiveness of ASAP (Accelerated Skill Acquisition Program), a focused, intense, evidence-based, upper extremity rehabilitation program. ASAP combines aspects of constraint-induced therapy, skill-based/impairment-mitigating task-specific training with embedded motivational enhancements and includes 30 hours of one-on-one therapy initiated during the early post-acute outpatient interval (1-3 months) after stroke. This RCT has one primary aim: Compare ASAP to a dose equivalent usual and customary occupational therapy (high dose) group. There are two secondary aims: a) Compare ASAP to a true (monitoring only) usual and customary therapy group (low dose) and b) Compare the high dose usual and customary occupational therapy group to the low dose usual and customary occupational therapy group. We will randomize 360 adults, within one to three months of stroke onset, with mild to moderate upper extremity impairment. Our primary outcome is a performance-based arm function test, Wolf Motor Function Test (WMFT) at one year after participation. Secondary outcomes include patients¿ self-perception of paretic hand function, a domain of the Stroke Impact Scale (SIS) and the full SIS. Specific subgroup analyses will explore important moderating factors including duration from onset, stroke type, and motor impairment. Given the trend toward diminished total reimbursable time for stroke rehabilitation, our ultimate goal is to provide evidence toward an optimal allocation of therapy services within the approved number of treatment sessions that will reduce disability, lessen the societal burden, and provide a standardized evidence-based treatment useful for the rehabilitation clinician and future clinical trialist.

项目总结/文摘