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一项前瞻性随机对照试验,旨在考察移动健康平台在住院脑卒中康复中的策略训练的可行性和残疾结局(iADAPT)。

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

机构信息

Department of Occupational Therapy, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, USA.

Department of Medicine, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA.

出版信息

Top Stroke Rehabil. 2023 Jul;30(5):512-521. doi: 10.1080/10749357.2022.2077522. Epub 2022 May 18.

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 , workbook ; Patient Provider Connection: iADAPT , workbook ), but the mobile health group reported greater satisfaction with remote intervention (Treatment Expectancy: iADAPT , workbook ; Patient Provider Connection: iADAPT , workbook ). .

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.

摘要

背景

策略训练是一种干预措施,在中风后的住院康复中实施时可能会减少残疾。然而,较短的住院时间和出院后护理连续性的挑战导致难以实现足够的干预剂量和训练的延续。

目的

我们研究了使用移动健康平台(iADAPT)在住院中风康复期间和出院后进行策略训练是否可行。

方法

在这项 RCT 中,参与者被随机分配接受使用 iADAPT 应用程序(n=16)或工作簿(n=15)的策略训练。两组参与者在住院康复期间都接受了 7 次面对面的课程,出院后接受了 3 次远程课程。我们计算了描述性统计数据,以检查接受度、出勤率和依从性,以及组内满意度和残疾的效应大小。

结果

iADAPT 组参加的总干预课程较少(n=5.5,工作簿 n=9.0),但尝试的目标数量相似(n=7.6,工作簿 n=8.2)。两组对面对面干预的满意度相似(治疗预期:iADAPT,工作簿;患者与提供者的联系:iADAPT,工作簿),但移动健康组对远程干预的满意度更高(治疗预期:iADAPT,工作簿;患者与提供者的联系:iADAPT,工作簿)。

结论

考虑到这些有希望的可行性指标和移动健康的优势,值得继续探索使用移动健康平台进行策略训练的疗效。

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