Barth Jessica, Geed Shashwati, Mitchell Abigail, Brady Kathaleen P, Giannetti Margot L, Dromerick Alexander W, Edwards Dorothy F
Veterans Affairs Medical Center, Center of Innovation for Long-Term Supports and Services, Providence, RI.
MedStar National Rehabilitation Hospital, Washington, DC.
Arch Rehabil Res Clin Transl. 2023 Jul 24;5(3):100282. doi: 10.1016/j.arrct.2023.100282. eCollection 2023 Sep.
To present the development of a novel upper extremity (UE) treatment and assess how it was delivered in the Critical Periods After Stroke Study (CPASS), a phase II randomized controlled trial (RCT).
Secondary analysis of data from the RCT.
Inpatient and outpatient settings the first year after stroke.
Of the 72 participants enrolled in CPASS (N=72), 53 were in the study groups eligible to receive the treatment initiated at ≤30 days (acute), 2-3 months (subacute), or ≥6 months (chronic) poststroke. Individuals were 65.1±10.5 years of age, 55% were women, and had mild to moderate UE motor capacity (Action Research Arm Test=17.2±14.3) at baseline.
The additional 20 hours of treatment began using the Activity Card Sort (ACS), a standardized assessment of activities and participation after stroke, to identify UE treatment goals selected by the participants that were meaningful to them. Treatment activities were broken down into smaller components from a standardized protocol and process that operationalized the treatments essential elements.
Feasibility of performing the treatment in a variety of clinical settings in an RCT and contextual factors that influenced adherence.
A total of 49/53 participants fully adhered to the CPASS treatment. The duration and location of the treatment sessions and the UE activities practiced during therapy are presented for the total sample (n=49) and per study group as an assessment of feasibility and the contextual factors that influenced adherence.
The CPASS treatment and therapy goals were explicitly based on the meaningful activities identified by the participants using the ACS as a treatment planning tool. This approach provided flexibility to customize UE motor therapy without sacrificing standardization or quantification of the data regardless of the location and UE impairments of participants within the first year poststroke.
介绍一种新型上肢治疗方法的开发，并评估其在中风后关键期研究（CPASS）中的实施情况，这是一项II期随机对照试验（RCT）。
对RCT数据进行二次分析。
中风后第一年的住院和门诊环境。
在CPASS研究中登记的72名参与者（N = 72）中，53名在研究组， eligible to receive the treatment initiated at ≤30 days（急性），2 - 3个月（亚急性）或≥6个月（慢性）中风后。个体年龄为65.1±10.5岁，55%为女性，基线时具有轻度至中度上肢运动能力（动作研究臂测试=17.2±14.3）。
额外的20小时治疗开始使用活动卡片分类（ACS），这是一种中风后活动和参与的标准化评估，以确定参与者选择的对他们有意义的上肢治疗目标。治疗活动从标准化方案和流程中分解为更小的组成部分，该方案和流程实施了治疗的基本要素。
在RCT的各种临床环境中进行治疗的可行性以及影响依从性的背景因素。
共有49/53名参与者完全遵守CPASS治疗。给出了治疗总样本（n = 49）和每个研究组的治疗疗程持续时间、地点以及治疗期间练习的上肢活动，作为对可行性和影响依从性的背景因素的评估。
CPASS治疗和治疗目标明确基于参与者使用ACS作为治疗计划工具确定的有意义活动。这种方法提供了灵活性，可定制上肢运动疗法，而不会牺牲数据的标准化或量化，无论参与者在中风后第一年的位置和上肢损伤情况如何。
