Study protocol: home-based telehealth stroke care: a randomized trial for veterans.

BACKGROUND: Stroke is one of the most disabling and costly impairments of adulthood in the United States. Stroke patients clearly benefit from intensive inpatient care, but due to the high cost, there is considerable interest in implementing interventions to reduce hospital lengths of stay. Early discharge rehabilitation programs require coordinated, well-organized home-based rehabilitation, yet lack of sufficient information about the home setting impedes successful rehabilitation. This trial examines a multifaceted telerehabilitation (TR) intervention that uses telehealth technology to simultaneously evaluate the home environment, assess the patient's mobility skills, initiate rehabilitative treatment, prescribe exercises tailored for stroke patients and provide periodic goal oriented reassessment, feedback and encouragement. METHODS: We describe an ongoing Phase II, 2-arm, 3-site randomized controlled trial (RCT) that determines primarily the effect of TR on physical function and secondarily the effect on disability, falls-related self-efficacy, and patient satisfaction. Fifty participants with a diagnosis of ischemic or hemorrhagic stroke will be randomly assigned to one of two groups: (a) TR; or (b) Usual Care. The TR intervention uses a combination of three videotaped visits and five telephone calls, an in-home messaging device, and additional telephonic contact as needed over a 3-month study period, to provide a progressive rehabilitative intervention with a treatment goal of safe functional mobility of the individual within an accessible home environment. Dependent variables will be measured at baseline, 3-, and 6-months and analyzed with a linear mixed-effects model across all time points. DISCUSSION: For patients recovering from stroke, the use of TR to provide home assessments and follow-up training in prescribed equipment has the potential to effectively supplement existing home health services, assist transition to home and increase efficiency. This may be particularly relevant when patients live in remote locations, as is the case for many veterans. TRIAL REGISTRATION: Clinical Trials.gov Identifier: NCT00384748.

Two years of outreach, 1968-1970 : a report from--the Administrator of Veterans Affairs.

Mode of access: Internet.

Better planning and management needed by the Veterans Administration to improve use of specialized medical services; report to the Congress,

Publication date stamped on t.p.

A guide for studying the utilization of nursing service personnel in Veterans Administration hospitals.

Cover title.

President's Private Sector Survey on Cost Control : report on the Department of State/AID/USIA : report on the Veterans Administration.

Mode of access: Internet.

Handicapped? Not on the job! : the physically impaired worker in the Veterans Administration.

"March 1959"

Personnel policies of the Veterans Administration /

Cover title.

Data on Vietnam era veterans.

Description based on: Sept. 1977; title from cover.

Data on female veterans.

Not issued in 1985.

Veterans' Administration activities [microform] /

Reuse of record except for individual research requires license from Congressional Information Service, Inc.

Local VER service to veterans; instructor's guide.

"Part A"

Oversight of Veterans' Administration target system : hearings before the Subcommittee on Special Investigations of the Committee on Veterans' Affairs, House of Representatives, Ninety-sixth Congress, first session, June 20, September 11 [i.e. July 13] and September 11, 1979.

Mode of access: Internet.

Directory of Veterans Administration facilities.

Title from cover.

Survey of female veterans : a study of the needs, attitudes and experiences of women veterans, conducted for the Veterans Administration /

"Study no. 843002."

Education and income characteristics of male war veterans and nonveterans, March 1982 /

"April 1984."