Comparing the Institution-based Supervision and Tele-based Supervision for Task-oriented Exercises on Upper Limb Motor Performance and Functional Ability among Stroke Patients: A Research Protocol
Introduction: Rehabilitation is a vital part of recovery for stroke patients, presenting a complex intervention that requires collaboration among patients, caregivers and the rehabilitation team. Telerehabilitation has emerged as a promising alternative to standard outpatient and home-care rehab...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2025-02-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/20580/73772_CE(Ra1)_F(Sh)_QC(PS_SS)_PF1(AG_SL)_PFA(IS)_PB(AG_IS)_PN(IS).pdf |
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| Summary: | Introduction: Rehabilitation is a vital part of recovery for
stroke patients, presenting a complex intervention that requires
collaboration among patients, caregivers and the rehabilitation
team. Telerehabilitation has emerged as a promising alternative
to standard outpatient and home-care rehabilitation, offering
advantages such as minimal travel barriers, flexible exercise
schedules and the integration of skills into daily activities.
Need of the study: The technologies that can be used for
telerehabilitation range from inexpensive internet-based solutions,
virtual reality, and robotic systems to more costly telephones and
mobile phones, which are present in most homes. Physiotherapists
have been suggested as being in the best position to help stroke
victims transition from the hospital to their homes. However, there
has been significant international professional resistance to using
telerehabilitation-based services, based on the belief that the lack
of in-person care may result in worse outcomes. Nevertheless,
research on numerous chronic health disorders demonstrates
that telerehabilitation strategies can effectively enhance results.
There is a dearth of literature comparing tele-based supervision
for task-oriented exercises with institution-based supervision for
task-oriented exercises. Thus, the need for this study is to identify
a cost-effective method for rehabilitation in stroke patients.
Aim: To compare the effect of institution-based supervision and
tele-based supervision for task-oriented exercises on upper
limb motor performance and functional ability among stroke
patients.
Materials and Methods: A two-group pretest-post-test
randomised clinical trial will be conducted in recognised hospitals
in Mullana and Panipat, using purposive sampling from December
2022 to December 2024. A total of 62 male and female patients,
aged 45-75 years, who have experienced their first ischaemic
or haemorrhagic stroke within the last six months and have
scores ranging from 26 to 56 on the Fugl-Meyer Assessment
for Upper Extremity (FMA-UE), mild to moderate spasticity (less
than 2 on the Modified Ashworth Scale (MAS), >24 on the Minimental State Examination (MMSE), and stages II and III of the
Brunnstrom score will be included in the study. Group B will
receive institution-based supervision for task-oriented exercises,
whereas Group A will receive tele-based supervision for live
sessions. Both groups will perform task-oriented exercises for
30 minutes, three days a week for eight weeks. There will be a
30-second break before switching tasks. Outcome measures,
including the Fugl-Meyer Assessment for Upper Extremity
(FMA UE) and the Motor Evaluation Scale for Upper Extremity
in Stroke Patients (MESUPES), will be assessed at baseline, the
4th week, and the 8th week of intervention, respectively. Repeated
measures of Analysis of Variance (ANOVA) or the Friedman test
will be chosen based on normality to find differences within the
groups at baseline, the 4th week, and the 8th week (completion).
A paired t-test or Wilcoxon signed-rank test will be applied to
identify differences between the groups for pre-post intervention
changes in outcome measures. An Independent t-test or MannWhitney U-test will be applied based on normality to compare
the changes in mean values of the outcome measures between
Group A and Group B at baseline, the 4th week, and the 8th week
of intervention. The level of statistical significance will be set at
alpha=0.05. |
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| ISSN: | 2249-782X 0973-709X |