E-learning+ Rehab Therapy

Not Applicable

Terminated

Brief Summary: Stroke survivors with arm paresis because of stroke use their "good" arm for daily activities, but in doing so may be self-limiting their own recovery of the "bad" arm. Traditional models of stroke rehabilitation fail to fully engage the survivor and care partner(s) in actively planning post-discharge habits that improve their capacity to live well over their entire lives. This study will test a cutting-edge in-person therapy + online training program designed to progressively transfer the responsibility of driving post-stroke recovery from the therapist to the survivor.

Recruitment & Eligibility

Inclusion Criteria

paresis of one arm/hand because of ischemic or hemorrhagic stroke >2 mo. and <3 yrs prior
moderate arm impairment defined as a baseline Fugl-Meyer Assessment of the Upper Extremity score of at least 32±2 points but no more than 47±2 points (out of 60 points)
Montreal Cognitive Assessment score ≥22
ability to read English
ability to communicate as per the therapists' judgement at baseline testing
21-90 years of age
wi-fi connection in the home and either a computer, smartphone or tablet.

Exclusion criteria:

lesion or injury to brainstem or cerebellum
other neurological disease that may impair motor or learning skills (e.g., Parkinson's Disease);
pain interfering with reaching
uncorrected vision making it difficult to read information on a computer, tablet or phone.

Exclusion Criteria

Not provided

Arm && Interventions

Group	Intervention	Description
e learning+therapy (TEAACH)	TEAACH	TEAACH-Training to Empower Activity-dependent plasticity-based Arm-use habits in the Community and at Home

Primary Outcome Measures

Name	Time	Method
Change in Health Literacy From Baseline to 3 Months	Baseline Visit and 3 months	Health Literacy will be assessed via a standardize 18-item test designed to assess an adult's ability to read and understand common medical terms. Minimum = 0, Maximum = 18. Higher scores indicate greater health literacy.
Change in Self Management Skills From Baseline to 3 Months	Baseline and 3 months	Participants' ability to manage their chronic condition (their stroke) will be assessed qualitatively using interview questions. Participants' narratives will be analyzed and reported as a description of how their own skills have changed.

Secondary Outcome Measures

Name	Time	Method
Change in Self-Efficacy for Managing Daily Activities From Baseline to 3 Months and 5 Months	Baseline Visit, 3 months and 5 months	Self-Efficacy will be assessed using the NIH PROMIS Self-Efficacy for Managing Daily Activities assessment. Minimum score = 0, Maximum score = 8. Higher numbers indicate greater self efficacy.
Change in Social Isolation From Baseline to 3 Months and 5 Months	Baseline Visit, 3 months & 5 months	Social Isolation will be assessed using the NIH PROMIS Social Isolation assessment. Minimum score = 0, Maximum score = 8. Higher numbers indicate less social isolation.
Change in Emotional Support From Baseline to 3 Months and 5 Months	Baseline Visit, 3 months (Post Treatment+/- 3 days), & 5 months (Follow up +/- 3 days)	Emotional Support will be assessed using the NIH PROMIS Emotional Support assessment. Minimum score = 0, Maximum score = 8. Higher numbers indicate greater emotional support.