Telerehabilitation In The Home After Stroke

Eligibility Criteria

• 1. Age 18-80 years at the time of randomization
• 2. The index stroke was radiologically verified, due to ischemia or intracerebral hemorrhage (ICH), and had time of onset 120±30 days prior to randomization
• 3. The stroke caused upper extremity deficits as defined by Action Research Arm Test score 18-44 (out of 57) at Baseline Visit 1
• 4. Box \& Block Test score with affected arm is ≥1 block in 60 seconds at Baseline Visit 1
• 5. Able to successfully perform all 3 rehabilitation exercise test examples (simple commands) at Baseline Visit 1
• 6. Informed consent and behavioral contract signed by the subject (i.e., no surrogate consent)
• 1. A major, active, coexistent neurological, psychiatric, or medical disease that reduces the likelihood that a subject will be able to comply with all study procedures
• 2. Unable or unwilling to perform study procedures/therapy, or expectation of noncompliance with study procedures/therapy, or expectation that subject cannot participate in all study visits
• 3. A diagnosis (apart from the index stroke) that substantially affects paretic arm function
• 4. Severe depression, defined as Geriatric Depression Scale Score \>10/15 at Baseline Visit 1
• 5. Significant cognitive impairment, defined as Montreal Cognitive Assessment score \<22 \[a lower score is permitted if due to aphasia and allowed by the site PI\]
• 6. Deficits in communication that interfere with reasonable study participation
• 7. Severe UE spasticity, defined as presence of contracture or modified Ashworth Scale score=4 in either biceps or pectoralis
• 8. Modified Rankin Scale score was \>2 prior to the index stroke
• 9. A new symptomatic stroke has occurred since the index stroke, or a separate stroke occurred within 30 days prior to the index stroke
• 10. Lacking visual acuity, with or without corrective lens, of 20/50 or better in at least one eye
• 11. Life expectancy \< 9 months
• 12. Pregnant; women of child-bearing potential must have a negative pregnancy test
• 13. Botulinum toxin to the paretic arm: received in the prior 3 months OR expected by the 8-Month Visit
• 14. Concurrent enrollment in another therapy-based investigational study where the duration of the investigational therapy's activity is likely to occur during the subject's participation in the study
• 15. Subject lacks sufficient English or Spanish to comply with study procedures and TR instructions
• 16. Expectation that subject will not have a single domicile address during the 6 weeks of therapy that is within 1.5-hr drive of the central study site \[this can be waived at the discretion of the site PI\]
• 17. Contraindication to MRI
• 18. On isolation precautions, e.g., due to active COVID-19