Abstract Details

Title SIRRACT: A Multi-Center, International, Randomized Clinical Trial Using Wireless Technology To Affect Outcomes during Acute Stroke Rehabilitation

Topic Neural Repair/Rehabilitation

Presentation(s) P04 - (-)

Poster/Presentation
Number 036

Objective

Background BACKGROUND: The amount of active therapy provided to patients during inpatient stroke rehabilitation is rather modest. The SIRRACT trial [Stroke Inpatient Rehabilitation Reinforcement of ACTivity, NCT01246882] aimed to increase the time patients spent being active by measuring and providing feedback about walking.

Design/Methods DESIGN/METHODS: Patients were recruited from 12 international (Egypt, India, Italy, Japan, New Zealand, Nigeria, South Korea, Spain, Taiwan, Turkey) and 4 American rehabilitation centers. Inclusion criteria included stroke within the past month requiring inpatient rehabilitation, residual hemiparesis, and the ability to walk at least 5 steps on study entry. All patients participated in standard therapies while wearing tri-axial accelerometers at both ankles to record purposeful activities. Sensor data were uploaded nightly to a central server for individualized processing using Bayesian machine-learning algorithms. Average and maximum daily walking speed, bouts and duration of activity, distance walked, and step counts were calculated. Subjects were randomized to receive one of two levels of activity feedback: low (speed during a weekly timed 10-m walk) or high (sensor-derived variables 3 days a week). Primary outcome measures were the daily duration of walking practice, derived from the sensors, and a timed 15-m walk at discharge by a blinded observer.

Results RESULTS: 150 subjects were recruited. Enrollment stopped as planned on October 1, 2012. No significant differences in age, gender, disability or walking speed were found between groups at baseline. Sensor data were successfully obtained and feedback provided to each study site. 120-126 subjects will be available for the efficacy analysis.

Conclusions CONCLUSIONS: This trial reveals, for the first time, the feasibility of using inexpensive wireless technology and the Internet to affect behavioral change in disabled persons. Statistical analysis of the results and problem-solving challenges for remote sensing will be discussed.

Authors/Disclosures
Andrew K. Dorsch, MD (Rush University Medical Center) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Bruce H. Dobkin, MD, FAAN (Dept of Neurology At Geffen UCLA School of Medicine)	No disclosure on file
	No disclosure on file

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