Principal Investigator: H.F. Machiel Van der Loos, PhD Project Staff: Charles G. Burgar, MD; Deborah E. Kenney, MS OTR; Ellie L. Buckley, MS RPT; Carol-Ann Davidson, RPT; Eric L. Topp, MS; and James J. Wagner, MS Project Category: Stroke - 2001 Objective: Patient education is an area of increasing importance within any therapy regimen due to the increasing pressure to shorten the acute care period. In stroke rehabilitation, this situation leads to a significantly greater reliance on home care and sub-acute care to achieve major functional gains. There is a need to develop effective, person-specific training aids that carry over from the shortened clinical stays to the home or sub-acute setting, and allow both client and caregivers the extended opportunity for learning and review of complex safety-related procedures. Our first goal is to implement an effective means of making and using personalized video as a training tool to teach safe wheelchair transfers. Our second goal is to develop and validate a web-mediated, digital video assessment instrument (F-PAT) for the clinician to assess functional performance before and after the training period. Research Plan: We are testing two hypotheses: 1) Subjects using the personalized videotape at home will be able to perform their wheelchair transfers more competently and with fewer incidents than those given only written instructions or a general videotape on transfer techniques; 2) The F-PAT video-based web site provides an objective tool for clinicians to assess patient status and progress. We are performing a Critical Elements Video Assessment (CEVA) validity study prior to the main assessment study. We will then conduct a trial of 45 stroke subjects over the course of this project with a random assignment to one of three groups: a) regular paper-based training materials; b) a generalized videotape to teach transfers, and c) a personalized training tape. A wheelchair transfer will be videotaped at discharge. After a 6-week period in the home following discharge from acute stroke rehabilitation, the follow-up exam will include a videotaped wheelchair transfer. The CEVA will then be used by 2 blinded clinicians to assess the relative performance before and after the 6-week period. Work Accomplished: In the first year of this project, the password-protected CEVA website has been implemented, the ten CEVA categories have been pre-tested with colleagues from local clinics, and we have contacted 20 therapists who have agreed to perform the inter-rate reliability study starting in December, 2001. The digital editing suite has been procured, a generalized videotape is 90% complete, A home packet to send with the subjects has been designed, and already one subject has received and has been using a personalized videotape and this packet to pre-test the study process. Expected Outcome: Based on preliminary data, The CEVA inter-rate reliability study is expected to validate our design of the ten CEVA categories. Based on data from our trial subject, we are confident that the video editing process, the logging data instruments and the web-based assessment software will be completed in preparation of the final assessment trials in years 2 and 3 of the study. Funding Source: VA/Rehab R&D Telemedicine RFP Funding Status: On-going |
