image: Fadi Musfee, MD, PhD, MPH, is leading a clinical trial testing a telerehabilitation program for stroke patients in the Texas Rio Grande Valley.
Credit: UTHealth Houston
A new at-home telerehabilitation care service for stroke patients will be offered to residents of Cameron County in the Rio Grande Valley as part of a randomized clinical trial led by researchers from across UTHealth Houston.
Investigators from UTHealth Houston School of Public Health in Brownsville, UTHealth Houston Institute for Stroke and Cerebrovascular Diseases, and McWilliams School of Biomedical Informatics at UTHealth Houston will create and test software delivered through a website to patients who have recently suffered a stroke.
“The key point is that the Rio Grande Valley is an underserved community and many people are uninsured,” said Fadi Musfee, MD, PhD, MPH, lead investigator of the trial and assistant professor of epidemiology at the School of Public Health. “It’s hard for them to go to rehabilitation after a stroke. If they don’t receive rehabilitation, it’s a big burden.”
Co-investigators of the multidisciplinary team include Belinda Reininger, DrPH, MPH, professor of health promotion and behavioral sciences and regional dean of the School of Public Health in Brownsville; Sean Savitz, MD, professor in the Department of Neurology and Frank M. Yatsu, MD, Chair in Neurology at McGovern Medical School at UTHealth Houston; Xiaoqian Jiang, PhD, chair of the Department of Health Data Science and Artificial Intelligence and Christopher Sarofim Family Professor in Biomedical Informatics and Bioengineering at McWilliams School of Biomedical Informatics; and Emily Stevens, DrPH, MOT, occupational therapist and research coordinator at the UTHealth Houston Institute for Stroke and Cerebrovascular Diseases. Musfee, Reininger, and Jiang are members of the stroke institute, and Savitz is the director.
The stroke survivors will be randomized, with half receiving the telerehabilitation program and half serving as controls. The software program, called Mobile Rehab and developed by Jiang, allows participants to be prescribed personalized rehabilitation strengthening video regimens based on respondent-indicated motor skills and activities of daily living deficits. The intervention will last for three months. They will also receive community health worker home visits to check on progress, provide stroke education, and troubleshoot issues. The control group will be provided a list of social services resources, including mental health, as part of usual care.
Researchers will estimate the functional health, mental health, and caregiver burden outcomes and identify barriers to, and facilitators of, adopting and delivering the new rehabilitation model.
The nine-month study will enroll 30 participants – 15 in each arm, ages 18-80 – who were discharged from Valley Baptist Medical Center within the past month and are uninsured. Individuals with psychiatric disorders, dementia, or baseline pre-stroke motor deficits will be excluded.
Funding is from the UTHealth Houston Center for Clinical and Translational Sciences.