Efficacy of Tele-CPASS Compared to In-person CPASS Therapy for Upper Extremity Motor Recovery
Efficacy of Tele-CPASS, a Telerehabilitation Intervention Using Critical Periods After Stroke Study (CPASS) Compared to In-person CPASS for Upper Extremity Motor Recovery
University of Texas, El Paso
42 participants
Sep 1, 2025
INTERVENTIONAL
Conditions
Summary
This study evaluates whether a home-based telerehabilitation program (tele-CPASS) is as effective as an in-person rehabilitation program (CPASS) for improving arm and hand function after stroke. Stroke often leads to long-term difficulty using the affected arm in daily activities, and access to in-person therapy can be limited. This study aims to determine whether therapy delivered remotely can provide similar benefits to standard in-clinic care. Participants who recently experienced a stroke will be randomly assigned to receive 20 hours of upper extremity rehabilitation therapy either in person or through a telehealth platform. Both groups will receive the same type and amount of therapy focused on practicing meaningful, patient-selected daily activities. Participants will complete assessments before treatment, immediately after treatment, and at 6 and 12 months to measure recovery of arm function, real-world arm use, and participation in daily life. The results of this study will help determine whether telerehabilitation can improve access to effective stroke recovery interventions while maintaining clinical effectiveness comparable to in-person therapy.
Eligibility
Inclusion Criteria8
- Age 21 years or older
- Neuroimaging-confirmed stroke within 40 days prior to enrollment
- Persistent hemiparesis resulting in impaired upper extremity function, defined by a score of 0 to 3 on the NIH Stroke Scale motor arm item
- Able to participate in all study-related activities, including 1-year follow-up
- Short Blessed Memory Orientation and Concentration Scale score less than 8
- Able to follow 2-step commands
- Montreal Cognitive Assessment (MoCA) score greater than 25
- No upper extremity injury or condition that limited upper extremity use prior to the stroke
Exclusion Criteria10
- Inability to provide informed consent
- Persistent disabling neurologic condition, such as multiple sclerosis, Parkinsonism, amyotrophic lateral sclerosis, or dementia requiring medication
- Clinically significant fluctuations in mental status within 72 hours prior to randomization
- Active psychosis, psychosis within the prior 2 years, active substance abuse, or prior substance abuse
- Dense sensory loss, defined by a score of 3 or 4 on the NIH Stroke Scale sensory item
- Ataxia out of proportion to weakness in the affected arm, defined by a score greater than 1 on the NIH Stroke Scale ataxia item
- Not expected to survive 12 months because of other illnesses
- Pregnancy
- Severe aphasia
- Receipt of botulinum toxin or expectation of receiving botulinum toxin during the study period
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Interventions
Intervention 1: Tele-CPASS Tele-CPASS is a home-based telerehabilitation intervention consisting of 20 hours of therapist-guided, task-specific upper extremity motor training delivered remotely using a telehealth platform for individuals with stroke. Therapy is individualized based on participant-selected functional goals and focuses on repetitive practice of meaningful daily activities to improve arm and hand function after stroke. Participants complete sessions in their home environment with real-time therapist guidance and may be provided with equipment and technology needed to support remote delivery.
Intervention 2: In-person CPASS therapy In-person CPASS is a clinic-based rehabilitation intervention consisting of 20 hours of therapist-guided, task-specific upper extremity motor training delivered face-to-face. Therapy is individualized based on participant-selected functional goals and focuses on repetitive practice of meaningful daily activities to improve arm and hand function after stroke. Sessions are conducted in a clinical setting under direct supervision of a therapist.
Locations(3)
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NCT07661849