TRAIL-RCTTRAIL: Telerehabilitation for Lower Extremity Recovery Post-Stroke

Stroke survival rates are high, but many survivors experience motor impairments that affect their daily activities and put a strain on healthcare resources. To help improve lower extremity recovery post-stroke, a telerehabilitation program called TRAIL has been developed. TRAIL is an exercise program that uses technology to provide real-time therapist instruction and guidance. A previous feasibility study showed potential for TRAIL to improve lower extremity function in stroke survivors. Now, a full-scaled randomized controlled trial, TRAIL-RCT, is proposed to further study the program's effectiveness. This study is important as it aims to address the unmet needs for lower extremity rehabilitation after stroke and provide accessible rehabilitation, especially in light of the COVID-19 pandemic. The TRAIL-RCT study compares the TRAIL program to an attention-controlled education program (EDUCATION) for individuals within 12 months post-stroke. The primary goal is to evaluate functional mobility improvement after 4 weeks, measured by the Timed Up and Go test. Secondary goals include assessing lower extremity strength, functional balance, motor impairment, and balance self-efficacy. The study also evaluates health economic outcomes, such as health-related quality of life and health resources and costs. It is hypothesized that the TRAIL program will lead to greater improvements in all these areas compared to the EDUCATION program. Additionally, the study will evaluate the feasibility of a subsequent larger multisite implementation of the TRAIL program.