Advancing virtual care in stroke rehabilitation: A randomized controlled trial investigating the TeleRehabilitation with Aims to Improve Lower Extremity Recovery Post-Stroke (TRAIL) program

Leg weakness is very common after stroke. It affects the ability to walk and balance among people who have had a stroke. The first year after stroke is an important time for rehabilitation because it is the best time for recovery. Unfortunately, many people who have had a stroke often feel that they do not receive enough rehabilitation to restore their ability to use their legs. This is especially true for people who live in smaller communities where there are few health services, and more recently due to the COVID-19 pandemic where physical distancing between patients and clinicians has limited the amount of in-person rehabilitation. It is therefore important to develop innovative leg rehabilitation programs that are both cost effective and accessible. Our team of stroke survivors, clinicians and research scientists from across Canada has recently developed TeleRehabilitation with Aims to Improve Lower Extremity Recovery Post-Stroke (TRAIL). TRAIL is a 4-week program that focuses on exercise to improve leg function. It is delivered using the Internet and computer/tablet by a physical therapist. In this study, we will examine if TRAIL improves walking, balance, leg strength, and quality of life to a greater extent than a 4-week education program (EDUCATION), that focuses on providing education on stroke risk factors for secondary prevention. Ninety-six volunteers who have had a stroke in the past year will be randomly assigned to participate in either TRAIL or EDUCATION. Volunteers will be asked to complete assessments and questionnaires before and after the programs, and again 2 and 5 months later. Assessments will be conducted using videoconferencing so that volunteers will not need to travel to a hospital to participate in the study. We are working with 6 cities across Canada (Halifax, Toronto, London, Winnipeg, Vancouver, Kelowna). We anticipate that TRAIL is an accessible program that will help improve leg recovery after stroke.