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Stroke Canada Optimization of Rehabilitation by Evidence Implementation Trial SCORE-IT)

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified July 2006 by Toronto Rehabilitation Institute.
Recruitment status was:  Recruiting
McGill University
Information provided by:
Toronto Rehabilitation Institute Identifier:
First received: July 31, 2006
Last updated: March 19, 2008
Last verified: July 2006
The aim of this project is to evaluate whether using an implementation intervention promotes use of best practices by rehabilitation professionals and leads to improvements in patient outcomes for individuals with stroke.

Condition Intervention Phase
Behavioral: Knowledge translation intervention package
Phase 2
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind
Official Title: Stroke Canada Optimization of Rehabilitation by Evidence Implementation Trial (SCORE IT)

Resource links provided by NLM:

Further study details as provided by Toronto Rehabilitation Institute:

Primary Outcome Measures:
  • Arm function as measured by the Box and Block test
  • Walking speed as measured by the 6 minutes walk test

Secondary Outcome Measures:
  • Arm function as measured by the Chedoke Arm and Hand Activity Inventory (CAHAI- 9)
  • Impairment as measured by the Chedoke-McMaster Stroke Assessment Scale (CMSA)
  • Independence of daily living as measured by the 3. Functional Independence Measure (FIM)
  • Economic outcomes measured by the Quality Adjusted Life Years (QALY)

Estimated Enrollment: 2000
Study Start Date: September 2006
Estimated Study Completion Date: April 2008
Detailed Description:

Stroke is a leading cause of disability in Canada and frequently causes hemiparesis (upper limb and lower limb weakness on one side of the body). Approximately one third of stroke survivors require physical rehabilitation to improve their motor and functional recovery (1). Although many strategies have been shown to be effective in promoting recovery after stroke, the uptake of evidence-based practice by rehabilitation professionals across Canada is variable. The aim of this project is to evaluate whether using an implementation intervention promotes use of best practices by rehabilitation professionals and leads to improvements in patient outcomes for individuals with stroke.

This project is a cluster randomized implementation trial for upper and lower limb interventions. Rehabilitation centres across Canada will be randomized to receive either an outcome-oriented implementation strategy (OOI) to facilitate implementation of the EIPRs or a process-oriented implementation strategy (POI). At the onset, rehabilitation professionals practicing in all centres will receive education in using best practice outcome measures related to stroke rehabilitation. All centres will be assessed for baseline adherence to the EIPRs. Centres in the OOI will receive "usual care" (i.e. passive dissemination of the written protocols and information about outcome measures). Centres in the POI arm will receive a combination of strategies to facilitate EIPR uptake (i.e., use of a local facilitator, practice audits with feedback, reminder systems and educational sessions). Following exposure to the EIPRs, all centres will document adherence to the EIPRs, and patient outcomes as assessed by the measures. An analysis of the costs associated with rehabilitation interventions and the incremental expense of a POI strategy will be undertaken. These data will be used to compare the OOI and POI centres with respect to the level of uptake and implementation of EIPRs and related expenses.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Rehabilitation Hospitals/Research Sites:

Inclusion Criteria:

  • hospital with designated rehabilitation beds;
  • regularly treats stroke patients;
  • has access to at least one physical (PT) and one occupational (OT) therapist on the health professional team

Exclusion Criteria:

  • Inadequate staffing to administer the outcome measures consistently


Inclusion Criteria:

  • medically stable;
  • stroke with residual disability;
  • requires complex rehabilitation interventions from at least 3 health care professionals, one of them being an OT or a PT;
  • admitted to rehabilitation centre within 90 days of stroke onset;
  • and age >18 years

Exclusion Criteria:

  • having a medical condition that is expected to result in death within 6 months;
  • presence of a serious chronic disabling condition that impacts on either the rehabilitation process or rehabilitation outcomes such as severe arthritis, dementia, Parkinson's disease;
  • active suicidal ideation or symptoms of psychosis
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00359593

Canada, Ontario
Toronto Rehabilitation Institute
Toronto, Ontario, Canada, M5G 2A2
Canada, Quebec
McGill University
Montreal, Quebec, Canada, H3G 1Y5
Sponsors and Collaborators
Toronto Rehabilitation Institute
McGill University
Principal Investigator: Mark T Bayley, MD Toronto Rehabilitation Institute
Principal Investigator: Sharon Wood-Dauphinee, PhD McGill University
  More Information Identifier: NCT00359593     History of Changes
Other Study ID Numbers: CSNscore 
Study First Received: July 31, 2006
Last Updated: March 19, 2008

Keywords provided by Toronto Rehabilitation Institute:
Knowledge translation
Evidence based practice

Additional relevant MeSH terms:
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Vascular Diseases
Cardiovascular Diseases processed this record on February 20, 2017