Aha BOOST. Arm-hand BOOST therapy to enhance recovery after stroke: clinical, health economic and process evaluation

Deficits in arm and hand movements after stroke are common and result in reduced independence in
activities of daily living and quality of life. Implementable therapy in the subacute rehabilitation
phase for improved arm and hand recovery long-term after stroke that demonstrates robust benefits
for patient and society is still required. This is what our project will investigate, specifically whetherfor
P: patients after stroke, who are admitted to inpatient stroke rehabilitation, and who have the
potential to relearn,
I: an additional, comprehensive, arm-hand intervention (Aha BOOST)
C: when compared to dose-matched therapy for the lower limb,
O: enhances arm-hand activity and quality of life post-treatment and long-term, and is costeffective.
For this evaluation, a randomized controlled trial will be conducted in two independent Flemish
rehabilitation centres, recruiting 80 patients in total. Our trial methodology is strongly based on a
sound rationale, documented in a proof of concept that demonstrated 80% of patients achieving a
clinical meaningful improvement in arm and hand function in the Aha BOOST intervention group
compared to 0% in the control group after four weeks of therapy. In our definitive trial, 40 patients
per group are included and evaluated pre- and post-intervention, three months after intervention and
12 months after stroke to evaluate immediate, retained and long-term clinical effects and costeffectiveness
in the first year after stroke. Results include upper limb function, capacity, activity of
daily living, participation and quality of life, health care utilisation and a dedicated process
evaluation. Primary analysis and endpoint is the between-group difference in arm and hand ICF
activity level from pre- to postintervention.
Utilisation objectives focus on the implementation of Aha BOOST in clinical practice, support
management in embedding this new approach in routine setting and advocate integration in stroke
care provision.