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Abstract Background In New Zealand, around 45,000 people live with stroke and many studies have reported that benefits gained during initial rehabilitation are not sustained. Evidence indicates that participation in physical interventions can prevent the functional decline that frequently occurs after discharge from acute care facilities. However, on-going stroke services provision following discharge from acute care is often related to non-medical factors such as availability of resources and geographical location. Currently most people receive no treatment beyond three months post stroke. The study aims to determine if the Augmented Community Telerehabilitation Intervention (ACTIV) results in better physical function for people with stroke than usual care, as measured by the Stroke Impact Scale, physical subcomponent. Methods/design This study will use a multi-site, two-arm, assessor blinded, parallel randomised controlled trial design. People will be eligible if they have had their first ever stroke, are over 20 and have some physical impairment in either arm or leg, or both. Following discharge from formal physiotherapy services (inpatient, outpatient or community), participants will be randomised into ACTIV or usual care. ACTIV uses readily available technology, telephone and mobile phones, combined with face-to-face visits from a physiotherapist over a six-month period, to help people with stroke resume activities they enjoyed before the stroke. The impact of stroke on physical function and quality of life will be assessed, measures of cost will be collected and a discrete choice survey will be used to measure preferences for rehabilitation options. These outcomes will be collected at baseline, six months and 12 months. In-depth interviews will be used to explore the experiences of people participating in the intervention arm of the study. Discussion The lack of on-going rehabilitation for people with stroke diminishes the chance of their best possible outcome and may contribute to a functional decline following discharge from formal rehabilitation. Best practice guidelines recommend a prolonged period of rehabilitation, however this is expensive and therefore not undertaken in most publicly funded centres. An effective, cost-effective, and preference-sensitive therapy using basic technology to assist programme delivery may improve patient autonomy as they leave formal rehabilitation and return home. Trial registration ACTRN12612000464864

Breast cancer survivors have known scapular kinematic alterations that may be related to the development of secondary morbidities. A measure of muscle activation would help understand the mechanisms behind potential harmful kinematics. The purpose of this study was to define muscle force strategies in breast cancer survivors. Shoulder muscle forces during 6 functional tasks were predicted for 25 breast cancer survivors (divided by impingement pain) and 25 controls using a modified Shoulder Loading Analysis Module. Maximum forces for each muscle were calculated, and 1-way analysis of variance (P <.05) was used to identify group differences. The differences between maximum predicted forces and maximum electromyography were compared with repeated-measures analysis of variance (P <.05) to evaluate the success of the model predictions. Average differences between force predictions and electromyography ranged from 7.3% to 31.6% but were within the range of previously accepted differences. Impingement related pain in breast cancer survivors is associated with increased force of select shoulder muscles. Both pectoralis major heads, upper trapezius, and supraspinatus peak forces were higher in the pain group across all tasks. These force prediction differences are also associated with potentially harmful kinematic strategies, providing a direction for possible rehabilitation strategies. [ABSTRACT FROM AUTHOR]