ABSTRACT NUMBER: ESOC2026LT6 PERSONALISED, 90-HOUR, 3-WEEK, MOTOR REHABILITATION FOR PEOPLE WITH STROKE AND SPINAL CORD INJURY IN THE CHRONIC PHASE (INTERACT): CLINICAL AND HEALTH ECONOMIC OUTCOMES

Abstract Background and aims Neurological conditions are a leading cause of long-term disability and rehabilitation needs. High-dose rehabilitation may improve persistent motor symptoms following stroke or spinal cord injury (SCI). We investigated the clinical and cost-effectiveness of the INTeRAcT treatment in adults in the chronic phase after stroke or SCI. Methods Participants were randomised to either the INTeRAcT treatment or usual care. INTeRAcT consisted of three weeks, 90-hour personalised, goal-directed motor rehabilitation, integrating rehabilitation technology, cardiovascular fitness and self-management. The primary outcome was the Functional-Spinal Cord Independence Measure (FIM-SCIM), and a secondary outcome was the goal attainment scale (GAS), both assessed at baseline (T0), after three weeks (T1) and nine months (T2). Analyses followed the intention-to-treat principle using multivariate linear models, with Cohen’s d effect sizes reported. Cost-effectiveness was assessed via trial-based cost-utility analysis over nine months from a healthcare perspective, applying a €50,000/QALY willingness-to-pay threshold. Results 101 participants (59 stroke – 42 SCI) were included. INTeRAcT (n=50) resulted in significant improvements compared to usual care (n=51) in FIM-SCIM from T0–T2 (mean difference (95% CI) = 4.1 (2.4–5.8), d=1.08), in GAS from T0–T1 (17.2 (13.9-20.5); d=3.1) and from T0–T2 (17.2 (13.0-21.5); d=2.1). No difference was observed for FIM-SCIM from T0–T1. The incremental cost-effectiveness ratio was €73,553/QALY. Conclusions INTeRAcT improved long-term independence in daily activities and the achievement of rehabilitation goals in the chronic phase after stroke and SCI, but was not cost-effective within nine months. The findings demonstrate clinical effectiveness; longer follow-up is needed to assess lifetime cost-effectiveness. Conflict of interest