Telerehab Improves Post-stroke Fitness

STeleR found to improve lower body physical functioning after a stroke

(RxWiki News) Rehabilitation after a stroke can be key to regaining functioning, but it can be a challenge for patients who live far from a facility that offers stroke rehab or who cannot attend a supervised program.

A telerehab program may be another option.

Stroke patients using the STeleR home tele-rehabilitation were found to have improved lower body physical functioning, and gained skills to help them maintain their independence.

"Ask your cardiologist about rehab options."

Neale Chumbler, PhD, a research scientist with the Center of Excellence on Implementing Evidence-Based Practice at the Richard Roudebush VA Medical Center, noted that post-stroke rehab is critically important, but participating in supervised rehabilitation can be challenging when distance or transportation are factors.

Traditional home rehabilitation also can be costly and qualified clinicians may be limited in rural areas, he said.

"We found that stroke survivors will participate in and can benefit from a telehealth system that enables therapists to deliver and monitor rehab in the patient's home from a remote location," Dr. Chumbler said.

During the study 52 veterans received post-stroke care from VA medical centers in Florida, North Carolina or Georgia. Most were men, and the average age was 67. All patients had experienced an ischemic or a hemorrhagic stroke within the past two years. They were randomly assigned to receive either telerehab or the usual care following a stroke.

Both groups received routine VA care. Patients assigned to telerehab had three one-hour home visits where a clinician made a video recording of their physical and functional performance and discussed the intervention.

After installing a messaging device that resembled a clock radio and plugs into a phone line, the intervention group patients were asked to enter data weekly.

They also met with a teletherapist every two weeks over a three-month period.

Investigators found that the patients assigned to telerehab experienced increased lower body functioning. In addition, the telerehab patients were more likely to exercise regularly.

They also improved skills to keep them independent, including better money management skills, and increased ability to prepare meals and care for personal needs such as bathing.

The most substantial gains were recorded during the three months when patients received the telerehab, but the improvements were retained during the subsequent three months when telerehab was no longer provided.

"STeleR has potential to be a useful supplement to traditional post-stroke rehabilitation, given the limited resources available for in-home rehabilitation for stroke survivors," Dr. Chumbler said. "STeleR or a similar telehealth program could be an important way to overcome access barriers and may be particularly useful for reaching vulnerable patient groups, such as individuals from a lower socioeconomic status and those who live in a rural area."

The study has been published online ahead of print publication in the August issue of the journal Stroke.

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Review Date: 
May 29, 2012