Choukou Mohamed-Amine, He Elizabeth, Moslenko Kelly
Department of Occupational Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada.
Centre on Aging, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
J Pers Med. 2023 Aug 3;13(8):1230. doi: 10.3390/jpm13081230.
Stroke rehabilitation is a lengthy procedure that is necessary for stroke recovery. However, stroke rehabilitation may not be readily available for patients who live rurally due to barriers such as transportation and expenses. This shortage in wearable technology, in turn, causes health disparity among the rural population, which was exacerbated by the COVID-19 pandemic restrictions. Telerehabilitation (TR) is a potential solution for stroke rehabilitation in rural areas. This one-case study aimed to examine the feasibility and safety of a technology-enabled at-home TR program for stroke survivors living in a rural area in Canada. A VR setup was installed successfully in the home of our participant. A tablet was also supplied for the TR program. Each program consisted of 24 sessions to be completed over a 12-week period. Our participant was assessed on day one using the Fugl-Meyer assessment, the Modified Ashworth Scale, the 10 m walk test, and the Mini-Mental State Exam. Three questionnaires were also completed, including the Motor Activity Log (MAL), the Stroke Index Scale (SIS), and the Treatment Self-Regulation Questionnaire. These assessments were completed thrice, on day 1, at week 6, and at week 12. The participant found the tablet and its accompanying exercises easy to use, with a few limitations. The participant found the VR system more challenging to manage independently as a lack of comfortability, the visual contrast during the first trials, and certain technical aspects of the technology created several functional barriers. Although some limitations with the technology were noted, this case study indicates that telerehabilitation is feasible under certain circumstances when used in conjunction with traditional rehabilitation services.
中风康复是中风恢复所必需的漫长过程。然而，由于交通和费用等障碍，农村地区的患者可能无法轻易获得中风康复服务。可穿戴技术的短缺反过来又导致农村人口的健康差距，而新冠疫情限制加剧了这种差距。远程康复（TR）是农村地区中风康复的一种潜在解决方案。本单病例研究旨在检验一项为加拿大农村地区中风幸存者提供的、基于技术的居家远程康复计划的可行性和安全性。在我们参与者的家中成功安装了虚拟现实（VR）设备。还为远程康复计划提供了一台平板电脑。每个计划包括在12周内完成的24次课程。在第一天，我们对参与者进行了Fugl-Meyer评估、改良Ashworth量表评估、10米步行测试和简易精神状态检查。还完成了三份问卷，包括运动活动日志（MAL）、中风指数量表（SIS）和治疗自我调节问卷。这些评估在第1天、第6周和第12周进行了三次。参与者发现平板电脑及其配套练习易于使用，但有一些局限性。参与者发现VR系统更具挑战性，难以独立操作，因为缺乏舒适度、首次试验时的视觉对比度以及该技术的某些技术方面造成了一些功能障碍。尽管注意到该技术存在一些局限性，但本病例研究表明，远程康复在与传统康复服务结合使用的某些情况下是可行的。
