Ackerley Suzanne, Wilson Neil, Boland Paul, Peel Rosemary, Connell Louise
School of Health, Social Work and Sport, University of Central Lancashire, Preston, Lancashire, UK.
Rakehead Rehabilitation Centre, East Lancashire Hospitals NHS Trust, Burnley, Lancashire, UK.
Digit Health. 2024 May 28;10:20552076241252263. doi: 10.1177/20552076241252263. eCollection 2024 Jan-Dec.
Providing recommended amounts of rehabilitation for stroke and neurological patients is challenging. Telerehabilitation is viable for delivering rehabilitation and an acceptable adjunct to in-person therapy. NeuroRehabilitation OnLine (NROL) was developed as a pilot and subsequently operationalised as a regional innovation embedded across four National Health Service (NHS) Trusts.
To describe the NROL innovation to assist future implementation and replication efforts.
The Template for Intervention Description and Replication (TIDieR) checklist, with guidance from the TIDieR-Telehealth extension, was used to describe NROL. The description was developed collaboratively by clinical academics, therapists, managers and researchers. Updated Consolidated Framework for Implementation Research domains were used to describe the context in which the innovation was delivered.
NROL delivers online group-based real-time neurorehabilitation with technology assistance. It incorporates multidisciplinary targeted therapy and peer support to complement existing therapy. Procedures, materials and structure are detailed to demonstrate how NROL is embedded within a healthcare system. NROL uses existing NHS therapy workforce alongside dedicated NROL roles, including an essential technology support role. Selection of NROL groups is dependent on patient needs. The NROL innovation is tailored over time in response to feedback. NROL described here is successfully integrated within a regional stroke and neurorehabilitation network, aligns with local and national strategies and capitalises on an existing clinical-academic partnership.
This comprehensive description of a regional NROL innovation, and clarification of core components, should facilitate other healthcare settings to adapt and implement NROL for their context. Continuous evaluation alongside implementation will ensure maximal impact for neurorehabilitation.
为中风和神经疾病患者提供推荐剂量的康复治疗具有挑战性。远程康复对于提供康复治疗是可行的，并且是面对面治疗可接受的辅助方式。神经康复在线（NROL）最初作为一个试点项目开发，随后作为一项区域创新在四个国民保健服务（NHS）信托机构中实施。
描述NROL创新，以协助未来的实施和推广工作。
使用干预描述与复制模板（TIDieR）清单，并在TIDieR - 远程医疗扩展版的指导下描述NROL。该描述由临床学者、治疗师、管理人员和研究人员共同制定。使用更新后的实施研究综合框架领域来描述实施该创新的背景。
NROL在技术辅助下提供基于在线群组的实时神经康复治疗。它纳入了多学科靶向治疗和同伴支持，以补充现有治疗。详细说明了程序、材料和结构，以展示NROL如何融入医疗保健系统。NROL利用现有的NHS治疗人员队伍以及专门的NROL角色，包括一个重要的技术支持角色。NROL群组的选择取决于患者需求。NROL创新会根据反馈随时间进行调整。这里描述的NROL已成功融入区域中风和神经康复网络，与地方和国家战略保持一致，并利用了现有的临床 - 学术伙伴关系。
对区域NROL创新的这一全面描述以及核心组件的阐明，应有助于其他医疗环境根据自身情况调整和实施NROL。在实施过程中持续评估将确保神经康复取得最大成效。
