Stevens Emily A, Muraly Neha, Da Silva Carolyn P, Richards Lorie, Sosa Aylen, Smith Heather, Richard Allyson Seals, Manji Shehzeen, Russell Mary E, Savitz Sean I
Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center, Houston, TX, US.
McGovern Medical School, The University of Texas Health Science Center, Houston, TX, US.
Digit Health. 2025 Mar 17;11:20552076251324443. doi: 10.1177/20552076251324443. eCollection 2025 Jan-Dec.
The objective of was to offer a fully remote telerehabilitation intervention to stroke survivors during the COVID-19 pandemic.
Participants were recruited from acute care, inpatient rehab, or provider/self-referral if they had a stroke within the previous year, prestroke modified Rankin Scale < 3, were recommended to participate in rehab, and had internet access. Exclusions were: prior injury/diagnoses that impacted functional level, life expectancy of less than six months, or safety concerns. Outcomes were within one week prior to initiation and within one week after completion of telerehabilitation sessions. Video call sessions were completed 1-2 times a week for 12 weeks. Occupational therapy, physical therapy, and/or speech therapy were provided. Analyses involved descriptive statistics; qualitative comments were aggregated and analyzed for broader themes. Twenty participants were consented.
Of the 20 participants (39-71 years old, 35% White, 50% female), 12 completed study activities, five completed exit interview; 10 demonstrated improvement on National Institute of Health Stroke Scale from a mean of 5.6 at baseline to 2.7 at end of study, six demonstrated improvement in modified Rankin Score and EuroQol (EQ-5D-5L) scores from a mean of 2.8 to 1.9 and 13.3 to 9.3, respectively, and five demonstrated an increase above the minimally clinically important difference (mean change = 5) on Montreal Cognitive Assessment. On the Stroke Impact Scale rating of total recovery, six of the 12 scored themselves with improvement (mean change = 18.2). Exit interview data revealed an emerging theme: while in-person therapy was preferred, telerehabilitation was an important resource for those without access to in-person therapy.
Our study adds to the growing data on the practice of telerehabilitation for survivors of stroke. Future studies are underway to address telerehabilitation serving the uninsured, underinsured, and populations in rural areas.
NCT05659784.
本研究的目的是在新冠疫情期间为中风幸存者提供完全远程的远程康复干预。
参与者从急性护理、住院康复机构招募，或由提供者/自我推荐而来，条件为他们在过去一年内发生过中风，中风前改良Rankin量表评分<3，被建议参加康复治疗，且有互联网接入。排除标准为：既往有影响功能水平的损伤/诊断、预期寿命少于六个月或存在安全问题。结果评估在远程康复治疗开始前一周内及结束后一周内进行。视频通话治疗每周进行1 - 2次，共12周。提供职业治疗、物理治疗和/或言语治疗。分析采用描述性统计；对定性评论进行汇总并分析以找出更广泛的主题。20名参与者签署了知情同意书。
20名参与者（年龄39 - 71岁，35%为白人，50%为女性）中，12人完成了研究活动，5人完成了退出访谈；10人在国立卫生研究院卒中量表上有改善，从基线时的平均5.6分降至研究结束时的2.7分，6人在改良Rankin评分和欧洲生活质量量表（EQ - 5D - 5L）评分上有改善，分别从平均2.8分降至1.9分和从13.3分降至9.3分，5人在蒙特利尔认知评估量表上的改善超过了最小临床重要差异（平均变化 = 5）。在卒中影响量表的总体恢复评分中，12人中有6人给自己的评分显示有改善（平均变化 = 18.2）。退出访谈数据揭示了一个新出现的主题：虽然面对面治疗更受青睐，但远程康复对于那些无法获得面对面治疗的人来说是一项重要资源。
我们的研究为中风幸存者远程康复实践的不断增长的数据增添了内容。未来的研究正在进行，以解决为未参保、参保不足人群以及农村地区人群提供远程康复服务的问题。
NCT05659784。
