Researchers at the Indianapolis-based Regenstrief Institute have developed STeleR, a home telerehabilitation program that they are reporting can improve lower body physical functioning after a stroke. According to the researchers’ study, participating in STeleR also increased the likelihood of maintaining a regular fitness routine, enhanced money management skills, and improved the capability to prepare meals and take care of personal needs such as bathing.
The report, "Effects of Telerehabilitation on Physical Function and Disability for Stroke Patients" will appear online ahead of print publication in the August issue of the journal Stroke. The research was led by investigator Neale Chumbler, Ph.D., a research scientist with the Center of Excellence on Implementing Evidence-Based Practice at the Richard Roudebush VA Medical Center in Indianapolis.
"We know that post-stroke rehab is critically important," Dr. Chumbler said in a statement. "But for many veterans and others who experience a stroke, participating in supervised rehab can be difficult because they live far from a rehab facility. Even if distance isn't an impediment, getting someone to provide transportation may not be easy. Providing rehab in the home is costly, and the availability of qualified physical or occupational therapists may be limited, particularly in rural areas.
"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."
For the study, 52 veterans in the multisite study received care from VA medical centers in Atlanta, Durham, N.C., and Tampa, Fla. They were predominantly male, ethnically diverse, and had an average age of 67. Each had experienced an ischemic or hemorrhagic stroke within the previous two years and lived in the community rather than in an institution. The study participants were randomized to usual care or the STeleR (short for stroke telerehab) intervention.
In the intervention part of the study, visits were made to the homes of those in the, during which a study team member used a camcorder to record physical and functional performance as well as discussed the home environment with the stroke survivor. An in-home messaging device that looks like a clock radio and plugs into a telephone line was installed and monitored weekly by a teletherapist who responded after reviewing information entered by the study patients. Over the three-month period, telephone calls between the teletherapist and the patient took place biweekly.
According to the researchers, most of the gains in physical functioning and other improvements occurred during the initial three months of the study but were maintained during the subsequent three months during which no STeleR services were provided.