Home-based telerehabilitation for community-dwelling persons with stroke during the COVID-19 pandemic: A pilot study
DOI:
https://doi.org/10.2340/jrm.v55.4405Keywords:
Healthcare delivery, telehealth, telerehabilitation, COVID-19, stroke, lower-middle-income country, social mediaAbstract
Objectives: To determine the feasibility and safety of use of asynchronous telerehabilitation for community-dwelling persons with stroke in the Philippines during the COVID-19 (SARS-CoV-2) pandemic, and to evaluate the change in participants’ telerehabilitation perceptions, physical activity, and well-being after a 2-week home-based telerehabilitation programme using a common social media application.
Design: Pilot study.
Participants: Nineteen ambulatory, non-aphasic adult members of a national university hospital stroke support group in the Philippines.
Methods: Pre-participation screening was performed using the Physical Activity Readiness Questionnaire. The participants were medically cleared prior to study enrollment. They then engaged in telerehabilitation by watching original easy-to-follow home exercise videos prepared and posted by the study authors on a private group page on Facebook™ every other day for 2 weeks. Descriptive statistics was performed.
Results: All 19 participants (mean age: 54.9 years) completed the programme with no significant adverse events. The majority of subjects improved their telerehabilitation perceptions (based on the Telepractice Questionnaire), physical activity levels (based on the Simple Physical Activity Questionnaire), and perceived well-being (based on the Happiness Scale).
Conclusion: Asynchronous telerehabilitation using a common low-cost social media application is feasible and safe for community-dwelling persons with chronic stroke in a lower-middle-income country.
LAY ABSTRACT
The COVID-19 (SARS-CoV-2) pandemic led us to find alternative ways to connect patients and healthcare providers despite physical distance. For instance, telerehabilitation via available telecommunication technologies can be used to provide consultation and therapy services to persons living with disability. In resource-limited countries, such as the Philippines, telerehabilitation was not widely practiced prior to the pandemic, due to several factors, such as lack of acceptance and high costs. This pilot study demonstrates the feasibility, effectiveness, and safety of telerehabilitation using a common low-cost social media application for patients with chronic stroke. Nineteen adult members of a stroke support group safely completed a 2-week telerehabilitation programme by watching original easy-to-follow home exercise videos posted on a private group page on Facebook™. The majority of subjects had positive experiences with the programme, and had improved perceptions of telerehabilitation, physical activity levels, and perceived well-being after 2 weeks.
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References
Seelman KD, Hartman LM. Telerehabilitation: policy issues and research tools. Int J Telerehabilitation 2009; 1: 47–58. DOI: 10.5195/IJT.2009.6013. DOI: https://doi.org/10.5195/ijt.2009.6013
Leochico CFD, Espiritu AI, Ignacio SD, Mojica JAP. Challenges to the emergence of telerehabilitation in a developing country: a systematic review. Front Neurol 2020; 11: 1007. DOI: 10.3389/fneur.2020.01007. DOI: https://doi.org/10.3389/fneur.2020.01007
Fernandez-Marcelo PG, Ongkeko AM, Sylim PG, Evangelista-Sanchez AM, Santos AD, Fabia JG, et al. Formulating the national policy on telehealth for the Philippines through stakeholders’ involvement and partnership. Acta Med Philipp 2016; 50: 247–263. DOI: 10.47895/amp.v50i4.766. DOI: https://doi.org/10.47895/amp.v50i4.766
Macabasag RL, Magtubo KM, Marcelo PG. Implementation of telemedicine services in lower-middle income countries: lessons for the Philippines. J Int Soc Telemed eHealth 2016; 4: 1–11. [accessed July 8, 2021]. Available from: https://journals.ukzn.ac.za/index.php/JISfTeH/article/view/168
Gordon NF, Gulanick M, Costa F, Fletcher G, Franklin BA, Roth EJ, et al. Physical activity and exercise recommendations for stroke survivors. Stroke 2004; 35: 1230–1240. DOI: 10.1161/01.STR.0000127303.19261.19. DOI: https://doi.org/10.1161/01.STR.0000127303.19261.19
Smith SC, Blair SN, Bonow RO, Brass LM, Cerqueira MD, Dracup K, et al. AHA/ACC guidelines for preventing heart attack and death in patients with atherosclerotic cardiovascular disease: 2001 update. J Am Coll Cardiol 2001; 38: 1581–1583. DOI: 10.1016/S0735-1097(01)01682-5. DOI: https://doi.org/10.1016/S0735-1097(01)01682-5
Hillier S, Inglis-Jassiem G. Rehabilitation for community-dwelling people with stroke: home or centre based? a systematic review. Int J Stroke 2010; 5: 178–186. DOI: 10.1111/j.1747-4949.2010.00427.x. DOI: https://doi.org/10.1111/j.1747-4949.2010.00427.x
Akamai Technologies, Inc. Akamai releases Q1 2017 state of the internet connectivity report. [accessed 2021 August 25]. Available from: https://www.akamai.com/fr/fr/multimedia/documents/state-of-the-internet/q1-2017-state-of-the-internet-connectivity-report.pdf
Ignatius JS, Hechanova MRM. Internet usage from a generational perspective. Philipp J Psychol 2014; 47: 73–92. [accessed 2021 August 31]. Available from: https://www.pap.org.ph/sites/default/files/upload/pjp2014-47-1-pp73-92-ignatiushechanova-internet_usage_from_generational_perspective.pdf
Leochico CFD. Adoption of telerehabilitation in a developing country before and during the COVID-19 pandemic. Ann Phys Rehabil Med 2020; 63: 563–564. DOI: 10.1016/j.rehab.2020.06.001. DOI: https://doi.org/10.1016/j.rehab.2020.06.001
Rhodes NC, Isaki E. Script training using telepractice with two adults with chronic non-fluent aphasia. Int J telerehabilitation 2018; 10: 89–104. DOI: 10.5195/ijt.2018.6259. DOI: https://doi.org/10.5195/ijt.2018.6259
SIMPAQ. (2016, October). Simple Physical Activity Questionnaire (SIMPAQ) instruction manual and scoring, version 4.0. [accessed 2020 April 27]. Available from: https://www.yorkshireandhumberinvolvementnetwork.nhs.uk/wp-content/uploads/2019/09/SIMPAQ-manual-4.0.pdf
Abdel-Khalek AM. Measuring happiness with a single-item scale. Soc Behav Personal an Int J 2006; 34: 139–150. DOI: 10.2224/sbp.2006.34.2.139. DOI: https://doi.org/10.2224/sbp.2006.34.2.139
Munce S, Andreoli A, Bayley M, Guo M, Inness EL, Kua A, et al. Clinicians’ experiences of implementing a telerehabilitation toolkit during the COVID-19 pandemic: qualitative descriptive study. JMIR Rehabil Assist Technol 2023; 10: e44591. DOI: 10.2196/44591. DOI: https://doi.org/10.2196/44591
Laver KE, Adey-Wakeling Z, Crotty M, Lannin NA, George S, Sherrington C. Telerehabilitation services for stroke. Cochrane Database Syst Rev 2020. DOI: 10.1002/14651858.CD010255.pub3. DOI: https://doi.org/10.1002/14651858.CD010255.pub3
Stephenson A, Howes S, Murphy PJ, Deutsch JE, Stokes M, Pedlow K, et al. Factors influencing the delivery of telerehabilitation for stroke: a systematic review. PLoS ONE 2022; 17: e0265828. DOI: 10.1371/journal.pone.0265828. DOI: https://doi.org/10.1371/journal.pone.0265828
Langan J, DeLave K, Phillips L, Pangilinan P, Brown S. Home-based telerehabilitation shows improved upper limb function in adults with chronic stroke: a pilot study. J Rehabil Med 2013; 45: 217–220. DOI: 10.2340/16501977-1115. DOI: https://doi.org/10.2340/16501977-1115
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