Abstract:Stroke is currently the world’s second cause of disability. It can cause deficits such as postural control, and telerehabilitation could improve the therapeutic dose as well as functional results. The aim of this work is to determine the effectiveness and usability of a low-cost telerehabilitation system in patients with stroke. We developed a telerehabilitation system based on exergames on smartphones, inertial sensors, and a cloud database. We trained the balance of six participants (three men and three wome… Show more
“…This resulted in the inclusion of 306 studies for full-text screening. Among these, 34 trials 9,10,33-64 were retained for the qualitative synthesis and 30 were selected for the meta-analysis. A flow chart diagram illustrating the selection process is presented in Figure 1.Figure 1.Selection process represented through a flow chart diagram.…”
Section: Resultsmentioning
confidence: 99%
“…In this review, only four studies evaluated the cost of intervention. 9,33,59,63 Among these, one study performed a cost-effectiveness analysis and showed that its program was more cost-effective than conventional face-to-face therapy. 9 This finding is supported by previous work that conducted cost-effectiveness analysis to compare telerehabilitation programs to conventional therapy in other pathologies.…”
Background. Due to an increasing stroke incidence, a lack of resources to implement effective rehabilitation and a significant proportion of patients with remaining impairments after treatment, there is a rise in demand for effective and prolonged rehabilitation. Development of self-rehabilitation programs provides an opportunity to meet these increasing demands. Objective. The primary aim of this meta-analysis was to determine the effect of self-rehabilitation on motor outcomes, in comparison to conventional rehabilitation, among patients with stroke. The secondary aim was to assess the influence of trial location (continent), technology, time since stroke (acute/subacute vs chronic), dose (total training duration > vs ≤ 15 hours), and intervention design (self-rehabilitation in addition/substitution to conventional therapy) on effect of self-rehabilitation. Methods. Studies were selected if participants were adults with stroke; the intervention consisted of a self-rehabilitation program defined as a tailored program where for most of the time, the patient performed rehabilitation exercises independently; the control group received conventional therapy; outcomes included motor function and activity; and the study was a randomized controlled trial with a PEDro score ≥5. Results. Thirty-five trials were selected (2225 participants) and included in quantitative synthesis regarding motor outcomes. Trials had a median PEDro Score of 7 [6–8]. Self-rehabilitation programs were shown to be as effective as conventional therapy. Trial location, use of technology, stroke stage, and intervention design did not appear to have a significant influence on outcomes. Conclusion. This meta-analysis showed low to moderate evidence that self-rehabilitation and conventional therapy efficacy was equally valuable for post-stroke motor function and activity.
“…This resulted in the inclusion of 306 studies for full-text screening. Among these, 34 trials 9,10,33-64 were retained for the qualitative synthesis and 30 were selected for the meta-analysis. A flow chart diagram illustrating the selection process is presented in Figure 1.Figure 1.Selection process represented through a flow chart diagram.…”
Section: Resultsmentioning
confidence: 99%
“…In this review, only four studies evaluated the cost of intervention. 9,33,59,63 Among these, one study performed a cost-effectiveness analysis and showed that its program was more cost-effective than conventional face-to-face therapy. 9 This finding is supported by previous work that conducted cost-effectiveness analysis to compare telerehabilitation programs to conventional therapy in other pathologies.…”
Background. Due to an increasing stroke incidence, a lack of resources to implement effective rehabilitation and a significant proportion of patients with remaining impairments after treatment, there is a rise in demand for effective and prolonged rehabilitation. Development of self-rehabilitation programs provides an opportunity to meet these increasing demands. Objective. The primary aim of this meta-analysis was to determine the effect of self-rehabilitation on motor outcomes, in comparison to conventional rehabilitation, among patients with stroke. The secondary aim was to assess the influence of trial location (continent), technology, time since stroke (acute/subacute vs chronic), dose (total training duration > vs ≤ 15 hours), and intervention design (self-rehabilitation in addition/substitution to conventional therapy) on effect of self-rehabilitation. Methods. Studies were selected if participants were adults with stroke; the intervention consisted of a self-rehabilitation program defined as a tailored program where for most of the time, the patient performed rehabilitation exercises independently; the control group received conventional therapy; outcomes included motor function and activity; and the study was a randomized controlled trial with a PEDro score ≥5. Results. Thirty-five trials were selected (2225 participants) and included in quantitative synthesis regarding motor outcomes. Trials had a median PEDro Score of 7 [6–8]. Self-rehabilitation programs were shown to be as effective as conventional therapy. Trial location, use of technology, stroke stage, and intervention design did not appear to have a significant influence on outcomes. Conclusion. This meta-analysis showed low to moderate evidence that self-rehabilitation and conventional therapy efficacy was equally valuable for post-stroke motor function and activity.
“…The risk of fall or injury during exercise has to be reduced to a minimum and redressing support in case of balance loss or standing up after a fall has to be assured [36]. Probably due to safety procedures, some studies found balance to be one of the outcomes where TR did not prove its efficacy [11]; however, there are some research results that suggest the opposite [33,37]. Therefore, when the exercises performed at home target walking and balance, it is of importance to ensure the safety of therapy sessions with the presence of a family member or another informal caregiver who can supervise, support and help the patient in case of loss of balance (Figure 1).…”
Section: How To Organize Tr At Patient's Home?mentioning
As the number of stroke survivors is continuously growing, with an important number suffering from consequent functional deficits, the rehabilitation field is facing more complex demands. Technological progress gives us the opportunity to remotely assist patients while they exercise at home through telerehabilitation (TR), addressing the problems of limited medical resources and staff, difficult transportation, or living a long distance from rehabilitation centers. In addition, TR is a way to provide continuity in long-term post-stroke recovery during the COVID-19 pandemic, which limits traveling and human interaction. While the implementation of TR is increasing, the biggest challenges are to raise patients’ acceptability of the new method and their motivation and engagement during the program. In this review, we aimed to find methods to address these challenges by identifying the patients who benefit the most from this therapy and efficiently organizing the space and technology used for telerehabilitation. User-friendly technologies and devices along with therapists’ constant support and feedback are some of the most important aspects that make TR an efficient intervention and an alternative to conventional therapy.
“…Many rehabilitation studies do not focus on participation outcomes but rather continue to measure and intervene at the level of body functions [ 13 , 18 , 19 ]. The same problem recurs in the telerehabilitation field; thus, most studies that examined the efficacy of telerehabilitation programs for this population focus on body functions such as balance, upper-extremity function, and cognitive skills [ 20 , 21 , 22 , 23 , 24 , 25 ]. Therefore, there is a need for developing telerehabilitation intervention models to facilitate participation and community reintegration for this population that extend beyond impairment remediation approaches (see Figure 1 ).…”
This pilot study aimed to investigate the initial effect of a remotely delivered performance-based client-centered intervention on activity performance and participation among adults in the chronic phase after acquired brain injury (ABI). Sixteen participants living at home with little to no assistance in basic daily activities were allocated into intervention or waitlist control groups. Assessments were conducted at the baseline, after the 3-month intervention/wait period, and at a 3-month follow-up. The primary outcomes were activity performance using the Canadian Occupational Performance Measure (COPM) and the Performance Quality Rating Scale (PQRS) and participation using the Mayo-Portland Adaptability Inventory-4 (MPAI-4). The intervention included weekly videoconferencing sessions using the Cognitive Orientation to Daily Occupational Performance approach (tele-CO-OP). The participants identified five functional goals, of which three were directly addressed. Wilcoxon signed-ranks test results showed no significant improvements in the control group at the end of the 3-month wait period. Pooled data from both groups showed significant improvements in COPM scores for trained and untrained goals following the intervention. Significant improvements were also found in the PQRS and MPAI-4 scores. Improvements were partially maintained at follow-up. Our preliminary results suggest that tele-CO-OP may positively impact the lives of adults after ABI who are coping with long-term disability.
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