Physical Rehabilitation Needs in the BRICS Nations from 1990 to 2017: Cross-National Analyses Using Data from the Global Burden of Disease Study

Jesus, Tiago S.; Landry, Michel D.; Hoenig, Helen; Zeng, Yi; Kamalakannan, Sureshkumar; Britto, Raquel Rodrigues; Pogosova, Nana; Sokolova, O Y; Grimmer, Karen; Louw, Quinette

doi:10.3390/ijerph17114139

Cited by 23 publications

(13 citation statements)

References 77 publications

(151 reference statements)

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“…Given this situation, rehabilitation services for stroke survivors especially after their hospital discharge can only be dreamt ( 5 ). In the absence of any community-based rehabilitation services, the need for rehabilitation and the burden of care exponentially increases when stroke survivors are discharged from hospitals after acute care and when they start living in their communities ( 6 ). The burden of care on the family members (informal caregivers) who lack knowledge and skills for this role could have devastating consequences for the stroke survivors during their road to recovery following a stroke ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the feasibility and acceptability of ReWin—A digital therapeutic rehabilitation innovation for people with stroke-related disabilities in India

Kamalakannan

Karunakaran²,

Balaji³

et al. 2023

Front. Neurol.

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BackgroundDeveloping culturally appropriate, scalable interventions to meet the growing needs for stroke rehabilitation is a significant problem of public health concern. Therefore, systematic development and evaluation of a scalable, inclusive, technology-driven solution for community-based stroke care are of immense public health importance in India. ReWin is a digital therapeutics platform that was developed systematically. This study aimed to evaluate its feasibility and acceptability in an Indian context.ObjectivesPhase–1: To pilot the intervention for identifying operational issues and finalize the intervention. Phase–2: To assess the feasibility and acceptability of ReWin intervention in an Indian context.MethodsDesign: Mixed-methods research design. Setting: Participant's home and rehabilitation centers. Participants were selected from rehabilitation centers in South India. Participants: Ten stroke survivors and their caregivers, as well as four rehabilitation service providers were recruited for phase 1. Thirty stroke survivors who were treated and discharged from the hospital, and their caregivers as well as 10 rehabilitation service providers were recruited for Phase 2. Intervention: ReWin a digital therapeutic platform with the provider and patient app for the rehabilitation of physical disabilities following stroke was piloted. Process: Evaluation of the intervention was completed in two phases. In the first phase, the preliminary intervention was field-tested with 10 stroke survivors and four rehabilitation service providers for 2 weeks. In the second phase, the finalized intervention was provided to a further 30 stroke survivors to be used in their homes with support from their carers as well as to 10 rehabilitation service providers for 4 weeks. Outcome measures: Primary outcomes: (1) operational difficulties in using the ReWin intervention; (2) feasibility and acceptability of the ReWin intervention in an Indian setting.ResultsField-testing identified operational difficulties related to 1. Therapeutic content; 2. Format; 3. Navigation; 4. Connectivity, 5. Video-streaming, 6. Language; and 7. Comprehensibility of the animated content. The intervention was reviewed, revised and finalized before pilot testing. Findings from the pilot testing showed that the ReWin intervention was feasible and acceptable. About 76% of the participants had used ReWin for more than half of the intervention period of 4 weeks. Ninety percentage of the stroke care providers and about 60% of the stroke survivors and caregivers felt that the content of ReWin was very relevant to the needs of the stroke survivors. Forty percentage of the stroke survivors and caregivers rated ReWin intervention as excellent. Another 45% of the stroke survivors and caregivers as well as 90% of the stroke care providers rated ReWin intervention as very good based on its overall credibility, usability, and user-friendliness.ConclusionsReWin has all the essential components to connect care providers and consumers not just for stroke rehabilitation but for several other health conditions with the use of several other technological features that support rehabilitation of persons with disabilities and strengthen rehabilitation in health systems worldwide. It is critical to amalgamate ReWin and other evidence-based interventions for rehabilitation to innovate scalable solutions and promote universal health coverage for stroke care worldwide.

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Section: Introductionmentioning

confidence: 99%

Evaluation of the feasibility and acceptability of ReWin—A digital therapeutic rehabilitation innovation for people with stroke-related disabilities in India

Kamalakannan

Karunakaran²,

Balaji³

et al. 2023

Front. Neurol.

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“…However, about 50% develop stroke-related impairments that limit their independence in everyday activities and functioning (3,4). This implies the substantial need for rehabilitation and support required by stroke survivors, especially outside the hospital setting (5). These support needs are met by the primary caregivers, usually the stroke survivors' family members.…”

Section: Introductionmentioning

confidence: 99%

Experiences and needs of the caregivers of stroke survivors in Malaysia—A phenomenological exploration

et al. 2022

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IntroductionInformal caregivers play a crucial role in supporting the activities of daily living, rehabilitation, and the road to recovery for stroke survivors. However, these informal caregivers are often reported as experiencing neglect and lack of recognition despite their primary contribution to stroke recovery. This study investigated the experiences of the caregivers of stroke survivors and access to stroke care in Malaysia.MethodThis qualitative study with a phenomenological approach utilized in-depth interviews, including ten primary caregivers, one formal caregiver, and stroke healthcare providers as the participants. The interviews were done until the data saturation was achieved, and the data was analyzed using thematic analysis.ResultThree primary themes and 14 subthemes were identified from the interviews. The role of primary caregivers of stroke survivors had tremendous physical, mental and social impact on the caregivers. Caregivers had two primary needs. The need for information about comprehensive stroke care at home and the need for psychological support to themselves. The key internal driver for providing care was identified to be the motivation level of the stroke survivor and the external driver was identified to be the societal support with access to comprehensive stroke care.ConclusionThe role of informal caregivers becomes critical for continuum of stroke care. As caregivers take up the roles and responsibilities of those who contribute to stroke rehabilitation single-handedly soon after hospital discharge. Results of this study highlights the needs for providing systematic support to caregivers for engaging them in effective stroke care, particularly in the community. Stroke service providers, policy makers and program planners must be sensitized to empower caregivers of stroke survivors in effectively supporting stroke survivor in their family on the road of recovery.

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“…[ 7 ] Given the situation, the demand and unmet need for reducing disabilities in India are increasing exponentially. [ 8 ]…”

Section: Introductionmentioning

confidence: 99%

Occupational Therapy for Reducing Disabilities in Persons with Disabilities in India: A Systematic Review

Kamalakannan

Chockalingam

Sethuraman

et al. 2021

Indian J Occup Ther

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Background The current evidence for occupational therapy practice, teaching, and research is replicated and implemented significantly from high-income countries in India. Therefore, a systematic review and an evaluation of existing evidence for occupational therapy (OT) to reduce disabilities including impairments, activity limitations, and participation restriction in persons with disabilities (PWD) in India are warranted. Objectives The objective of this review was to evaluate the effectiveness of OT interventions for reducing disabilities in PWD in India. Study Design Systematic review. Methods We searched the Cochrane CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, AMED, and Web of Science. A hand search was also carried out in selected Indian journals, OT-specific databases, and repositories, such as Indian Journal of Occupational Therapy , Indian Journal of Physiotherapy and Occupational Therapy , OT Seekers, World Federation of Occupational Therapy Bulletin, Asia Pacific Occupational Therapists Regional Group, and clinical trials registers. The search was restricted to published studies conducted in India during 2000–2021. We included randomized controlled trials (RCTs) of an occupational therapy intervention delivered by OTs for PWD, where the effects of the intervention were evaluated using any relevant disability outcome measure. Studies without access to full text were excluded. Two review authors independently completed screening, and one author reviewed the full text of the screened studies. Another pair of authors extracted data from included studies for prespecified disability outcomes, and two authors assessed the risk of bias in the included studies. Results We identified seven RCTs of occupational therapy interventions for PWD in India with 305 participants in total. All seven studies were very different in terms of their objective, participants, comparison, and outcomes. Allocation concealment and blinding and risk of bias were high in five trials. All the trials reported impairment outcomes with a statistically significant difference between the experimental arm and the control arm in terms of their primary outcomes except one. Given the sample size and the risk of bias in each of the included trials, the effect size has to be understood and interpreted with utmost caution. Conclusion Overall, this review establishes the paucity of evidence for occupational therapy for PWD in India. Building the capacity for rigorous and relevant scientific research in occupational therapy would enable bridging the gaps in evidence for occupational therapy in India.

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Physical Rehabilitation Needs in the BRICS Nations from 1990 to 2017: Cross-National Analyses Using Data from the Global Burden of Disease Study

Cited by 23 publications

References 77 publications

Evaluation of the feasibility and acceptability of ReWin—A digital therapeutic rehabilitation innovation for people with stroke-related disabilities in India

Evaluation of the feasibility and acceptability of ReWin—A digital therapeutic rehabilitation innovation for people with stroke-related disabilities in India

Experiences and needs of the caregivers of stroke survivors in Malaysia—A phenomenological exploration

Occupational Therapy for Reducing Disabilities in Persons with Disabilities in India: A Systematic Review

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