Virtually assisted home rehabilitation after acute stroke (VAST-rehab): A descriptive pilot study for young and underserved stroke survivors.

Abstract

Introduction: The objective of Virtually Assisted home rehabilitation after acute STroke was to offer a fully remote telerehabilitation intervention to stroke survivors during the COVID-19 pandemic.

Methods: 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.

Results: 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.

Conclusion: 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.

Clinicaltrialsgov id: NCT05659784.