Development and Feasibility Testing of Video Home Based Telerehabilitation for Stroke Survivors in Resource Limited Settings

Abstract

Tele-physiotherapy has been shown to be valuable to improve clinical outcomes after stroke. Yet, home-based interventions for stroke survivors (SSVs) who speak indigenous African languages are sparse. This study developed a video-based home exercise programme (VHEP) for SSV speakers of Yoruba. A qualitative descriptive pilot study was conducted in two phases: development and feasibility testing. VHEP development followed the American Stroke Association’s recommendations to include demonstrations of task-specific mobility-task and postural training; trunk exercises, and overground walking. The exercise instructions were presented in the Yoruba language. Each exercise was demonstrated for five minutes on video for a total of 30 minutes. The feasibility testing involved ten consenting chronic SSVs. Each imitated the VHEP twice per week for two weeks and thereafter completed a feasibility questionnaire. Criteria for feasibility were: cost of using VHEP, recruitment rate, retention of participants, adherence to the exercises, and intervention delivery. The ten SSVs were recruited within one week, had prior home access to a video player at no-cost, adhered to the exercises as recorded, completed the 30 minute-duration for two weeks, and confirmed intervention delivery of VHEP. Most participants liked the novel use of Yoruba as the language of instruction on VHEP. The VHEP was feasible and acceptable among the studied sample of SSVs. Video based home telerehabilitation for SSVs therefore has the potential to meet the growing need for tele-physiotherapy in resource limited settings.

Development and Effectiveness Testing of a Mobile Health Education Package for Stroke Prevention Among Stroke Survivors

“…Only the levels of education showed significant increase with identification of stroke risk factors and warning signs, between the primary and the tertiary levels of education 2 nd week post-intervention. These findings are consistent with previous studies on stroke education of Denny et al, 30 and Maisarah et al, 36 . Earlier studies, have reported increase in stroke knowledge across education levels, with the largest effect on those with at least college education.…”

“…The choice of mobile phones as an easy means of information delivery is supported by similar reports of no difficulty with operating the exercise package on the mobile device or at home. 32, 35 The educational tool in this study was of 14-minute duration, in contrast to a stroke literacy video of 5-minute duration by Denny et al, 9 and a 30-minute video home-based exercise for SSVs by Odetunde et al, 36 The varied duration was to address the study objectives and accommodate the contents of each of the videos. This study revealed that the AVmHealth stroke education was associated with improved stroke literacy at the 2 nd and 4 th week post intervention, consistent with previous studies on stroke education.…”

A scoping review of feasibility, cost, access to rehabilitation services and implementation of telerehabilitation: Implications for low- and middle-income countries

“…This review identified 16 studies that investigated the feasibility of TR programs for neurological conditions, 16 – 19 , 21 , 23 – 25 , 28 , 31 medical conditions, 20 , 22 , 27 , 30 neuromusculoskeletal disorders, 29 as well as older people. 26 Fourteen (14) out of 16 studies 16 – 20 , 22 , 23 , 25 – 31 were conducted in HICs and only 2 studies 21 , 24 in LMICs.…”

“…This review identified 16 studies that investigated the feasibility of TR programs for neurological conditions, 16 – 19 , 21 , 23 – 25 , 28 , 31 medical conditions, 20 , 22 , 27 , 30 neuromusculoskeletal disorders, 29 as well as older people. 26 Fourteen (14) out of 16 studies 16 – 20 , 22 , 23 , 25 – 31 were conducted in HICs and only 2 studies 21 , 24 in LMICs. Feasibility was determined by recruitment rate, retention rate, attendance/adherence to the program, completion rate, satisfaction, adverse events and technical faults during the implementation.…”

“…More than half of the eligible papers (55%) investigated the feasibility of TR program in different topic areas of which only two studies 21 , 24 were conducted in LMICs. This is an indication that despite the popularity TR is gaining in HICs, its use in LMICs is still in the infancy stage and that it has not penetrated well in these areas.…”