Feasibility of a home-based telerehabilitation system compared to usual care: arm/hand function in patients with stroke, traumatic brain injury and multiple sclerosis

Abstract

We conducted a randomized controlled multicentre trial to investigate the feasibility of a telerehabilitation intervention for arm/hand function (the Home Care Activity Desk [HCAD] training) in a home setting. Usual care was compared to HCAD training. The hypothesis was that the clinical outcomes of the HCAD intervention would be at least the same as those measured after a period of usual care for patients with stroke, traumatic brain injury (TBI) and multiple sclerosis (MS) with respect to their arm/hand function. Eighty-one patients with affected arm/hand function resulting from either stroke, MS or TBI were recruited in Italy, Spain and Belgium; 11 were lost during follow-up (14%). The outcome measures were the Action Research Arm Test (ARAT) and the Nine Hole Peg Test (NHPT). There were no significant differences between the two groups on the outcome measures (ARAT and NHPT); in both groups, patients maintained or even improved their arm/hand function. The HCAD training was found to be as feasible as usual care in terms of clinical outcomes, and both therapists and patients were satisfied with the HCAD intervention. A telerehabilitation intervention using HCAD may increase the efficiency of care.

Canadian Stroke Best Practice Recommendations: Telestroke Best Practice Guidelines Update 2017

“…The results of these yielded ambiguous results. [21][22][23][24][25] In particular, the results from two systematic reviews, 24,25 which were both negative, may be problematic to interpret largely due to the variability in treatment contrasts. Interventions provided in the included studies, 7 and 10, respectively, were delivered by virtual reality, phone, and internet-based therapies.…”

A comparison of remote therapy, face to face therapy and an attention control intervention for people with aphasia: a quasi-randomised controlled feasibility study

“…5 However, the strength of evidence is low, with much of the data drawn from case series, 6,7 or feasibility studies. 8,9 A recent Cochrane review of telerehabilitation services for stroke concluded that there is insufficient evidence to guide practice. 10 Applications of telerehabilitation in the domain of aphasia are even more preliminary.…”

Determining the use and value of social support in Telerehabiliation Interventions for individuals with Multiple Sclerosis: A narrative synthesis review

“…A high completion rate across all the included studies was noted. The greatest participant dropout rate was in Huijgen et al [38], which lost 11 out of 81 participants (13.58%), however this was a mixed sample of participants and it was not reported whether the participants who dropped out had a diagnosis of MS, traumatic brain injury or stroke. Detailed information of the included studies' interventions is presented in Supplementary Table 1 in the appendix.…”