Home-based telerehabilitation for community-dwelling persons with stroke during the COVID-19 pandemic: A pilot study

Abstract

Objectives: To determine the feasibility and safety of use of asynchronous telerehabilitation for community-dwelling persons with stroke in the Philippines during the COVID-19 (SARS-CoV-2) pandemic, and to evaluate the change in participants’ telerehabilitation perceptions, physical activity, and well-being after a 2-week home-based telerehabilitation programme using a common social media application.Design: Pilot study.Participants: Nineteen ambulatory, non-aphasic adult members of a national university hospital stroke support group in the Philippines.Methods: Pre-participation screening was performed using the Physical Activity Readiness Questionnaire. The participants were medically cleared prior to study enrollment. They then engaged in telerehabilitation by watching original easy-to-follow home exercise videos prepared and posted by the study authors on a private group page on Facebook™ every other day for 2 weeks. Descriptive statistics was performed. Results: All 19 participants (mean age: 54.9 years) completed the programme with no significant adverse events. The majority of subjects improved their telerehabilitation perceptions (based on the Telepractice Questionnaire), physical activity levels (based on the Simple Physical Activity Questionnaire), and perceived well-being (based on the Happiness Scale).Conclusion: Asynchronous telerehabilitation using a common low-cost social media application is feasible and safe for community-dwelling persons with chronic stroke in a lower-middle-income country. LAY ABSTRACTThe COVID-19 (SARS-CoV-2) pandemic led us to find alternative ways to connect patients and healthcare providers despite physical distance. For instance, telerehabilitation via available telecommunication technologies can be used to provide consultation and therapy services to persons living with disability. In resource-limited countries, such as the Philippines, telerehabilitation was not widely practiced prior to the pandemic, due to several factors, such as lack of acceptance and high costs. This pilot study demonstrates the feasibility, effectiveness, and safety of telerehabilitation using a common low-cost social media application for patients with chronic stroke. Nineteen adult members of a stroke support group safely completed a 2-week telerehabilitation programme by watching original easy-to-follow home exercise videos posted on a private group page on Facebook™. The majority of subjects had positive experiences with the programme, and had improved perceptions of telerehabilitation, physical activity levels, and perceived well-being after 2 weeks.

Commentary on: Home-based telerehabilitation for community-dwelling persons with stroke during the Covid-19 pandemic: a pilot study”

“…Carl FROILAN D. LEOCHICO, PTRP, MD 1,2 From the 1 Department of Physical Medicine and Rehabilitation, St. Luke's Medical Center, Global City and Quezon City, Philippines, and 2 Department of Rehabilitation Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines. E-mail: cfdleochico@stlukes.com.ph is invaluable in advancing scholarly discourse, and I welcome the chance to clarify and expand upon the ideas presented in our article.…”

“…We have read the article by Carl Froilan D. Leochico et al (1) with great interest but have also found some points that need further clarification.…”

“…In our study, the participants who passed the eligibility criteria, which implicitly included technology know-how (i.e., using a gadget on their own or assisted by a family member), had a wide age range (i.e. 54.9±11.6 years) ( 1 ).…”

“…Nonetheless, in our eligibility criteria we included only community ambulators, providing us with general information on their functional capacity, which we deemed was relevant to our study methods. In addition, we included only patients without aphasia or significant communication difficulties, inability to follow complex commands, and unstable medical illnesses, which were verified during our pre-intervention video teleconsultation that included mental status examination ( 1 ).…”

“…In terms of the intervention, we provided details following the FITT principle (frequency, intensity, time, type of exercise) in our article. As indicated in our Methods section and Appendix S1, the participants were instructed to follow our exercise videos for a total of 30 min every other weekday for 2 weeks (i.e., 6 sessions) at their most preferred time ( 1 ). For every session, the exercises were composed of warm-up and cool-down periods (approximately 5 min each) and an exercise proper (approximately 20 min), which mainly consisted of simple calisthenics and body conditioning.…”