Identification of main characteristics influencing the suitability for telerehabilitation in stroke patients: Quantitative analyses of the REHA2030 Assessment

Abstract

Background The Austria-Slovenian project REHA2030, with a broad spectrum of expertise, was focused on making the process of telerehabilitation (TR) possible as valuable user-centred post-clinical rehabilitation of stroke patients in rural areas. Health-related factors, impairments, and environmental and demographic factors influence the patients´ suitability for stroke TR interventions and serve as possible risk factors for patients´ non-adherence or drop-out. The REHA2030 Assessment aimed to identify barriers and resources that should be considered to enable people to participate in TR according to the REHA2030 approach. For that, a structured questionnaire, the “REHA Assessment”, with 88 items, was developed and conducted by therapists about 160 stroke survivors in two rehabilitation clinics. The effect of the 87 characteristics on suitability was statistically analysed using parametric and non-parametric tests. Results Twenty-five main personal and environmental characteristics significantly influencing TR's suitability in stroke patients were identified. Significant factors differences between participants ranked as suitable or not suitable for TR were short-term memory, motivation, visual and hearing abilities, and the ambulation scale. Furthermore, the ability to use technology (self-tech knowledge), daily phone or tablet use, and the general willingness to participate in the therapy were considered. The living situation (housing) and their independence in performing daily tasks such as eating (grooming, dressing, and use of toilet also influence the suitability of the participants. Another essential variable to indicate suitability is compliance. Conclusions Analysis of the study results showed cognitive abilities, visual and hearing abilities, compliance and willingness to participate in the therapy, together with the knowledge of using technology, as the most enabling factors influencing the suitability for TR in stroke patients in chronic stage. Additionally, the patients´ compliance depends on intrinsic motivation to participate in the REHA2030 TR system, which could be supported by increasing proficiency in digital technologies. In the deliberations of TR assessment, the acquired knowledge from the presented study should be considered with caution to limitations of the research data representing personal views of therapists on the patient´s suitability for REHA2030 TR.