http://www.tandfonline.com/doi/abs/10.1080/10749357.2015.1120453
- DOI:
- 10.1080/10749357.2015.1120453
- Received: 8 Jun 2015
- Accepted: 23 Aug 2015
- Published online: 14 Dec 2015
Abstract
Background:
After discharge from in-hospital rehabilitation, post-stroke patients
should have the opportunity to continue the rehabilitation through
structured programs to maintain the benefits acquired during intensive
rehabilitation treatment.
Objective: The primary objective was to
evaluate the feasibility of implementing an home-based telesurveillance
and rehabilitation (HBTR) program to optimize the patient's recovery by
reducing dependency degree.Method: Post-stroke patients were consecutively screened. Data were expressed as mean ± standard deviation (SD). 26 patients enrolled: 15 were sub-acute (time since stroke: 112 ± 39 days) and 11 were chronic (time since stroke: 470 ± 145 days). For 3 months patients were followed at home by a nurse-tutor, who provided structured phone support and vital signs telemonitoring, and by a physiotherapist (PT) who monitored rehabilitation sessions by videoconferencing.
Results: 23 patients completed the program; 16.7 ± 5.2 phone contacts/patient were initiated by the nurse and 0.9 ± 1.8 by the patients. Eight episodes of atrial fibrillation that required a change in therapy were recorded in two patients. Physiotherapists performed 1.2 ± 0.4 home visits, 1.6 ± 0.9 phone calls and 4.5 ± 2.8 videoconference-sessions per patient. At least three sessions/week of home exercises were performed by 31% of patients, two sessions by 54%. At the end of the program, global functional capacity improved significantly (P < 0.001), in particular, static (P < 0.001) and dynamic (P = 0.0004) postural balance, upper limb dexterity of the paretic side (P = 0.01), and physical performance (P = 0.002). Symptoms of depression and caregiver strain also improved.
Conclusion:
The home-based program was feasible and effective in both sub-acute and
chronic post-stroke patients, improving their recovery, and maintaining
the benefits reached during inpatient rehabilitation
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