At-home rehab comparable to clinic-based therapy to improve mobility

Home-based telerehabilitation is just as effective as clinic-based therapy at restoring arm function among stroke survivors, according to late-breaking science presented at the American Stroke Association's International Stroke Conference 2019.

"Many patients receive suboptimal rehabilitation therapy doses after stroke due to limited access to therapists and difficulty with transportation," said the study's lead author Steven C. Cramer, M.D., M.M.Sc., a professor of Neurology, Anatomy & Neurobiology, and Physical Medicine & Rehabilitation at University of California Irvine. "This can be addressed by telehealth, which enables patients to access high doses of rehabilitation therapy in their home."

Researchers conducted a randomized, assessor-blinded, non-inferiority trial with 124 stroke survivors (average age 61) at 11 U.S. StrokeNet Clinical Trial Network sites. Survivors underwent six weeks of intensive rehabilitation therapy targeting arm weakness. Each was randomized to receive therapy either in the clinic using traditional methods or in their home using a telerehabilitation system.

"A computer-based telerehabilitation system delivered to patient's homes uses "game-ified" therapy activities, exercises and educational sessions (such as "Stroke Jeopardy"). Therapists can assess progress via videoconference. In clinic-based therapy, patients drive to the clinic and perform standard exercises and therapeutic activities with a therapist without a computer and without game-ification of these activities," Cramer explained.

Compliance was high and similar between both groups. Arm function improved substantially and equivalently in both groups.

"We demonstrated that home-based telehealth methods provide comparable benefits to traditional in-clinic methods," Cramer said. "In the future, telehealth approaches to post-stroke rehabilitation might help patients reduce disability by accessing large doses of therapy."