Implementing Team-Based Post-Stroke Telerehabilitation: A Case Example
DOI:
https://doi.org/10.5195/ijt.2022.6438Keywords:
Interdisciplinary teams, Service delivery models, Stroke Treatment, Telehealth, TelerehabilitationAbstract
Access to extensive, interdisciplinary rehabilitation following stroke is necessary to optimize recovery. Telerehabilitation is an appropriate model for delivering these services. However, given its relatively recent increase in popularity as a service delivery model, researchers have yet to explore the feasibility of interprofessional coordination and collaboration as a guiding framework for telerehabilitation and the effects of team-based remote service delivery on recovery of body functions and activities. This case example reports the development, implementation, and progression of a post-acute treatment program delivered via telerehabilitation to a woman with left hemorrhagic stroke. As is typical, therapy time alone afforded insufficient practice to exploit neuroplasticity and ensure maintenance and generalization of improved functioning; hence, the team worked collaboratively to encourage interdisciplinary activities outside scheduled treatment sessions. Standardized and informal assessments administered at the start and conclusion of treatment confirmed improved functioning as did the client’s progress toward independent living and return to work. Implications for telerehabilitation practices are discussed.
References
Agency for Healthcare Research and Quality (2019, March). TeamSTEPPS fundamentals course: Module 3. Communication. https://www.ahrq.gov/teamstepps/instructor/fundamentals/module3/igcommunication.html
American Physical Therapy Association. (2020). Impact of COVID-19 on the physical therapy profession: A report from the American Physical Therapy Association. American Physical Therapy Association. https://www.apta.org/contentassets/15ad5dc898a14d02b8257ab1cdb67f46/impact-of-covid-19-on-physical-therapy-profession.pdf
Atwal, A., & Caldwell, K. (2005). Do all health and social care professionals interact equally: A study of interactions in multidisciplinary teams in the United Kingdom. Scandinavian Journal of Caring Sciences, 19(3), 268-273. https://doi.org/10.1111/j.1471-6712.2005.00338.x
Belagaje, S. R. (2017). Stroke rehabilitation. Continuum: Lifelong Learning in Neurology, 23(1), 238-253. https://doi.org/10.1212/CON.0000000000000423
Buheji, M., & Hassani, A. (2020). Design of lean tele-rehabilitation services for post COVID-19 pandemic. International Journal of Advanced Research in Engineering and Technology, 11(11), 1360-1371. https://doi.org/0.34218/IJARET.11.11.2020.123
Careau, E., Vincent, C., & Noreau, L. (2008). Assessing interprofessional teamwork in a videoconference-based telerehabilitation setting. Journal of Telemedicine and Telecare, 14(8), 427-434. https://doi.org/10.1258/jtt.2008.080415
Clarke, D. J. (2010). Achieving teamwork in stroke units: The contribution of opportunistic dialogue. Journal of Interprofessional Care, 24(3), 285-297. https://doi.org/10.3109/13561820903163645
Clarke, D. J., & Forster, A. (2015). Improving post-stroke recovery: The role of the multidisciplinary health care team. Journal of Multidisciplinary Healthcare, 8, 433-442. https://doi.org/10.2147/JMDH.S68764
Cramer, S. C., Dodakian, L., Le, V., See, J., Augsburer, R., McKenzie, A., Zhou, R. J., Ghiu, N. L., Heckhausen, J., Cassidy, J. M., Scacchi, W., Smith, M. T., Barrett, A. M., Knutson, J., Edwards, D., Putrino, D., Argawal, K., Ngo, K., Roth, E. J., … Janis, S. (2019). Efficacy of home-based telerehabilitation vs in-clinic therapy for adults after stroke. JAMA Neurology, 76(9), 1079-1087. https://doi.org/10.1001/jamaneurol.2019.1604
Heuer, A., Hector, J. R., & Cassell, V. (2019). An update on telehealth in allied health and interprofessional care. Journal of Allied Health, 48(2), 140-147.
Macoir, J., Sauvageau, V. M., Boissy, P., Tousignant, M., & Tousignant, M. (2017). In-home synchronous telespeech therapy to improve functional communication in chronic poststroke aphasia: Results from a quasi-experimental study. Telemedicine and e-Health, 23(8), 630-639. https://doi.org/10.1089/tmj.2016.0235
Markle-Reid, M., Orridge, C., Weir, R., Browne, G., Gafni, A., Lewis, M., Walsh, M., Levy, C., Daub, S., Brien, H., Roberts, J. & Thabane, L. (2011). Interprofessional stroke rehabilitation for stroke survivors using home care. Canadian Journal of Neurological Sciences, 38(2), 317-334. https://doi.org/10.1017/S0317167100011537
Meltzer, J. A., Baird, A. J., Steele, R. D., & Harvey, S. J. (2017). Computer-based treatment of poststroke language disorders: A non-inferiority study of telerehabilitation compared to in-person service delivery. Aphasiology, 32(3), 290-311. https://doi.org/10.1080/02687038.2017.1355440
Miller, K., Chumbler, N. R., Carlson, K., & Daggett, V. (2014). Tele-rehabilitation to promote exercise in Veterans post-stroke: An observational pilot study. International Journal of Physical Medicine and Rehabilitation, 2(3), 1-5. https://doi.org/10.4172/2329-9096.1000200
Moradi, V., Babaee, T., Esfandiari, E., Lim, S. B., & Kordi, R. (2021). Telework and telerehabilitation programs for workers with a stroke during the COVID-19 pandemic: A commentary. Work, 68, 77-80. https://doi.org/10.3233/WOR-203356
Prabawa, I. M. Y., Silakarma, D., & Widnyana, M. (2021). Telerehabilitation as a physical therapy solution for the post-stroke patient in COVID-19 pandemic situations: A review. Intisari Sains Medis, 12(1), 1-5. https://doi.org/10.15562/ism.v12i1.873
Stein, J., Visco, C. J., & Barbuto, S. (2020). Rehabilitation medicine response to the COVID-19 pandemic. Advance online publication. American Journal of Physical Medicine & Rehabilitation. https://doi.org/10.1097/PHM.0000000000001470
Stroke Unit Trialists’ Collaboration. (2013). Organised inpatient (stroke unit) care for stroke. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD000197.pub3
Tchero, H., Tabue-Teguo, M., Lannuzel, A., & Rusch, E. (2018). Telerehabilitation for stroke survivors: Systematic review and meta-analysis. Journal of Medical Internet Research, 20(10), e10867. https://doi.org/10.2196/10867
Temkin, A. J., Ulicny, G. R., & Versarovich, S. H. (1996). Telerehab: A perspective of the way technology is going to change the future of patient treatment. Rehab Management, 9(2), 28-30.
Tenforde, A. S., Borgstrom, H., Polich, G., Steere, H., Davis, I. S., Cotton, K., O’Donnell, M., & Silver, J. K. (2020). Outpatient physical, occupational, and speech therapy synchronous telemedicine: A survey study of patient satisfaction with virtual visits during the COVID-19 pandemic. American Journal of Physical Medicine & Rehabilitation. Advance online publication. https://doi.org/10.1097/PHM.0000000000001571
Yagura, H., Miyai, I., Seike, Y., Suzuki, T., & Yanagihara, T. (2003). Benefit of inpatient multidisciplinary rehabilitation up to 1 year after stroke. Archives of Physical Medicine and Rehabilitation, 84(11), 1687-1691. https://doi.org/10.1053/S0003-9993(03)00286-7
Yagura, H., Miyai, I., Suzuki, T., & Yanagihara, T. (2005). Patients with severe stroke benefit most by interdisciplinary rehabilitation team approach. Cerebrovascular Diseases, 20(4), 258-263. https://doi.org/10.1159/000087708
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