Virtual Rehabilitation to Enhance Resource Efficiency in Stroke and Orthopedic Patients

Research

Objectives: To explore the potential of using technology to enhance resource efficiency and augment therapy, enabling individuals needing rehabilitation to access services earlier through consultation with rehabilitation professionals and a self-managed rehabilitation program.

Design: A before-after trial over approximately one year. Setting: Patients were identified in an inpatient setting at a community hospital. They would participate in the program at home, virtually connecting with an inpatient rehabilitation professional. Participants: Participants include patients who had a total hip or total knee replacement (n=44), patients who had a mild or moderate stroke (n=16), and their caregivers. Participants were, on average, 67 years old, with 42% identified as female. Eligibility included being independent or one person assist, able to learn and carry over information, have access to technology, have sufficient space at home to participate, and live within Mackenzie Health’s catchment area. Interventions: Patients were educated on the program by the therapy team during their inpatient stay. Those who consented to participate were provided a Virtual Rehab Kit (VRK) and had an appointment booked with the virtual therapist. If required, a provider would go to the patient's home to set up the (VRK). Using the VRK, the therapist would assess the patient and develop a treatment plan using exergames on the VRK. Patients would play the prescribed exergames at their convenience before the next appointment with the therapist. Main Outcome Measures: Health outcomes such as the Functional Independence Measure (FIM) and EQ VAS were measured during the initial and discharge assessment. Additionally, attendance rates and compliance completing the prescribed exergames were measured and patient and provider experience data was collected.

Results: Patients with a hip or knee replacement saw an average increase of 12 and 18 points for their FIM and EQ VAS score respectively, while patients diagnosed with stroke saw an average increase of 8 and 15 points for their FIM and EQ VAS score respectively. 88% of participants attended all their sessions and on average, patients completed 65% of their prescribed exergames. On average, both patients and caregivers were either satisfied or very satisfied in all areas of the satisfaction survey.

Conclusions: Changes in health outcomes were positive and patients and their caregivers were generally pleased with the program. The program identified opportunities to start patients on their post-acute rehabilitation pathway sooner and provided opportunities for patients to augment their therapy at a location and time most convenient to them. Author(s) Disclosures: n/a