EFFECTIVENESS OF TELEREHABILITATION ON THE PERFORMANCE OF POST-STROKE PATIENTS' DAILY LIVING ACTIVITIES IN VIETNAM: A PILOT STUDY

¹University of Medicine and Pharmacy at Ho Chi Minh City, Physiotherapy, Ho Chi Minh, Vietnam

Background: The performance of post-stroke patients' daily living activities (ADLs) is severely affected because of hemiplegia. Thus, it is vital to provide a rehabilitation program to enhance patients' performance in ADLs and help them become more independent. As the COVID-19 pandemic exacerbates the situation in the healthcare systems, telerehabilitation can democratize treatment making it accessible even to vulnerable patients including stroke survivors.

Purpose: This study aims to evaluate the efficacy of telerehabilitation on stroke patients' capability to perform ADLs such as eating, dressing, undressing, bathing, personal hygiene, and mobility after one month of telerehabilitation intervention. Additionally, we explored relationships between demographic characteristics and change in ADL performance.

Methods: We conducted our study by recruiting 20 stroke survivors with moderate severity of stroke according to the National Institute of Health Stroke Scale (NIHSS) from five hospitals in Vietnam. All subjects were provided the one-month treatment program that included Video - based rehabilitation and virtual rehabilitation appointments (three sessions per week and 60 minutes per session) between patients and therapists. We employed the Barthel Index (BI) with scores from 0 (unable) to 100 (independent) to evaluate the task performances of the patients before and after the intervention and used the Paired T-test to analyse the results. We also utilized the linear mixed effects (LME) model to identify changes in the BI scores over the treatment duration. We included several prognostic factors such as age, gender, and measurement (at discharge and after one month of telerehabilitation intervention).

Results: The treatment program demonstrated a statistically significant difference in patients' ADL performance. The mean BI score, in the beginning, was 43.5 with a standard deviation (stdev) of 12.9; after one month, the mean was 77.5 with the stdev of 17.5 (p<0.0001). Besides, the results indicated a decrease in the adjusted BI score as the age factor increased and there is no statistically significant difference in the BI score between men and women.

Conclusions: The telerehabilitation intervention improved the patients' capability on ADLs after stroke, and such improvement was influenced by age. Specifically, the independence of post-stroke patients when performing ADLs tends to decrease in older patients. Additional studies with a larger sample size are required to evaluate the efficacy of the proposed intervention program with greater accuracy.

Implications: This study shows that the application of telerehabilitation to provide treatment has positive outcomes for stroke patients. This form of intervention can be applied to increase the accessibility of rehabilitation in the community for patients. From this study, telerehabilitation models should be deeply studied and expanded in the clinical context in Vietnam.

Funding acknowledgements: Unfunded

Keywords:
Stroke
Telerehabilitation
Daily living activities

Topics:
Neurology: stroke
Community based rehabilitation
Innovative technology: information management, big data and artificial intelligence

Did this work require ethics approval? Yes

Institution: University of Medicine and Pharmacy at Ho Chi Minh City

Committee: Research Ethics Committee

Ethics number: 21431- ĐHYD