Telerehabilitation for Stroke: A Personalized Multi-Domain Approach in a Pilot Study

Author:

Federico Sara1ORCID,Cacciante Luisa1,De Icco Roberto23ORCID,Gatti Roberto45,Jonsdottir Johanna6ORCID,Pagliari Chiara6ORCID,Franceschini Marco78,Goffredo Michela78ORCID,Cioeta Matteo7ORCID,Calabrò Rocco Salvatore9ORCID,Maistrello Lorenza10ORCID,Turolla Andrea1112ORCID,Kiper Pawel1ORCID,

Affiliation:

1. Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, 30126 Venice, Italy

2. Department of Brain and Behavioral Science, University of Pavia, 27100 Pavia, Italy

3. Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy

4. Humanitas Clinical and Research Center, IRCCS, Rozzano, 20148 Milan, Italy

5. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20148 Milan, Italy

6. IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy

7. Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 00163 Rome, Italy

8. Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, 00163 Rome, Italy

9. IRCCS Centro Neurolesi “Bonino Pulejo”, 98121 Messina, Italy

10. IRCCS San Camillo Hospital, 30126 Venice, Italy

11. Department of Biomedical and Neuromotor Sciences—DIBINEM, Alma Mater Studiorum Università di Bologna, 40138 Bologna, Italy

12. Unit of Occupational Medicine, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy

Abstract

Stroke, a leading cause of long-term disability worldwide, manifests as motor, speech language, and cognitive impairments, necessitating customized rehabilitation strategies. In this context, telerehabilitation (TR) strategies have emerged as promising solutions. In a multi-center longitudinal pilot study, we explored the effects of a multi-domain TR program, comprising physiotherapy, speech therapy, and neuropsychological treatments. In total, 84 stroke survivors (74 analyzed) received 20 tailored sessions per domain, addressing individual impairments and customized to their specific needs. Positive correlations were found between initial motor function, cognitive status, independence in activities of daily living (ADLs), and motor function improvement after TR. A lower initial health-related quality of life (HRQoL) perception hindered progress, but improved ADL independence and overall health status, and reduced depression correlated with a better QoL. Furthermore, post-treatment improvements were observed in the entire sample in terms of fine motor skills, upper-limb functionality, balance, independence, and cognitive impairment. This multi-modal approach shows promise in enhancing stroke rehabilitation and highlights the potential of TR in addressing the complex needs of stroke survivors through a comprehensive support and interdisciplinary collaboration, personalized for each individual’s needs.

Funder

Italian Ministry of Health—Ricerca Corrente Reti

Publisher

MDPI AG

Subject

Medicine (miscellaneous)

Reference41 articles.

1. World Stroke Organization (WSO): Global Stroke Fact Sheet 2022;Feigin;Int. J. Stroke,2022

2. Global stroke statistics 2022;Thayabaranathan;Int. J. Stroke,2022

3. Virtual Reality for Upper Limb Rehabilitation in Subacute and Chronic Stroke: A Randomized Controlled Trial;Kiper;Arch. Phys. Med. Rehabil.,2018

4. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association;Winstein;Stroke,2016

5. Telerehabilitation: An Adjunct Service Delivery Model for Early Intervention Services;Cason;Int. J. Telerehabilit.,2011

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