Telework and telerehabilitation programs for workers with a stroke during the COVID-19 pandemic: A commentary.

BACKGROUND: Due to the coronavirus disease 2019 (COVID-19) pandemic, rehabilitation facilities have become less accessible for patients with a stroke. Lack of early, intensive rehabilitation misses the opportunity for recovery during the critical time window of endogenous plasticity and improvement post-stroke. OBJECTIVES: The purpose of this commentary was to highlighting the benefits of telework and telerehabilitation programs for workers with a stroke during the COVID-19 pandemic. METHODS: Relevant publications regarding the management of individuals with a stroke, telerehabilitation and teleworking in the setting of COVID-19 were reviewed. RESULTS: Previous studies showed that telerehabilitation can effectively provide an alternate method of promoting recovery for patients with a stroke. With the physical distancing precautions in place for mitigating viral spread, teleworking can also provide a method for long term recovery and improvements in quality of life after a stroke. CONCLUSIONS: Overall, this commentary addresses the benefits of physically distant, safe and effective alternatives to support individuals who live with a stroke during COVID-19 pandemic.

One Step at a Time, One Day at a Time': Life Profiles of Individuals with Disabilities across the First Year of the COVID-19 Pandemic

Individuals with disabilities underwent substantial changes in life due to the COVID-19 pandemic. However, little is known about the experiences of this population during the first year of the pandemic. Hence, drawing on data from a longitudinal mixed-methods study, this study aimed to identify different COVID-19 life profiles among people with disabilities. Sixty-one participants were interviewed at four timepoints, which paralleled restriction changes in British Columbia, Canada. These data were analyzed to identify different life profiles over the course of the first year of the pandemic. The analysis identified three interlinked profiles: (1) 'being in a straitjacket' examines the increasing restriction-related frustrations experienced by participants;(2) 'seizing the reins' explores the positive routines that participants established by filling the gaps with meaningful activities;and (3) 'staying content during COVID' describes a 'keep calm, carry on' attitude, where minimal impact of the pandemic was observed by participants. The three COVID-19 life profiles provide insight to the challenges encountered, resources used, and the varying experiences of individuals with disabilities as they adjusted to a different way of living. These findings can facilitate future research that could develop interventions and services for individuals with disabilities in subsequent pandemics or disasters.

Describing the Function, Disability, and Health of Adults and Older Adults during the Early Coronavirus Restrictions in 2019: An Online Survey

The restrictions in 2019 due to Coronavirus impacted Canadians' daily living, especially those at higher risk of compromised health conditions. This study aimed to describe the physical, psychological, and social well-being of adults with disabilities, and older adults from May to June 2020. Participants from the group of community-dwelling adults (≥19 years of age), who communicated in English, lived in British Columbia, and had Internet access via a computer, tablet, or smartphone with special focus on populations who had stroke, spinal cord injury and other disabilities were included. For measurement outcomes, an online survey was used to administer standardized measures of level of participation, mobility, anxiety and depression, boredom, resilience, technology readiness, social support, and social networks. Seventy-two participants were recruited, with a mean age (SD) of 61.2 (13.8). This study was comprised of two groups: the adult group consisted of individuals with disabilities under the age of 65 (48.6%) and the older adult group consisted of individuals over the age of 65 with and without self-identified disability (51.4%). There was no significant difference in the proportion of participation restriction between adult (83%) and older adult' (81%) groups (p = 0.69). In the study population, 27.8% and 16.7% of participants exceeded the anxiety and depression cut-off scores, respectively. Boredom was experienced by 76.4% of participants. Participants' mean (SD) resilience and life space scores were 72.4 (14.0) and 51.9 (24.0), respectively. The older adults (≥65 years) showed significantly lower depression (p = 0.012) and better resilience (p = 0.038), social support (p = 0.043), and social network (p = 0.021) than the younger adults. Issues with anxiety, boredom, participation, and life space activity were identified in both study groups. This information may provide supporting evidence when creating policies to mitigate existent health and social inequities.

Pandemic-Related Experiences of Older Adults and People with Disabilities...American Congress of Rehabilitation Medicine (ACRM) Annual Conference (Virtual), September 24−29, 2021

To understand how pandemic related restrictions and regulations have affected older adults and people with disabilities we drew on Sen's Capabilities Approach (Sen, 1985;Venkatapuram, 2011) to explore their pandemic-related experiences. This qualitative description study (Sandelowski, 2000;2010) used interview data that were collected as part of a larger mixed-methods study. Interviews were transcribed verbatim and inductive analysis was informed by Sen's Capabilities Approach. Teleconference. We recruited community dwelling participants from four groups: people with spinal cord injuries (SCI) (n = 22), people who have experienced a stroke (n = 26), people with other disabilities (n = 13), and older adults (over the age of 65) without reported disabilities (n = 10). N/A. N/A. Our analysis identified one overarching theme: "navigating the new normal" described the challenges and successes participants experienced in the face of pandemic-related recommendations, restrictions and regulations. The overarching theme encapsulated three sub-themes. 1) "Trying to stay connected" explored feelings of social isolation and strategies used to reduce feelings of loneliness. 2) "Worrying about the future" described the personal and societal uncertainties participants grappled with. 3) "Exerting control" emphasized how participants tried to deal with pandemic related restrictions that affected their daily activities and health management. As has been found in previous survey research, pandemic restrictions appear to have exacerbated previously existing inequities experienced by some older adults and people with disabilities, as those who were disadvantaged prior to the pandemic, bore the brunt of restrictions (Drum et al., 2020). Greater consultation is needed to reduce detrimental effects of pandemic restrictions on these populations and promote strengths-based approaches to deal with the current situation and potential future pandemics. The authors have no disclosures.

The Impact of COVID-19-Related Restrictions on Social and Daily Activities of Parents, People With Disabilities, and Older Adults: Protocol for a Longitudinal, Mixed Methods Study.

BACKGROUND: The COVID-19 pandemic has led to wide-scale changes in societal organization. This has dramatically altered people's daily activities, especially among families with young children, those living with disabilities such as spinal cord injury (SCI), those who have experienced a stroke, and older adults. OBJECTIVE: We aim to (1) investigate how COVID-19 restrictions influence daily activities, (2) track the psychosocial effects of these restrictions over time, and (3) identify strategies to mitigate the potential negative effects of these restrictions. METHODS: This is a longitudinal, concurrent, mixed methods study being conducted in British Columbia (BC), Canada. Data collection occurred at four time points, between April 2020 and February 2021. The first three data collection time points occurred within phases 1 to 3 of the Province of BC's Restart Plan. The final data collection coincided with the initial distribution of the COVID-19 vaccines. At each time point, data regarding participants' sociodemographics, depressive and anxiety symptoms, resilience, boredom, social support, instrumental activities of daily living, and social media and technology use were collected in an online survey. These data supplemented qualitative videoconference interviews exploring participants' COVID-19-related experiences. Participants were also asked to upload photos representing their experience during the restriction period, which facilitated discussion during the final interview. Five groups of participants were recruited: (1) families with children under the age of 18 years, (2) adults with an SCI, (3) adults who experienced a stroke, (4) adults with other types of disabilities, and (5) older adults (>64 years of age) with no self-reported disability. The number of participants we could recruit from each group was limited, which may impact the validity of some subgroup analyses. RESULTS: This study was approved by the University of British Columbia Behavioural Research Ethics Board (Approval No. H20-01109) on April 17, 2020. A total of 81 participants were enrolled in this study and data are being analyzed. Data analyses are expected to be completed in fall 2021; submission of multiple papers for publication is expected by winter 2021. CONCLUSIONS: Findings from our study will inform the development and recommendations of a new resource guide for the post-COVID-19 period and for future public health emergencies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/28337.