Home-based telerehabilitation for community-dwelling persons with stroke during the COVID-19 pandemic: A pilot study.

OBJECTIVES: To determine the feasibility and safety of use of asynchronous telerehabilitation for community-dwelling persons with stroke in the Philippines during the COVID-19 (SARS-CoV-2) pandemic, and to evaluate the change in participants' telerehabilitation perceptions, physical activity, and well-being after a 2-week home-based telerehabilitation programme using a common social media application. DESIGN: Pilot study. PARTICIPANTS: Nineteen ambulatory, non-aphasic adult members of a national university hospital stroke support group in the Philippines. METHODS: Pre-participation screening was performed using the Physical Activity Readiness Questionnaire. The participants were medically cleared prior to study enrollment. They then engaged in telerehabilitation by watching original easy-to-follow home exercise videos prepared and posted by the study authors on a private group page on Facebook™ every other day for 2 weeks. Descriptive statistics was performed. RESULTS: All 19 participants (mean age: 54.9 years) completed the programme with no significant adverse events. The majority of subjects improved their telerehabilitation perceptions (based on the Telepractice Questionnaire), physical activity levels (based on the Simple Physical Activity Questionnaire), and perceived well-being (based on the Happiness Scale). CONCLUSION: Asynchronous telerehabilitation using a common low-cost social media application is feasible and safe for community-dwelling persons with chronic stroke in a lower-middle-income country.

Measurement properties of the upright motor control test in adults with subacute stroke.

BACKGROUND: Previous studies have distilled the Upright Motor Control Test Knee Extension and Knee Flexion subscales (UMCT-KE and UMCT-KF, respectively) from the original 6-item instrument and examined these as stand-alone rapid tests of voluntary movement control in the standing position. Systematic review evidence suggests that the UMCT-KE and UMCT-KF may have value in predicting walking ability after stroke. OBJECTIVE: To examine the interrater and intrarater reliability, and concurrent validity of the UMCT-KE and UMCT-KF, and associations with walking ability in adults with subacute stroke. METHODS: A prospective repeated assessments design was implemented in a rehabilitation department in a public teaching hospital. A consecutive sample of patients with subacute first-time stroke (N = 50; mean age = 51 ± 12 years; 20 females; mean time post-stroke = 68 ± 48 days) completed the study. Three physical therapists independently administered the UMCT-KE and UMCT-KF on two testing occasions 2 days apart (t1 and t2). On t2, a fourth rater administered the Leg subscale of the Motricity Index (MI-Leg) as criterion standard. RESULTS: The UMCT-KE and UMCT-KF demonstrated substantial to almost perfect interrater and intrarater reliability (W = 0.77-0.95), with lower limits of 95% confidence intervals extending to no lower than the substantial level. Both the UMCT-KE and UMCT-KF showed high correlations with the MI-Leg (ρ = 0.747-0.775) and significant associations with walking ability. p Values for all tests were <0.001. CONCLUSIONS: The UMCT-KE and UMCT-KF are reliable and valid tests for rapidly estimating voluntary movement control of the lower limbs in adults with subacute stroke.

Intensive task-oriented training for mobility and balance in a patient with multiple strokes: A case report

@#<p style="text-align: justify;">Patients with multiple strokes are often excluded from studies due to poor outcomes. This case report described change in mobility and balance in a 54-year-old male with four strokes following intensive physical therapy (PT) based on the Task oriented Approach. Outcome assessment demonstrated clinically meaningful change in balance and mobility, and no adverse events. Intensive task-oriented PT is safe and feasible, and may contribute toward positive outcomes in severe disability related to multiple strokes.</p>