Knowledge and Attitudes of Rehabilitation Professional Toward Telerehabilitation in Saudi Arabia: A Cross-Sectional Survey.

Background: Continuity of rehabilitation care after completion of a hospital-based rehabilitation program remains a challenge. This is of considerable significance in Saudi Arabia where there is a lack of community-based rehabilitation, which renders the need of telemedicine services. There is lack of data regarding understanding, awareness, and attitudes of rehabilitation professional toward telerehabilitation. This study was aimed to explore Saudi-based rehabilitation professionals' knowledge of telerehabilitation. Materials and Methods: After pilot testing, a survey questionnaire was distributed to 82 rehabilitation professionals working in different regions of Saudi Arabia. The survey included 14 close-ended questions targeting five domains: demographics, telemedicine knowledge, telerehabilitation service knowledge, social acceptance of these services, and risks associated with these services. Descriptive statistics were obtained by analyzing data using Microsoft Excel. Results: In total 46% of the participants were aware of telerehabilitation service technology but did not use it. 69.51% considered both telerehabilitation and community-based rehabilitation as the best service delivery methods. About 43% of participants reported that lack of knowledge about information technology and cost were the main factors that led to their limited use of telerehabilitation systems. The majority of the participants (52.44%) considered breach of confidentiality to be a risk associated with telerehabilitation services. Conclusions: Even though considerable number of the participants considered telerehabilitation as an important service delivery method, most of them are not involved in telerehabilitation. This renders the need of establishing local telerehabilitation guidelines and addressing the barriers pertaining to training, resources, cost, policy making, confidentiality, and perception of patients.

Characteristics and functional outcomes of pediatric stroke survivors at a rehabilitation unit in Saudi Arabia.

There is a lack of data regarding functional outcomes of comprehensive inpatient rehabilitation (IPR) in children with stroke in Saudi Arabia. The objective of this study was to analyze the effect of IPR on functional outcomes of pediatric stroke survivors. This retrospective cohort study included pediatric stroke survivors (n = 18) admitted to pediatric rehabilitation unit from January 2011 to December 2018. Data were obtained regarding functional status based on WeeFIM at the time of admission and discharge. Functional gain was compared within genders, age-groups, geographical regions, lesion characteristics, location of motor deficits, primary etiology, comorbidities, and risk factors. Improvement in self-care, mobility, and cognition was also compared. Results showed a delayed admission to IPR from the time of stroke; however, a significant gain was observed in overall WeeFIM score (p < 0.001), self-care, and mobility (both p = 0.001) but not in cognition (p = 0.13). WeeFIM gain was significantly better in hemorrhagic stroke survivors than ischemic stroke survivors (p = 0.027). Age-group, gender, geographical region, primary etiology, lesion characteristics, comorbidities, risk factors, and location of motor deficits did not affect the functional improvement. The association analysis of WeeFIM gain with age, duration from onset of stroke to IPR admission, WeeFIM score at admission, and length of stay did not yield any significant value. Self-care domain of WeeFIM had significantly better percentage gain than mobility and cognition (p = 0.01). In conclusion, functional outcomes among our cohort of Saudi pediatric stroke survivors improved significantly after IPR especially in self-care. Hemorrhagic strokes had better functional outcome than ischemic strokes.

An unusual mechanism of spinal cord injury due to active neck stretching and its functional implications.

Spinal cord injury without radiological abnormality is a rare entity and has not been reported to occur secondary to active neck stretching. The case report highlights the possible mechanisms of injury and functional outcomes of multidisciplinary rehabilitation.

Falls in individuals with stroke during inpatient rehabilitation at a tertiary care hospital in Saudi Arabia.

OBJECTIVE: To determine the incidence and risk factors of falls in individuals with stroke undergoing inpatient rehabilitation. METHODS: Retrospective analysis of all patients with stroke admitted to from January 2011 to June 2013 was carried out in Inpatient rehabilitation Unit at King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. Data collected included demographic variables, types of stroke, comorbidities, characteristics of falls, factors affecting falls and length of hospital stay. Data was descriptively analyzed. The Pearson Chi-square test was used to determine any significant relationship between the categorical variables. Binary logistic regression was used to evaluate predictors of falls during rehabilitation. RESULTS: Out of 146 stroke survivors, 36 patients had a fall during inpatient rehabilitation. Majority did not sustain any injury. Fall status was significantly associated with age group (p=0.048), type of stroke (p=0.005) and previous history of stroke (p=0.020). The side of stroke (p=0.011) and fall risk were statistically significantly related to fall outcomes (p=0.005). Length of hospital stay (LOS) was also associated with fall outcome (p=0.044). CONCLUSION: Age, hemorrhagic stroke, laterality of stroke and previous history of stroke were identified as risk factors associated with falls. Injured patients tend to stay longer for inpatient rehabilitation. Due to different culturual, environmental and health system variations, development of regional guidelines for fall prevention in stroke survivors can help to reduce the risk of falls.