Pilot trial of a tele-rehab intervention to improve outcomes after stroke in Ghana: A feasibility and user satisfaction study

JOURNAL OF THE NEUROLOGICAL SCIENCES

卷:387

Article

Sarfo, Fred S.^1,2  Adusei, Nathaniel²  Ampofo, Michael²  Kpeme, Frank K.²  Ovbiagele, Bruce³ 

[1] Kwame Nkrumah Univ Sci & Technol, Kumasi, Ghana

[2] Komfo Anokye Teaching Hosp, Kumasi, Ghana

[3] Med Univ South Carolina, Charleston, SC USA

关键词: Post-stroke rehabilitation;    M-health;    Disability;    Ghana;    Tele-rehabilitation;    Feasibility;    Stroke survivors;    Resource-limited;   

DOI  :  10.1016/j.jns.2018.01.039

来源: Elsevier

【 摘 要 】

Background: Tele-rehabilitation after stroke holds promise for under-resourced settings, especially sub-Saharan Africa (SSA), with its immense stroke burden and severely limited physical therapy services. Objective: To preliminarily assess the feasibility and outcomes of mobile technology-assisted physical therapy exercises for stroke survivors in Ghana. Methods: We conducted a prospective, single arm, pre-post study involving 20 stroke survivors recruited from a tertiary medical center, who received a Smartphone with the 9zest Stroke App (R) to deliver individualized, goal targeted 5-days-a-week exercise program that was remotely supervised by a tele-therapist for 12 weeks. Outcome measures included changes in stroke levity scale scores (SLS), Modified Rankin score (MRS), Montreal Cognitive Assessment (MOCA), and feasibility indicators. Results: Among study participants, mean +/- SD age was 54.6 +/- 10.2 years, 11 (55%) were men, average time from stroke onset was 6 months. No participants dropped out. Compared with baseline status, mean SD scores on SLS improved from 7.5 +/ 3.1 to 11.8 +/- 2.2 at month 1 (p < 0.0001) and 12.2 +/- 2.4 at month 3 (p < 0.0001), MOCA scores improved from 18.2 +/- 4.3 to 20.4 +/- 4.7 at month 1 (p = 0.14), and 22.2 +/- 7.6 at month 3 (p = 0.047). Mean SD weekly sessions performed by participants per month was 5.7 +/- 5.8 and duration of sessions was 25.5 +/- 16.2 min. Erratic internet connectivity negatively affected full compliance with the intervention, although satisfaction ratings by study participants were excellent. Conclusion: It is feasible to administer an m-health delivered physical therapy intervention in SSA, with high user satisfaction. Randomized trials to assess the efficacy and cost-effectiveness of this intervention are warranted.

【 授权许可】

Free