Telehealth for Stroke Rehabilitation
Health professionals and academics across New Zealand and Australia have complied practical resources to help stroke teams implement TeleRehabilitation. These resources are designed to give clinicians practical advice and references for how to deliver the best care for people with stroke during COVID-19.
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Telehealth is the delivery of care across a distance via information and communication technologies. Telehealth can be used to provide rehabilitation (TeleRehab). Just like in-person rehabilitation TeleRehab can include:
-subjective interview
-patient assessment
-goal setting, and
-individualised exercises and rehabilitation tasks.
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This model of care has multiple advantages including:
-enabling access to rehabilitation services
-reducing practical barriers like travel time and parking
-enabling rehabilitation to take place in the persons own home.
TeleRehab allows us to maintain social distancing, minimize the risk of disease transmission by keeping patients, families and clinicians safe while reducing the disruption for those receiving stroke rehabilitation services.
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Telephone: If you need to monitor your patient's general wellbeing progress and engagement in an existing rehabilitation programme, picking up the phone is often the simplest solution. Text messaging (SMS) can also be used to support engagement and provide simple education. Telephone consultation maybe less fatiguing for the patient.
Videoconferencing: There are lots of advantages to being able to see and hear your patient. Video conferencing can be used to deliver a more comprehensive rehabilitation programme. For example, to observe function, perform assessments remotely or demonstrating and modifying rehabilitation exercises. Both business (e.g. zoom) and telehealth (e.g. Coviu, Vsee) platforms may have whiteboard, screen sharing and file sharing functions, which may be useful features in TeleRehab sessions.
Email and Web-based resources: If you don't require interaction consider sharing web-based links, video and pdfs of educational and rehabilitation activities via email or text. It is also possible to quickly develop and share video resources to groups and individual patients.
Telerehabilitation Platforms: There are a number of purpose built TeleRehab platforms.
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These examples have been developed by NZ DHB rehabilitation teams:
Client telehealth brochure for use with smartphone or tablet : Auckland City Hospital
Zoom for android - Counties Manukau
Zoom for iphone - Counties Manukau
Communication
The documents below provide a range of suggestions to optimise communication, engagement and therapeutic relationships in telerehabilitation. They are designed to be living documents - if you have areas that haven't been addressed or resources you think could be incorporated, please contact felicity.bright@aut.ac.nz.
Assessment and Therapy Tools and Resources 2020
Resources have been collated in response to COVID-19 by Australian and New Zealand rehabilitation health professionals and academics. Visiting the Australian Stroke Foundation INFORM ME website for more details.
TeleRehab Webinars and Forums
Dr Fiona Graham - Rehabilitation Teaching and Research Unit (RTRU), University of Otago, Wellington, NZ has posted a series of telehealth sessions on youtube.