When someone survives a stroke they could have paralysis or weakness, balance issues and visual impairments. There can be communication and cognitive effects and emotional and behavioral changes. Stroke rehabilitation helps people rebuild strength and relearn how to do everyday basic tasks.
Stroke specialists are primarily located in urban areas, limiting access for rural patients. However, the Medical University of South Carolina is delivering rehabilitation services to patients at home, using telehealth.
Through telerehabilitation occupational therapy, patients living in rural areas no longer have to travel out of their community several times a week for several months to receive physical and occupational therapy along with speech language therapy and mental health support.
“People are less likely to miss their therapy visits because they don’t have to drive a couple hours to get there,” said Michelle Woodbury, a professor and occupational therapist in the College of Health Professions at MUSC. “And it’s more likely that they’ll engage in the rehab program so hopefully the outcomes will be better.”
Telerehabilitation sessions also include a cognitive behavioural therapy component which helps patients overcome anxiety and depression.
“The idea is that while people are recovering their movement skills or their language skills they’re also learning skills for dealing with anxiety and worry and dread and depression,” Woodbury said.
One of the key differences between in-person occupational therapy and telerehabilitation is keeping patients safe. Jul Laura is an occupational therapist at MUSC. She uses an emergency response protocol when she’s providing telerehab to a patient.
“We can’t be there in person with a patient as we’re working with them and so we spend extra time validating where their physical location is, who’s in the house with them, how they’re feeling that day if there are any differences,” Laura said.
The emergency response protocol is one unique procedure involved in the telerehab model. Laura said her team is prioritizing the sustainability of telerehab by sharing these evidence based practices with other clinicians.
“We focus on how we can create a model that expands beyond just our research program, beyond just our stroke survivors that we work with,” Laura said.