The development and pilot testing of a stroke telerehabilitation decision toolkit

Dr Annie Hill’s research is helping provide better outcomes for stroke survivors

A new toolkit is being developed to improve outcomes of rehabilitation following stroke, with input from researchers and clinicians at the Surgical, Treatment and Rehabilitation Service (STARS).

On average, stroke survivors receive five hours of community rehabilitation after being discharged from hospital. These five hours are intended to cover all aspects of rehabilitation including physiotherapy, speech pathology and occupational therapy. Evidence suggests that high intensity rehabilitation is required to optimise stroke recovery outcomes.

Although telerehabilitation was in use before 2020, the COVID-19 pandemic saw a rapid and widespread uptake of delivering stroke services via telerehabilitation. Telerehabilitation has several potential advantages including delivering rehabilitation close to home, improving patient flow and supporting patient-and-family-centred care.

Despite the increase in telerehabilitation during the pandemic, there was limited accessible guidance on how to deliver in-person rehabilitation via telerehabilitation and the potential legal, safety and security requirements.

Dr Annie Hill, Speech Pathology Conjoint Senior Research Fellow in the STARS Education and Research Alliance, is leading a project funded by the three Queensland Clinical Networks – Stroke, Rehabilitation and Rural and Remote –  to develop and test a toolkit which enables clinicians to align the Stroke Foundation’s Clinical Guidelines and patient goals with the technological features needed to deliver the rehabilitation task.

A co-design methodology was used for the first phase, involving researchers and clinicians with expertise in telerehabilitation and stroke rehabilitation, to determine the design and content of the toolkit. Clinicians were asked about their experiences delivering telerehabilitation and their needs in determining which patient goals can be successfully delivered through telerehabilitation.

In phase two, the toolkit will be pilot tested at STARS to evaluate its usability, feasibility and acceptability. Clinicians will be trained in how to use the telerehabilitation decision toolkit and supported in their use of it.

The toolkit has enormous potential for use throughout Queensland, particularly as there are many patients living in rural and remote areas where there is little to no access to specialised stroke care. It is anticipated the toolkit will also allow clinicians to confidently identify patients and their goals that are suitable for telerehabilitation, choose the types of technology appropriate to an individual patient’s needs and identify considerations regarding the legal, safety and security directions from Queensland Health.