Project Title

‘Computer Assisted Rehabilitation Environment for Innovative Telerehabilitation’

Introduction

There is an increasing incidence of stroke in the United Kingdom and those who survive require rehabilitation. There are a large amount of resources in the United Kingdom used for acute stroke care and initial rehabilitation. However, after initial rehabilitation the patient can struggle and require further long term rehabilitation. With the Department of Health declaring that there is no universal understanding of what is meant by ‘long-term stroke care’, this is becoming an area of concern.

There has been a multitude of research in recent years attempting to develop a method for providing long-term rehabilitation for stroke care. The particular area this project will focus on is a field termed ‘Telerehabilitation’, which defined as:

“Conventional rehabilitation services at a distance, using telecommunication technology as the service delivery medium.”

This project will attempt to focus on one particular area of telerehabilitation, namely the remote assessment of patients. Currently assessment of stroke patients is performed at the clinician’s discretion using an ad-hoc method of picking and choosing different assessment scales. When looking at the Department of Health’s National Clinical Guidelines for Stroke this becomes quite clear:

“Many valid tools exist [patient assessment scales], and although these guidelines do not specify which ones should be used, some suggestions are made in the appropriate parts of the document. It is important staff are trained in whichever scales are chosen to ensure consistency of their use within the team and an understanding of their limitations and purposes. This section only considers general principles.”

Due to the lack of conformity on a national scale, developing a remote and possibly automated assessment system becomes a difficult task.

This project will attempt to research into and develop method(s) for assessing patients who have suffered from a stroke for rehabilitation in order to track their recovery through telerehabilitation, allowing information regarding the patients’ performance to be sent to the hospital for review.

Methodology

This project will initially begin by performing key informant interview with a group of physiotherapists and occupational therapists within the NHS in order to discover their current views on assessment for rehabilitation of persons who have suffered a stroke. The data from this will be collected and a paper produced detailing the findings. IRAS approval was gained for this.

The outcome of these findings will be used to develop separate technologies in order to develop either one or a selection of assessment tools for telerehabilitation.

Once these new tools are developed they will be taken into three NHS hospitals in which they will be tested on a group of patients who have suffered from a stroke. Quantitiative data will be taken from the system, as well as qualitative data that is taken from semi-structured interviews that are conducted at the end of the trial period. This study is currently underway.

Conclusion

This project will provide new knowledge on the type of assessment systems that can be used for the long term rehabilitation of stroke patients, with proven efficacy of the systems. The project shall also involve producing a plan for how to introduce these systems into the current NHS structure and potentially provide knowledge on how to implement the first steps towards a full telerehabilitation system within the UK.