Web-based physiotherapy for people undergoing stroke rehabilitation

Abstract

In the UK, disability is a common consequence of stroke. The improvement of post-stroke arm function is one of the top 10 priority research areas for stroke survivors, carers and healthcare professionals. However, current clinical practice in most of the stroke units within the UK does not meet the recommended dose for rehabilitating stroke patients in the acute stage when functional recovery is at its peak. A higher dose of rehabilitation can result in enhanced functional recovery. Therefore, developing interventions to augment current clinical practice in order to increase the dose of rehabilitation without supervision is becoming a necessity, given the anticipated rise in stroke incidence coupled with the reduction in the number of available physiotherapists worldwide. Telerehabilitation has the potential to provide the stroke population with access to rehabilitation without direct supervision, but stroke-related complications, such as aphasia, may hinder their ability to access these services. This thesis aims to do the following: 1) To evaluate whether an existing web-based physiotherapy platform (www.webbasedphysio.com, now www.giraffehealth.com) can be adapted through a user-centred design to be an acceptable medium to deliver exercise programmes for people after a stroke and 2) To evaluate the acceptability and feasibility, and to explore the possible effectiveness, of an individualised 4-week programme of augmented upper-limb rehabilitation, delivered via the modified webbased physiotherapy platform, for the stroke population in acute stroke rehabilitation.