Telehealth, Wearable Sensors, and the Internet: Will They Improve Stroke Outcomes Through Increased Intensity of Therapy, Motivation, and Adherence to Rehabilitation Programs?

Jane H. Burridge*, Alan Chong W. Lee, Ruth Turk, Maria Stokes, Jill Whitall, Ravi Vaidyanathan, Phil Clatworthy, Ann Marie Hughes, Claire Meagher, Enrico Franco, Lucy Yardley

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

18 Citations (Scopus)

Abstract

Background and Purpose: Stroke, predominantly a condition of older age, is a major cause of acquired disability in the global population and puts an increasing burden on health care resources. Clear evidence for the importance of intensity of therapy in optimizing functional outcomes is found in animal models, supported by neuroimaging and behavioral research, and strengthened by recent meta-Analyses from multiple clinical trials. However, providing intensive therapy using conventional treatment paradigms is expensive and sometimes not feasible because of social and environmental factors. This article addresses the need for cost-effective increased intensity of practice and suggests potential benefits of telehealth (TH) as an innovative model of care in physical therapy. Summary of Key Points: We provide an overview of TH and present evidence that a web-supported program, used in conjunction with constraint-induced therapy (CIT), can increase intensity and adherence to a rehabilitation regimen. The design and feasibility testing of this web-based program, "LifeCIT," is presented. We describe how wearable sensors can monitor activity and provide feedback to patients and therapists. The methodology for the development of a wearable device with embedded inertial and mechanomyographic sensors, algorithms to classify functional movement, and a graphical user interface to present meaningful data to patients to support a home exercise program is explained. Recommendations for Clinical Practice: We propose that wearable sensor technologies and TH programs have the potential to provide most-effective, intensive, home-based stroke rehabilitation.

Original languageEnglish
Pages (from-to)S32-S38
Number of pages7
JournalJournal of Neurologic Physical Therapy
Volume41
Early online date1 Jul 2017
DOIs
Publication statusPublished - Jul 2017

Keywords

  • internet
  • stroke
  • telehealth
  • upper limb
  • wearable sensors

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