Delivery of Gait Device Treatment Using Telehealth For Individuals With Stroke

Abstract

Research Objectives To investigate the feasibility of two adapted telehealth delivery models for remote gait treatment using a novel gait device. Design The study followed a single-group, pretest-posttest design. Setting All study-related activities occurred in each participant's home. The treatment protocol was overseen remotely by licensed physical therapists using telehealth technologies. Participants Five individuals with chronic stroke (average age 72 years and 84 months post-stroke) participated in the study. Four of the participants had previously begun in-person treatment with the gait device before the onset of the coronavirus pandemic. After worsening pandemic conditions interrupted in-person treatment, these individuals transitioned to the telehealth delivery model to continue their gait treatment remotely. The fifth participant performed all activities (recruitment through follow-up) remotely. Interventions The treatment protocol included a virtual caregiver training session followed by three months of remote treatment with the gait device. Gait sensors were worn during all activities to monitor gait patterns and treatment compliance. Functional assessments occurred at baseline and after three months of remote treatment with the gait device. Main Outcome Measures The feasibility assessment comprised evaluations of safety, compliance, acceptability, and efficacy. Functional improvement was assessed using the 10-Meter Walk Test (10MWT), the Timed Up and Go (TUG) test, the Six-Minute Walk Test (6MWT), and the Stroke Specific Quality of Life Scale. Results No significant adverse events occurred and survey responses indicated a high level of acceptability for the remote treatment delivery. Participants complied with >94% of remote treatment sessions and 100% of assessments during the study period. Additionally, the average improvement on the 10MWT, TUG, and 6MWT after three months of treatment surpassed the minimal clinically important difference or minimal detectable change value. Conclusions Results indicate considerable promise for the feasibility of safe, remote treatment with the gait device. Larger, future studies will further evaluate efficacy and clarify characteristics around a broader population that may benefit from this treatment delivery. Author(s) Disclosures The gait device is a commercial product by Moterum Technologies. Authors BD, LR, NT, DH, and SB have stock options in Moterum. To investigate the feasibility of two adapted telehealth delivery models for remote gait treatment using a novel gait device. The study followed a single-group, pretest-posttest design. All study-related activities occurred in each participant's home. The treatment protocol was overseen remotely by licensed physical therapists using telehealth technologies. Five individuals with chronic stroke (average age 72 years and 84 months post-stroke) participated in the study. Four of the participants had previously begun in-person treatment with the gait device before the onset of the coronavirus pandemic. After worsening pandemic conditions interrupted in-person treatment, these individuals transitioned to the telehealth delivery model to continue their gait treatment remotely. The fifth participant performed all activities (recruitment through follow-up) remotely. The treatment protocol included a virtual caregiver training session followed by three months of remote treatment with the gait device. Gait sensors were worn during all activities to monitor gait patterns and treatment compliance. Functional assessments occurred at baseline and after three months of remote treatment with the gait device. The feasibility assessment comprised evaluations of safety, compliance, acceptability, and efficacy. Functional improvement was assessed using the 10-Meter Walk Test (10MWT), the Timed Up and Go (TUG) test, the Six-Minute Walk Test (6MWT), and the Stroke Specific Quality of Life Scale. No significant adverse events occurred and survey responses indicated a high level of acceptability for the remote treatment delivery. Participants complied with >94% of remote treatment sessions and 100% of assessments during the study period. Additionally, the average improvement on the 10MWT, TUG, and 6MWT after three months of treatment surpassed the minimal clinically important difference or minimal detectable change value. Results indicate considerable promise for the feasibility of safe, remote treatment with the gait device. Larger, future studies will further evaluate efficacy and clarify characteristics around a broader population that may benefit from this treatment delivery.