Abstract
BackgroundThe majority of stroke survivors experience motor impairment which benefits from rehabilitation treatment. Telerehabilitation, remote delivery of rehabilitation services, is a possible solution providing access to rehabilitation for stroke survivors living in rural areas or in situations like the COVID-19 pandemic where face-to-face treatment may be risky. However, valid and reliable motor impairment measures have not yet been established over a telerehabilitation platform. The Fugl-Meyer (FM) lower extremity assessment is widely used clinically and in research. Thus, the aim was to develop a modified FM for telerehabilitation (FM-tele) and assess the feasibility and preliminary agreement of FM-tele scores with the FM.MethodsThree phases were employed: phase 1 development, phase 2 feasibility, and phase 3 preliminary agreement. Literature review and consultation with clinicians were employed to develop the FM-tele. Community-dwelling individuals with stroke and FM evaluators were consulted to provide feedback via questionnaires on the feasibility of the FM-tele. To assess the preliminary agreement of the FM-tele, individuals with stroke participated in two sessions, one in-person and one via telerehabilitation. The standard version of the FM was administered during the in-person session. The FM-tele was administered in both sessions.ResultsFrom phase 1, clinician consultation identified the following key principles: safety of the client, clear lower extremity visualization, and minimization of position changes which guided FM-tele development (n = 7). Feasibility was established in phase 2 where participants with stroke indicated that they felt safe and experienced ease following the standardized instructions, despite some technological concerns (n = 5). FM evaluators agreed that participants were safe and indicated effective standardized instructions. Phase 3 (n = 5) indicated preliminary agreement of the FM-tele compared with the FM.ConclusionsParticipants with stroke and clinical consultation indicated the FM-tele developed for telerehabilitation is feasible. A lower extremity motor assessment tool for telerehabilitation is urgently needed for stroke survivors living in rural areas or when face-to-face visits are impossible. This pilot study provides preliminary support for a future study.
Highlights
The majority of stroke survivors experience motor impairment which benefits from rehabilitation treatment
What uncertainties existed regarding the feasibility? Using the standard Fugl-Meyer (FM) in telerehabilitation is in question as the current scale requires a therapist to apply manual resistance, test reflexes, and for stroke survivors to attain supine, sitting, and standing positions; transitions between positions increase fall risk and may reduce visualization of the lower extremities in telerehabilitation
Key principles of safety, clear visualization of the lower extremities, and minimizing position changes guided the development of the Fugl-Meyer telerehabilitation (FM-tele)
Summary
The majority of stroke survivors experience motor impairment which benefits from rehabilitation treatment. Telerehabilitation, remote delivery of rehabilitation services, is a possible solution providing access to rehabilitation for stroke survivors living in rural areas or in situations like the COVID-19 pandemic where face-to-face treatment may be risky. 85% of stroke survivors cope with long-term motor impairments that hinder daily function and decrease quality of life [2, 3]. These motor impairments benefit from rehabilitation which can be provided through telerehabilitation, the remote delivery of rehabilitation services. Telerehabilitation is a possible solution to provide access to rehabilitation to stroke survivors living in rural areas or in situations like the COVID-19 pandemic where face-to-face treatment. Consultation sessions with clinicians centered on generating key principles to guide development of the new scale for telerehabilitation, and evaluating each item of the FM for criteria that the FM-tele would need to include
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
