Factors influencing the delivery of telerehabilitation for stroke: a systematic review

Aoife Stephenson; Sarah Howes; Paul Murphy; Judith Deutsch; Maria Stokes; Katy Pedlow; S McDonough

doi:10.1371/journal.pone.0265828

Factors influencing the delivery of telerehabilitation for stroke: a systematic review

Aoife Stephenson, Sarah Howes, Paul Murphy, Judith Deutsch, Maria Stokes, Katy Pedlow, S McDonough

Research output: Contribution to journal › Review article › peer-review

32 Citations (Scopus)

165 Downloads (Pure)

Abstract

Objective: Despite the available evidence regarding effectiveness of stroke telerehabilitation, there has been little focus on factors influencing its delivery or translation from the research setting into practice. There are complex challenges to embedding telerehabilitation into stroke services and generating transferable knowledge about scaling up and routinising this service model. This review aimed to explore factors influencing the delivery of stroke telerehabilitation interventions, including platforms, technical requirements, training, support, access, cost, usability and acceptability.

Methods: MEDLINE, EMBASE, CINAHL, Web of Science and Cochrane Library and Central Registry of Clinical Trials were searched to identify full-text articles of randomised controlled trials (RCTs) and protocols for RCTs published since a Cochrane review on stroke telerehabilitation services. A narrative synthesis was conducted, providing a comprehensive description of the factors influencing stroke telerehabilitation intervention delivery.

Results: Thirty-one studies and ten protocols of ongoing studies were included. Interventions were categorised as synchronous telerehabilitation (n = 9), asynchronous telerehabilitation (n = 11) and tele-support (n = 11). Telephone and videoconference were the most frequently used modes of delivery. Usability and acceptability with telerehabilitation were high across all platforms, although access issues and technical challenges may be potential barriers to the use of telerehabilitation in service delivery. Costs of intervention delivery and training requirements were poorly reported.

Conclusions: This review synthesises the evidence relating to factors that may influence stroke telerehabilitation intervention delivery at a crucial timepoint given the rapid deployment of telerehabilitation in response to the COVID-19 pandemic. It recommends strategies, such as ensuring adequate training and technical infrastructure, shared learning and consistent reporting of cost and usability and acceptability outcomes, to overcome challenges in embedding and routinising this service model and priorities for research in this area.

Original language	English
Article number	e0265828
Pages (from-to)	1-30
Number of pages	30
Journal	PLoS ONE
Volume	17
Issue number	5
Early online date	11 May 2022
DOIs	https://doi.org/10.1371/journal.pone.0265828
Publication status	Published online - 11 May 2022

Bibliographical note

Funding Information:
AS’s time was co-funded by Royal College of Surgeons in Ireland (School of Physiotherapy) and the European Union’s Horizon 2020 Research and Innovation Programme under grant agreement no. 687228, MAGIC PCP. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
Copyright: © 2022 Stephenson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Keywords

Stroke
Telerehabilitation
Covid-19
Technical Requirements
Usability and Acceptability
COVID-19
Telephone
Humans
Videoconferencing
Telerehabilitation/methods

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1371/journal.pone.0265828Licence: CC BY

100500546 - Final Published VersionFinal published version, 932 KBLicence: CC BY

Cite this

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abstract = "Objective: Despite the available evidence regarding effectiveness of stroke telerehabilitation, there has been little focus on factors influencing its delivery or translation from the research setting into practice. There are complex challenges to embedding telerehabilitation into stroke services and generating transferable knowledge about scaling up and routinising this service model. This review aimed to explore factors influencing the delivery of stroke telerehabilitation interventions, including platforms, technical requirements, training, support, access, cost, usability and acceptability.Methods: MEDLINE, EMBASE, CINAHL, Web of Science and Cochrane Library and Central Registry of Clinical Trials were searched to identify full-text articles of randomised controlled trials (RCTs) and protocols for RCTs published since a Cochrane review on stroke telerehabilitation services. A narrative synthesis was conducted, providing a comprehensive description of the factors influencing stroke telerehabilitation intervention delivery.Results: Thirty-one studies and ten protocols of ongoing studies were included. Interventions were categorised as synchronous telerehabilitation (n = 9), asynchronous telerehabilitation (n = 11) and tele-support (n = 11). Telephone and videoconference were the most frequently used modes of delivery. Usability and acceptability with telerehabilitation were high across all platforms, although access issues and technical challenges may be potential barriers to the use of telerehabilitation in service delivery. Costs of intervention delivery and training requirements were poorly reported.Conclusions: This review synthesises the evidence relating to factors that may influence stroke telerehabilitation intervention delivery at a crucial timepoint given the rapid deployment of telerehabilitation in response to the COVID-19 pandemic. It recommends strategies, such as ensuring adequate training and technical infrastructure, shared learning and consistent reporting of cost and usability and acceptability outcomes, to overcome challenges in embedding and routinising this service model and priorities for research in this area.",

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KW - Telerehabilitation/methods

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Factors influencing the delivery of telerehabilitation for stroke: a systematic review

Abstract

Bibliographical note

Keywords

UN SDGs

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Factors influencing the delivery of telerehabilitation for stroke: a systematic review

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