Development and Feasibility Testing of Video Home Based Telerehabilitation for Stroke Survivors in Resource Limited Settings

  • Marufat O. Odetunde OBAFEMI AWOLOWO UNIVERSITY ILE IFE, OSUN STATE https://orcid.org/0000-0001-8130-7255
  • Overcomer T. Binuyo OBAFEMI AWOLOWO UNIVERSITY ILE IFE, OSUN STATE
  • Fatai A. Maruf Nnamdi Azikiwe University, Nnewi Campus, Anambra State
  • Sunday O. Ayenowowon Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun state
  • Adaobi M. Okonji OBAFEMI AWOLOWO UNIVERSITY ILE IFE, OSUN STATE
  • Nurain A. Odetunde General Hospital, Gusau, Zamfara State
  • Chidozie E. Mbada OBAFEMI AWOLOWO UNIVERSITY ILE IFE, OSUN STATE
Keywords: Stroke, Telerehabilitation, Video-based exercise, Yoruba language

Abstract

Tele-physiotherapy has been shown to be valuable to improve clinical outcomes after stroke. Yet, home-based interventions for stroke survivors (SSVs) who speak indigenous African languages are sparse. This study developed a video-based home exercise programme (VHEP) for SSV speakers of Yoruba.  A qualitative descriptive pilot study was conducted in two phases: development and feasibility testing. VHEP development followed the American Stroke Association’s recommendations to include demonstrations of task-specific mobility-task and postural training; trunk exercises, and overground walking. The exercise instructions were presented in the Yoruba language. Each exercise was demonstrated for five minutes on video for a total of 30 minutes. The feasibility testing involved ten consenting chronic SSVs.  Each imitated the VHEP twice per week for two weeks and thereafter completed a feasibility questionnaire. Criteria for feasibility were: cost of using VHEP, recruitment rate, retention of participants, adherence to the exercises, and intervention delivery. The ten SSVs were recruited within one week, had prior home access to a video player at no-cost, adhered to the exercises as recorded, completed the 30 minute-duration for two weeks, and confirmed intervention delivery of VHEP. Most participants liked the novel use of Yoruba as the language of instruction on VHEP. The VHEP was feasible and acceptable among the studied sample of SSVs. Video based home telerehabilitation for SSVs therefore has the potential to meet the growing need for tele-physiotherapy in resource limited settings.

 

 

  

Author Biographies

Marufat O. Odetunde, OBAFEMI AWOLOWO UNIVERSITY ILE IFE, OSUN STATE

Lecturer I

Department of Medical Rehabilitation

Overcomer T. Binuyo, OBAFEMI AWOLOWO UNIVERSITY ILE IFE, OSUN STATE

Department of Medical Rehabilitation

Graduate physiotherapist

 

Fatai A. Maruf, Nnamdi Azikiwe University, Nnewi Campus, Anambra State

Department of Medical Rehabilitation

Associate Professor

Sunday O. Ayenowowon, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun state

Department of Physiotherapy

Chief Physiotherapist

Adaobi M. Okonji, OBAFEMI AWOLOWO UNIVERSITY ILE IFE, OSUN STATE

Department of Medical Rehabilitation

Lecturer II

Nurain A. Odetunde, General Hospital, Gusau, Zamfara State

General Out-patient Department

Consultant Family Physician

Chidozie E. Mbada, OBAFEMI AWOLOWO UNIVERSITY ILE IFE, OSUN STATE

Department of Medical Rehabilitation

Senior Lecturer

References

Adhikari, S.P., Shrestha, P. and Dev, R., (2020). Feasibility and effectiveness of telephone-based telephysiotherapy for treatment of pain in low-resource setting: A retrospective pre-post design. Pain Research and Management, 2741278. https://doi.org/10.1155/2020/2741278

Altman, D.G., (2009). Challenges in sustaining public health interventions. Health Education and Behavior, 36(1) 24-28. https://doi.org/10.1177/1090198107299788

Billinger, S. A., Arena, R., Bernhardt, J., Eng, J. J., Franklin, B. A., Johnson, C. M., ... & Shaughnessy, M. (2014). Physical activity and exercise recommendations for stroke survivors: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 45(8), 2532-2553. https://doi.org/10.1161/str.0000000000000022

Billingham SAM, Whitehead AL, Julious SA (2013). An audit of sample sizes for pilot and feasibility trials being undertaken in the United Kingdom registered in the United Kingdom Clinical Research Network database. BMC Medical Research Methodology, 13, 104. https://doi.org/10.1186/1471-2288-13-104

Chen, M.D., Rimmer, J.H. (2011). Effects of exercise on quality of life in stroke survivors: A meta-analysis. Stroke, 42(3), 832-852. https://doi.org/10.1161/strokeaha.110.607747

Dettmers C, Nedelko V, Hassa T, Starrost K, Schoenfeld MA (2014). “Video Therapy”: Promoting hand function after stroke by Action Observation Training – a pilot randomized controlled trial. International Journal of Physical Medicine & Rehabilitation. 2, 189. https://doi.org/ 10.4172/2329-9096.1000189

Donkor, ES (2018). Stroke in the century: A snapshot of the burden, epidemiology, and quality of life. Stroke Research and Treatment, 2018, 3238165. https://doi.org/10.1155/2018/3238165

Feigin, V.L., Forouzanfar, M.H., Krishnamurthi, R., Mensah, G.A, Connor, M., Bennett, D.A., O’Donnell, M. (2013). Global and regional burden of stroke during 1990–2010: Findings from the Global Burden of Disease Study 2010. Lancet, 383, 245–254. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4181600/epub/

Fernández-González, P., Carratalá-Tejada, M., Monge-Pereira, E., Collado-Vázquez, S., Baeza, P.S.H., Cuesta-Gómez, A., Oña-Simbaña, E.D., Jardón-Huete, A., Molina-Rueda, F., de Quirós, C.B.B., Miangolarra-Page, J.C., & Cano-de la Cuerda (2019). Leap motion controlled video game-based therapy for upper limb rehabilitation in patients with Parkinson’s disease: A feasibility study. Journal of Neuroengineering and Rehabilitation, 16(1), 133. https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-019-0593-x#article-info

Franck, J.A., Smeets, R.J.E.M. & Seelen, H.A.M., (2017). Changes in arm-hand function and arm-hand skill performance in patients after stroke during and after rehabilitation. PloS One, 12(6), e0179453. https://doi.org/10.1371/journal.pone.0179453

Kubota, S., Nakata, Y., Eguchi, K., Kawamoto, H., Kamibayashi, K., Sakane, M., & Ochiai, N. (2013). Feasibility of rehabilitation training with a newly developed wearable robot for patients with limited mobility. Archives of Physical Medicine and Rehabilitation, 94(6), 1080-1087. https://doi.org/10.1016/j.apmr.2012.12.020

Linder, S. M., Rosenfeldt, A. B., Bay. R.C., Sahu, K., Wolf, S.L., & Alberts, J.L. (2015). Improving quality of life and depression after stroke telerehabilitation. American Journal of Occupational Therapy, 69(2), 6902290020. https://doi.org/10.5014/ajot.2015.014498

Mbada, C.E., Olaoye, M.I., Dada, O.O., Ayanniyi, O., Johnson, O.E., Odole, A.C., Ishaya, G.P., Omole, O.J. and Makinde, M.O. (2019). Comparative efficacy of clinic-based and telerehabilitation application of Mckenzie therapy in chronic low-back pain. International Journal of Telerehabilitation, 11(1), 41-58. https://doi.org/ 10.5195/ijt.2019.6260

Modified Rankin Scale Specification Manual for Joint Commission National Quality Measures (v2018A) https://manual.jointcommission.org/releases/TJC2018A/DataElem0569.html

National Population Commission. (2006). National Population Commission Figures for Nigeria States for 2006. https://www.june12posts.com/national-population-commissions-population-figures-for-nigeria-states-for-2006-population-and-housing-census-real-or-imagined.

Odole, A.C., Odunaiya, N.A., Ojo, O.D. and Afolabi, K., (2015). Tele-physiotherapy in Nigeria: Perceived challenges by physiotherapists to its implementation. International Journal of Telemedicine and Clinical Practices, 1(2), 186-196 https://doi.org/10.1504/IJTMCP.2015.069763

Owolabi, M.O., Arulogun, O., Melikam, S., Adeoye, A.M., Akarolo-Anthony, S., Akinyemi, R., Arnett, D., Tiwari, H., Gebregziabher, M., Jenkins, C., Lackland, D., Ovbiagele, B., Akpalu,A., Sagoe,K., Sarfo, F.S., Obiako, R., & Owolabi, L. (2015). The burden of stroke in Africa: A glance at the present and a glimpse into the future. Cardiovascular Journal of Africa, 26(2 H3Africa Suppl), S27–S38. https://dx.doi.org/10.5830%2FCVJA-2015-038

Pang, M.Y., Eng, J.J., Dawson, A.S., & Gylfadóttir, S. (2006). The use of aerobic exercise training in improving aerobic capacity in individuals with stroke: A metaanalysis. Clinical Rehabilitation, 20, 97–111. https://doi.org/10.1191/0269215506cr926oa

Richmond, T., Peterson, C., Cason, J., Billings, M., Terrell, E.A., Lee, A.C.W., Towey, M, Parmanto, B., Saptono, A, Cohn, E.R., & Brennan D (2017). American Telemedicine Association’s Principles for Delivering Telerehabilitation Services. International Journal of Telerehabilitation, 9(2), 63-68. https://doi.org/10.5195/ijt.2017.6232

Russell, T.G. (2007). Physical rehabilitation using telemedicine, Journal of Telemedicine and Telecare, 13(5), 217–220. https://doi.org/10.1258/135763307781458886

Sarfo, F.S., Adesei, N., Ampofo, M., Kpeme, F.K., & Ovbiagele, B. (2018). Pilot trial of a tele-rehab intervention to improve outcomes after stroke in Ghana: A feasibility and user satisfaction study. Journal of Neurological Sciences, 387, 94-97. https://doi.org/10.1016/j.jns.2018.01.039

Sauro, J., 2011. How to find the right sample size for a usability test. Erişim adresi: Accessed on 15 October 2019 https://measuringu.com/sample-size-problems

Sheebah JL, Winzeler-Mercay U, Mudie HM (2006). A randomized controlled pilot study to obtain the best estimate of the size of the effect of a thermoplastic resting splint on spasticity in the stroke –affected wrist and fingers. Clinical Rehabilitation 20(12), 1032-7 https://doi/org.10.1177/0269215506071267

Shirley R. (2018). Borg Rating Scale of Perceived Exertion. https://www.sralab.org/rehabilitation-measures/borg-rating-scale-perceived-exertion#stroke

Sureshkumar K, Murthy GVS, Natarajan S, Naveen C, Goenka S, Kuper H (2015). Evaluation of the feasibility and acceptability of the ‘Care for Stroke’ intervention in India, a smartphone-enabled, carer-supported, educational intervention for management of disability following stroke. British Medical Journal Open, 6(2). http://dx.doi.org/10.1136/bmjopen-2015-009243

Vardeh, D. E., Edward, R. R., & Jamison, R. N. (2013). There’s an app for that: Mobile technology is a new advantage in managing chronic pain. Pain Clinical Update, XXI(6), 1-6. Available at https://s3.amazonaws.com/rdcms-iasp/files/production/public/FileDownloads/PCU_21-6_web.pdf

Winstein, C.J., Stein, J., Arena, R., Bates, B., Cherney, L.R., Cramer, S.C., Deruyter, F., Eng, J.J., Fisher, B., Harvey, R.L. & Lang, C.E. (2016). Guidelines for adult stroke rehabilitation and recovery: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 47(6), e98-e169 https://doi.org/10.1161/str.0000000000000098

Published
2020-12-08
How to Cite
Odetunde, M. O., Binuyo, O. T., Maruf, F. A., Ayenowowon, S. O., Okonji, A. M., Odetunde, N. A., & Mbada, C. E. (2020). Development and Feasibility Testing of Video Home Based Telerehabilitation for Stroke Survivors in Resource Limited Settings. International Journal of Telerehabilitation, 12(2), 125–136. https://doi.org/10.5195/ijt.2020.6321
Section
Country Reports