Implementing Team-Based Post-Stroke Telerehabilitation: A Case Example


  • Melissa Anderson Kintinu Telerehab, Quality Living, Inc., Omaha, Nebraska, USA
  • Brad Dexter Kintinu Telerehab, Quality Living, Inc., Omaha, Nebraska, USA
  • Ana Hancock Kintinu Telerehab, Quality Living, Inc., Omaha, Nebraska, USA
  • Nealey Hoffman Kintinu Telerehab, Quality Living, Inc., Omaha, Nebraska, USA
  • Steve Kerschke Kintinu Telerehab, Quality Living, Inc., Omaha, Nebraska, USA
  • Karen Hux Kintinu Telerehab, Quality Living, Inc., Omaha, Nebraska, USA
  • Dipika Aggarwal Department of Neurology, University of Kansas Health System, Kansas City, Kansas, USA



Interdisciplinary teams, Service delivery models, Stroke Treatment, Telehealth, Telerehabilitation


Access to extensive, interdisciplinary rehabilitation following stroke is necessary to optimize recovery. Telerehabilitation is an appropriate model for delivering these services. However, given its relatively recent increase in popularity as a service delivery model, researchers have yet to explore the feasibility of interprofessional coordination and collaboration as a guiding framework for telerehabilitation and the effects of team-based remote service delivery on recovery of body functions and activities. This case example reports the development, implementation, and progression of a post-acute treatment program delivered via telerehabilitation to a woman with left hemorrhagic stroke. As is typical, therapy time alone afforded insufficient practice to exploit neuroplasticity and ensure maintenance and generalization of improved functioning; hence, the team worked collaboratively to encourage interdisciplinary activities outside scheduled treatment sessions. Standardized and informal assessments administered at the start and conclusion of treatment confirmed improved functioning as did the client’s progress toward independent living and return to work. Implications for telerehabilitation practices are discussed.  




Agency for Healthcare Research and Quality (2019, March). TeamSTEPPS fundamentals course: Module 3. Communication.

American Physical Therapy Association. (2020). Impact of COVID-19 on the physical therapy profession: A report from the American Physical Therapy Association. American Physical Therapy Association.

Atwal, A., & Caldwell, K. (2005). Do all health and social care professionals interact equally: A study of interactions in multidisciplinary teams in the United Kingdom. Scandinavian Journal of Caring Sciences, 19(3), 268-273.

Belagaje, S. R. (2017). Stroke rehabilitation. Continuum: Lifelong Learning in Neurology, 23(1), 238-253.

Buheji, M., & Hassani, A. (2020). Design of lean tele-rehabilitation services for post COVID-19 pandemic. International Journal of Advanced Research in Engineering and Technology, 11(11), 1360-1371.

Careau, E., Vincent, C., & Noreau, L. (2008). Assessing interprofessional teamwork in a videoconference-based telerehabilitation setting. Journal of Telemedicine and Telecare, 14(8), 427-434.

Clarke, D. J. (2010). Achieving teamwork in stroke units: The contribution of opportunistic dialogue. Journal of Interprofessional Care, 24(3), 285-297.

Clarke, D. J., & Forster, A. (2015). Improving post-stroke recovery: The role of the multidisciplinary health care team. Journal of Multidisciplinary Healthcare, 8, 433-442.

Cramer, S. C., Dodakian, L., Le, V., See, J., Augsburer, R., McKenzie, A., Zhou, R. J., Ghiu, N. L., Heckhausen, J., Cassidy, J. M., Scacchi, W., Smith, M. T., Barrett, A. M., Knutson, J., Edwards, D., Putrino, D., Argawal, K., Ngo, K., Roth, E. J., … Janis, S. (2019). Efficacy of home-based telerehabilitation vs in-clinic therapy for adults after stroke. JAMA Neurology, 76(9), 1079-1087.

Heuer, A., Hector, J. R., & Cassell, V. (2019). An update on telehealth in allied health and interprofessional care. Journal of Allied Health, 48(2), 140-147.

Macoir, J., Sauvageau, V. M., Boissy, P., Tousignant, M., & Tousignant, M. (2017). In-home synchronous telespeech therapy to improve functional communication in chronic poststroke aphasia: Results from a quasi-experimental study. Telemedicine and e-Health, 23(8), 630-639.

Markle-Reid, M., Orridge, C., Weir, R., Browne, G., Gafni, A., Lewis, M., Walsh, M., Levy, C., Daub, S., Brien, H., Roberts, J. & Thabane, L. (2011). Interprofessional stroke rehabilitation for stroke survivors using home care. Canadian Journal of Neurological Sciences, 38(2), 317-334.

Meltzer, J. A., Baird, A. J., Steele, R. D., & Harvey, S. J. (2017). Computer-based treatment of poststroke language disorders: A non-inferiority study of telerehabilitation compared to in-person service delivery. Aphasiology, 32(3), 290-311.

Miller, K., Chumbler, N. R., Carlson, K., & Daggett, V. (2014). Tele-rehabilitation to promote exercise in Veterans post-stroke: An observational pilot study. International Journal of Physical Medicine and Rehabilitation, 2(3), 1-5.

Moradi, V., Babaee, T., Esfandiari, E., Lim, S. B., & Kordi, R. (2021). Telework and telerehabilitation programs for workers with a stroke during the COVID-19 pandemic: A commentary. Work, 68, 77-80.

Prabawa, I. M. Y., Silakarma, D., & Widnyana, M. (2021). Telerehabilitation as a physical therapy solution for the post-stroke patient in COVID-19 pandemic situations: A review. Intisari Sains Medis, 12(1), 1-5.

Stein, J., Visco, C. J., & Barbuto, S. (2020). Rehabilitation medicine response to the COVID-19 pandemic. Advance online publication. American Journal of Physical Medicine & Rehabilitation.

Stroke Unit Trialists’ Collaboration. (2013). Organised inpatient (stroke unit) care for stroke. Cochrane Database of Systematic Reviews.

Tchero, H., Tabue-Teguo, M., Lannuzel, A., & Rusch, E. (2018). Telerehabilitation for stroke survivors: Systematic review and meta-analysis. Journal of Medical Internet Research, 20(10), e10867.

Temkin, A. J., Ulicny, G. R., & Versarovich, S. H. (1996). Telerehab: A perspective of the way technology is going to change the future of patient treatment. Rehab Management, 9(2), 28-30.

Tenforde, A. S., Borgstrom, H., Polich, G., Steere, H., Davis, I. S., Cotton, K., O’Donnell, M., & Silver, J. K. (2020). Outpatient physical, occupational, and speech therapy synchronous telemedicine: A survey study of patient satisfaction with virtual visits during the COVID-19 pandemic. American Journal of Physical Medicine & Rehabilitation. Advance online publication.

Yagura, H., Miyai, I., Seike, Y., Suzuki, T., & Yanagihara, T. (2003). Benefit of inpatient multidisciplinary rehabilitation up to 1 year after stroke. Archives of Physical Medicine and Rehabilitation, 84(11), 1687-1691.

Yagura, H., Miyai, I., Suzuki, T., & Yanagihara, T. (2005). Patients with severe stroke benefit most by interdisciplinary rehabilitation team approach. Cerebrovascular Diseases, 20(4), 258-263.




How to Cite

Anderson, M., Dexter, B., Hancock, A., Hoffman, N. ., Kerschke, S., Hux, K., & Aggarwal, D. (2022). Implementing Team-Based Post-Stroke Telerehabilitation: A Case Example. International Journal of Telerehabilitation, 14(1).



Clinical Reports