Poster The Joint Annual Meeting of the Stroke Society of Australasia (SSA) and Smartstrokes 2023

Stroke survivor experiences of completing a constraint induced movement therapy program via telehealth: The ReCITE study (#175)

Lauren J Christie 1 2 , Nicola Fearn 1 , Anna Kilkenny 3 , Christine T Shiner 4 5 , Annie McCluskey 6 7 , Natasha A Lannin 8 9 , Jessamy Boydell 10 , Annie Meharg 11 , Steven Faux 4 5 , Sandy Middleton 12
  1. Allied Health Research Unit, St Vincent's Health Network Sydney, Darlinghurst, NSW, Australia
  2. Faculty of Health Sciences, Australian Catholic University, North Sydney, NSW, Australia
  3. Physiotherapy Department, Waikato Hospital, Hamilton, Waikato, New Zealand
  4. Department of Rehabilitation, St Vincent's Health Network Sydney, Sydney, NSW, Australia
  5. School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
  6. The StrokeEd Collaboration, Ashfield, NSW, Australia
  7. Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
  8. Department of Neurosciences, Monash University, Melbourne, Victoria, Australia
  9. Alfred Health, Melbourne, Victoria, Australia
  10. Arm's Reach Occupational Therapy, Bristol, United Kingdom
  11. Harrison's Training, Wiltshire, United Kingdom
  12. Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Sydney, NSW, Australia

Background: Constraint-induced movement therapy (CIMT) is recommended in the Australian and New Zealand Clinical Guidelines for Stroke Management, however only 11% of eligible stroke survivors receive CIMT. Difficulties attending a program is one of the identified barriers to access for stroke survivors. The remote constraint induced therapy of the upper extremity (ReCITE) study explored the feasibility and acceptability of delivering CIMT via telehealth (TeleCIMT).

 

Aim: To explore the experiences of stroke survivors who have completed a three-week TeleCIMT program.  

 

Methods: Qualitative design using semi-structured interviews. Stroke survivors who had completed a three-week TeleCIMT program as part of usual rehabilitation were interviewed individually one month post program completion. Interviews were conducted by a researcher not involved in their care. Interviews were audio-recorded, transcribed and imported into Nvivo for thematic analysis using inductive coding.

 

Results: Eight participant interviews have been completed to date. Preliminary analysis indicates that whilst participants found programs beneficial and reported seeing improvements in their arm function both during and after a program, there were several challenges to program adherence. Challenges to the program included the level of direct input of a therapist during the program and the high cognitive demands of technology use to complete sessions online with a therapist. Participants also reported a high time burden for program preparation and recording of practice when completing CIMT remotely. Tolerating six hours of mitt wear per day within the home was also reported to be challenging, especially during the first week of the program and when trying to also maintain employment. Most participants completed their programs on their own however reported having a support person would have been beneficial to support program adherence, assist with paperwork and to provide encouragement.

 

Conclusion: Stroke survivors describe TeleCIMT as an acceptable intervention. Additional support is required for technology use and recording practice.