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Tele-rehabilitation to Promote Exercise in Veterans Post-Stroke: An Observational Pilot Study

Kristine K Miller, Neale R Chumbler, Katherine Carlson and Virginia Daggett

Objectives: The objectives of this study were to: 1) explore the feasibility of implementing in-home exercises via a tele-rehabilitation program for Veterans with stroke in Home-Based Primary Care (HBPC) in a single US Department of Veteran’s Affairs Medical Center (VAMC); and 2) assess exercise adherence and progression in Veterans with stroke during the program. Materials and Methods: Study participants completed 3 televideo visits and 5 telephone visits with a physical therapist (PT) over a 3 month period. Participants were instructed in an exercise program and were asked to report adherence with the exercise program and reasons for non-adherence per a standardized questionnaire throughout the program. Televideo visits were conducted using a video link installed on a lap top computer taken to the participant’s home and a desk-top computer at the PT work station. The Late Life Function and Disability Instrument (LLFDI) were used to assess self-report of disability and function at baseline and 3 months. Results: Six male Veterans with a mean age of 61 years enrolled in the study. Four study participants completed the intervention with an average exercise adherence rate of 90%. Self-reported reasons for non-adherence were lack of strength, lack of understanding and lack of needed assistance for the exercises. Increased exercise intensity was demonstrated by all 4 participants. Modest improvements in disability (7%) and function (6%) were reported on the LLFDI. Conclusions: Veterans with stroke were able to actively participate in a tele-rehabilitation program. Study participants reported good exercise adherence and improved disability/function thatwas not statistically significant as well as increased exercise intensity throughout the intervention. Based on these preliminary findings with a small sample, a tele-rehabilitation program aimed at p