The COVID-19 pandemic forced a shift towards telehealth practices in rehabilitation. A study explores the feasibility of using telehealth to deliver gait treatment using a wearable gait device, the iStride device, to stroke survivors.
During the COVID-19 pandemic, the adoption of telehealth practices by rehabilitation providers and consumers reached unprecedented levels. While studies have demonstrated the feasibility and comparable efficacy of remote treatment for certain impairments caused by stroke, such as upper extremity weakness, there has been limited guidance regarding gait assessment and treatment.
Recognizing the importance of safe and effective gait treatment in optimizing health and well-being after stroke, researchers set out to explore the feasibility of using telehealth to deliver gait treatment during the pandemic. They focused on a wearable gait device called the iStride device, specifically designed to address hemiparetic gait impairments resulting from stroke. The device induces subtle destabilization of the nonparetic limb, necessitating supervision during usage.
Traditionally, treatment with the gait device was provided in person by physical therapists and trained personnel. However, due to pandemic guidelines, in-person treatment was halted. The study aimed to assess the feasibility of two remote delivery treatment models with the gait device for stroke survivors.
The study recruited five individuals with chronic stroke, four of whom were previous gait device users transitioning to the telehealth delivery model. The fifth participant engaged in all study-related activities remotely. The protocol involved virtual training for the at-home care partner, followed by three months of remote treatment with the gait device. Participants were instructed to wear gait sensors during all treatment activities.
Feasibility was evaluated by monitoring the safety of the remote treatment, compliance with protocol activities, acceptability of telehealth delivery, and preliminary efficacy of the gait treatment. Functional improvement was measured using standardized tests such as the 10-Meter Walk Test, the Timed Up and Go Test, and the 6-Minute Walk Test. Quality of life was assessed using the Stroke-Specific Quality of Life Scale.
The results of the study were encouraging. No serious adverse events occurred, and participants expressed high acceptance of telehealth delivery. Protocol compliance rates were impressive, with participants completing an average of 95% of treatment sessions, 100% of assessments, and 85% of sensor usage during treatment. Importantly, after three months of remote treatment, participants exhibited improvements in functional outcomes that exceeded the minimal clinically important difference or minimal detectable change value.
In summary, the study highlights the successful implementation of telehealth for gait treatment in stroke survivors during the COVID-19 pandemic. The use of a wearable gait device, the iStride device, combined with remote supervision and assessment, proved to be feasible, safe, and well-accepted by participants. The promising results indicate that telehealth can effectively bridge the gap in gait treatment accessibility, ensuring continued progress and enhanced quality of life for stroke survivors, even during challenging times.
To read the full study, click HERE.