Supporting Home-Based Stroke Care with Hybrid Self-Directed and Supervised Tele-Rehabilitation

通过混合自我指导和监督远程康复支持家庭中风护理

• 批准号: 64314
• 金额: $ 6.35万
• 依托单位: GRIPABLE LIMITED
• 依托单位国家: 英国
• 项目类别: Feasibility Studies
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=64314
• 关键词: Supporting; Home; Based; Stroke; Care

Over 100,000 people are affected by stroke in the UK annually, resulting in long-term disability /and dependency. The Covid-19 pandemic is expected to compound this healthcare challenge even further, placing significant additional strain on healthcare resource both during the crisis and in the period that follows as social-isolation restrictions are relaxed. Many new stroke cases are now reluctant to access emergency-care because of fear of infection, resulting in worse stroke outcomes. Conversely, hospitalized stroke patients are currently facing reduced length-of-stay, with rehabilitation curtailed, due to the need to prioritise beds and therapists for critically-ill patients; and to prevent stroke inpatients catching infection given their high risk of complications. As a result, standard in-patient rehabilitation: the current standard of care, is both more difficult to resource and more dangerous to deliver.GripAble comprises of a portable handheld device and interactive software enabling self-directed arm therapy in disabled people. Since arm disability is the commonest impediment caused by stroke (affecting ~70%); and arm- exercises account for ~50% of in-patient physiotherapy sessions, GripAble can provide a cost-effective, home-based therapy substitute in place of a significant fraction of in-hospital therapy time.A broader package of rehabilitation care is now required, to cover multiple physical and psychological needs of stroke patients, which can facilitate early supported discharge. This can be achieved by combining self-directed therapy offered by GripAble, with remote supervised therapy, (via video-streaming). This 'hybrid telerehabilitation' will offer significantly greater opportunities for home-therapy than conventional telerehabilitation (i.e. video alone).With Innovate UK support, a 6-month programme of work will be delivered to develop, and trial, a holistic, home-therapy package that combines GripAble (allowing independent arm exercises); with an approved video-consultation software (allowing specialists to supervise patients where necessary). This combination package will allow a wide range of disabled stroke patients to be discharged from hospital earlier than is currently achieved; and be more effective than video-consultations alone, that lacks features such as interactive-exercise games, or personalised feedback.

在英国，每年有超过10万人受到中风的影响，导致长期的残疾和依赖。新冠肺炎疫情预计将进一步加剧这一医疗挑战，在危机期间以及随后的一段时间内，随着社会隔离限制的放松，都会给医疗资源带来显著的额外压力。由于担心感染，许多新的中风病例现在不愿获得紧急护理，导致更糟糕的中风结果。相反，住院的中风患者目前面临住院时间缩短，康复减少，因为需要为危重患者优先安排床位和治疗师；并防止中风住院患者感染，因为他们有很高的并发症风险。因此，标准的住院康复：目前的护理标准，既更难提供资源，也更危险。GrigAble由便携式手持设备和交互软件组成，使残疾人能够进行自我定向手臂治疗。由于手臂残疾是中风最常见的障碍(影响~70%)，而手臂锻炼约占住院物理治疗的50%，因此Gipable可以提供一种经济高效的家庭治疗替代方案，取代很大一部分住院治疗时间。现在需要更广泛的康复护理方案，以满足中风患者的多种身体和心理需求，这可以促进早期支持出院。这可以通过将Gipable提供的自我指导治疗与远程监督治疗(通过视频流)相结合来实现。这种“混合式远程康复”将为家庭治疗提供比传统远程康复(即只有视频)更多的机会。在Innovate UK的支持下，将提供一项为期6个月的工作计划，以开发和试验一套全面的家庭治疗方案，该方案结合了可握持的(允许独立手臂练习)；以及经批准的视频咨询软件(允许专家在必要时监督患者)。这一组合方案将允许范围广泛的残疾中风患者比目前实现的更早出院；而且比缺乏互动锻炼游戏或个性化反馈等功能的视频会诊更有效。