Stroke is a relatively common condition with a large impact on patients’ lives. Rehabilitation treatment aims to support patients in coping with the physical, mental, cognitive and social... Show moreStroke is a relatively common condition with a large impact on patients’ lives. Rehabilitation treatment aims to support patients in coping with the physical, mental, cognitive and social consequences of stroke. Recently, there is an increasing interest in the application of digital technologies (eRehabilitation) in healthcare in general, including in stroke rehabilitation. ERehabilitation may include physical and cognitive exercise programs, patient information and education, e-consultations, physical activity tracking and serious gaming, preferably all together in one digital environment.Although there is evidence on the effectiveness and feasibility of eRehabilitation, the uptake of eRehabilitation in specialized stroke rehabilitation facilities has been slow, warranting the need for implementation research. The aim of this thesis was to provide insight in the complex interplay between the effectiveness, the implementation strategy and the context of eRehabilitation after stroke, as delivered in a specialized rehabilitation facility, in order to improve future use of eRehabilitation in specialized stroke rehabilitation facilities. Show less
Objective: To compare the effect on disability and quality of life, of conventional rehabilitation (control group) with individualized, tailored eRehabilitation intervention alongside conventional... Show moreObjective: To compare the effect on disability and quality of life, of conventional rehabilitation (control group) with individualized, tailored eRehabilitation intervention alongside conventional rehabilitation (Fast@home; intervention group), for people with stroke.Methods: Pre-post design. The intervention comprised cognitive (Braingymmer (R)) and physical (Telere-validatie (R)/Physitrack (R)) exercises, activity-tracking (Activ8 (R)) and psycho-education. Assessments were made at admission (T0) and after 3 (T3) and 6 months (T6). The primary outcome concerned disability (Stroke Impact Scale; SIS). Secondary outcomes were: health-related qual-ity of life, fatigue, self-management, participation and physical activity. Changes in scores be-tween T0-T3, T3-T6, and T0-T6 were compared by analysis of variance and linear mixed models.Results: The study included 153 and 165 people with stroke in the control and intervention groups, respectively. In the intervention group, 82 (50%) people received the intervention, of whom 54 (66%) used it. Between T3 and T6, the change in scores for the SIS subscales Communication (control group/ intervention group -1.7/-0.3) and Physical strength (-5.7/3.3) were significantly greater in the total intervention group (all mean differences< minimally clinically important differences). No significant differences were found for other SIS subscales or secondary outcomes, or between T0-T3 and T0-T6.Conclusion: eRehabilitation alongside conventional stroke rehabilitation had a small positive effect on communication and physical strength on the longer term, compared to conventional rehabilitation only. Show less
Brouns, B.; Bodegom-Vos, L. van; Kloet, A. de; Vlieland, T.P.M.V.; Gil, I.L.C.; Souza, L.M.N.; ... ; Meesters, J.J.L. 2020
Background To improve the use of eRehabilitation after stroke, the identification of barriers and facilitators influencing this use in different healthcare contexts around the world is needed.... Show moreBackground To improve the use of eRehabilitation after stroke, the identification of barriers and facilitators influencing this use in different healthcare contexts around the world is needed. Therefore, this study aims to investigate differences and similarities in factors influencing the use of eRehabilitation after stroke among Brazilian Healthcare Professionals (BHP) and Dutch Healthcare Professionals (DHP). Method A cross-sectional survey study including 88 statements about factors related to the use of eRehabilitation (4-point Likert scale; 1-4; unimportant-important/disagree-agree). The survey was conducted among BHP and DHP (physical therapists, rehabilitating physicians and psychologists). Descriptive statistics were used to analyse differences and similarities in factors influencing the use of eRehabilitation. Results ninety-nine (response rate 30%) BHP and 105 (response rate 37%) DHP participated. Differences were found in the top-10 most influencing statements between BHP and DHP BHP rated the following factors as most important: sufficient support from the organisation (e.g. the rehabilitation centre) concerning resources and time, and potential benefits of the use of eRehabilitation for the patient. DHP rated the feasibility of the use of eRehabilitation for the patient (e.g. a helpdesk and good instructions) as most important for effective uptake. Top-10 least important statements were mostly similar; both BHP and DHP rated problems caused by stroke (e.g. aphasia or cognitive problems) or problems with resources (e.g. hardware and software) as least important for the uptake of eRehabilitation. Conclusion The results indicate that the use of eRehabilitation after stroke by BHP and DHP is influenced by different factors. A tailored implementation strategy for both countries needs to be developed. Show less
Brouns, B.; Meesters, J.J.L.; Wentink, M.M.; Kloet, A.J. de; Arwert, H.J.; Vlieland, T.P.M.V.; ... ; Bodegom-Vos, L. van 2018
