Feasibility, acceptability, usability and quality of life levels in post-stroke patients undergoing telerehabilitation: Results from a multicentric pilot study

Objective: This study aims to evaluate the feasibility of an integrated multi-domain telerehabilitation (TR) system in stroke patients and to observe whether there are changes in the quality of life (QoL) levels of patients undergoing TR treatments. Methods: Patients were enrolled for a longitudinal multicentric pilot study conducted in six Italian research hospitals (IRCCS). The primary outcome was the feasibility of an integrated TR system, assessed by calculating treatment adherence and by collecting data from the Technology Acceptance Model and the System Usability Scale (SUS). Information on time and travel distance savings was also collected. As secondary outcomes, we evaluated changes in QoL levels with the EuroQol 5-dimensions (EQ-5D) and the Short Form-36 (SF-36) and in caregiver burden through the Zarit Burden Inventory. Results: We enrolled 84 patients. Our system turned out to be feasible (treatment adherence = 85%), usable (SUS = 73.36/100, classifying it as a ‘good’ system) and well accepted by patients. Quality of life levels improved significantly from pre- to post-treatment (EQ-5D: p = 0.0014; SF-36 general health: p = 0.047). Caregivers perceived little or no significant care burden. Conclusions: Telerehabilitation has been confirmed to be a feasible, usable and acceptable solution to guarantee continuity of care and improve accessibility to rehabilitation treatments to post-stroke patients. Furthermore, the strength of TR is in the possibility to improve patients’ QoL, which in turn could impact on functioning.