While many physical therapists turn to virtual care, how can you be sure if telerehab is right for you? Find out here if you should join the telerehab train.

Is Post-Stroke Telerehab For Me? What You Need to Know

COVID-19 has disrupted many aspects of daily life. On the other hand, it has
accelerated the way in which you are able to access healthcare services. Now,
thanks to technology, you can connect to healthcare specialists with a few
clicks of a mouse. 

Telerehabilitation for post-stroke care has been around for over a decade.
Lately, it has become more mainstream, especially after the pandemic began. It
is a way to connect with your physical therapists to improve upper arm function,
strength, balance, and walking after a stroke. 

Many research studies have supported the use of post-stroke telerehabilitation
for physical therapy [https://pubmed.ncbi.nlm.nih.gov/21097560/]. But, you still
may have questions about the pros and cons of virtual care. Below you will find
helpful information about whether telerehab is right for you. 


Telerehab makes physical therapy (PT) treatment possible through video or audio
technology.Benefits of telerehabilitation for stroke survivors
Telerehabilitation, or telerehab, is the delivery of rehabilitation services
through video or audio format. It also allows for easy access to experts in
post-stroke care without leaving the comfort of home. 

Other benefits of post-stroke telerehabilitation include: 

 * Real time health monitoring
 * The ability to share information with caregivers
 * Providing immediate feedback on exercise technique

Before the pandemic, post-stroke telerehab was used for people who could not
easily travel to appointments. Now, stroke survivors with COVID-19, who are
asymptomatic or have mild symptoms in self-quarantine, can see providers without
gaps in treatment. 

Research studies have found post-stroke telerehab to be equally effective as
face-to-face care.
[https://www.sciencedirect.com/science/article/abs/pii/S1052305715005005] Simply
put, post-stroke telerehab can still help you reach meaningful outcomes, like
arm function, independence with walking, and balance, like face-to-face rehab. 


Instead of clinic equipment, a telerehab session may make use of things
available in your home environment.Drawbacks to telerehabilitation
Unfortunately, there are a few barriers to post-stroke telerehab.

There is always the possibility of delays in WiFi connectivity or poor video
quality. Depending on where you live, legal barriers
[https://www.apaservices.org/practice/clinic/covid-19-telehealth-state-summary#indiana] 
may affect the timing and delivery of your care. 

Several research studies have looked at the cost of post-stroke telerehab in
comparison to face-to-face visits. The general consensus is that there is not a
significant cost difference
[http://nebula.wsimg.com/5ffa0b7e108a03a8e6f6f658b515f0fb?AccessKeyId=369F185A9EFA841F6B6A&disposition=0&alloworigin=1] 
between the two. 

Despite this, insurance companies have been slow to offer coverage of telerehab
visits. Be sure to check with your insurance provider before setting up virtual
appointments . This will ensure that you are not slapped with an enormous bill
at the end of your care.

Determining whether telerehab is right for you depends on a few factors,
including your comfort with technology and the type of interaction that you
prefer with your therapists. If you like face-to-face interaction, getting out
of the house, and personal contact, then telerehab may not be the best option
for you. 


A telerehab PT will guide you through session activities and monitor your
performance over live video.


Is post-stroke telerehab going to be the new norm?
In short, yes. 

If this year has taught us one thing, it is that virtual medical and
rehabilitation appointments are here to stay. Once the outbreak is over, expect
to see telerehab practices continue as more clinicians, and insurance companies
get on board.



The reality of telerehabilitation
Telerehabilitation has become an effective way to deliver post-stroke
rehabilitation without increasing your risk of getting infected with COVID-19. 

It allows physical therapists and other rehabilitation experts to deliver
treatments that are important to you. Virtual services also improve access for
stroke survivors who live in rural areas with limited local resources. 

Telerehab will be more successful once the issues with software and legal
concerns are resolved. Despite its drawbacks, post-stroke telerehab can still be
a useful tool because it allows for access to expert care as you continue to
work towards your mobility goals. Moving forward, you can expect telerehab to
become the new standard for post-stroke care. 




--------------------------------------------------------------------------------

Home rehab is easy and effective with Neofect’s Smart Rehabilitation Solutions
for stroke! Check out our cutting-edge home exercise products here
[https://www.neofect.com/us/for-home].

Stroke Recovery

Is Post-Stroke Telerehab for Me? What You Need to Know

Research suggests an association between COVID-19 and stroke in young adults. Read more on how the novel coronavirus could increase stroke risk, symptoms to recognize, and why you should always take an ambulance in the event of a medical emergency.

COVID-19 and Stroke in Young Adults: Know the Signs to Save a Life

Our understanding of COVID-19 evolves with each passing week of the global
pandemic. This week, the Centers for Disease Control and Prevention (CDC) added
six additional symptoms
[https://www.nytimes.com/2020/04/27/health/coronavirus-symptoms-cdc.html] of the
novel coronavirus to its growing list. With worldwide cases now surpassing 3
million, another concerning association has emerged: COVID-19 may increase risk
of stroke in adults under 50 years old.

Emerging association between COVID-19 and young stroke
A physician group from Mount Sinai Hospital System in New York recently
published a report [https://www.nejm.org/doi/full/10.1056/NEJMc2009787?query=RP] 
concerning a two-week period in March in which five adults under age 50
presented with symptoms of acute stroke. All were subsequently diagnosed with
COVID-19. This figure constitutes a greater than fivefold increase of
large-vessel stroke in adults under 50 than seen in previous weeks within the
hospital system.

On average, the five cases presented to the hospital with severe stroke (NIHSS
[https://www.neofect.com/us/blog/what-is-the-national-institutes-of-health-stroke-scale-nihss] 
= 17). Two of the five adults in this cohort had no significant medical history
or known risk factors for stroke. Four of the five presented to the hospital
eight or more hours after initial onset of stroke symptoms. A Mount Sinai
physician who had worked with these patients stated that two reportedly delayed
calling an ambulance
[https://www.cnn.com/2020/04/22/health/strokes-coronavirus-young-adults/index.html]
.



How can COVID-19 cause a stroke?
It is thought that COVID-19 promotes vascular inflammation and increased blood
coagulability, leading to blood clot formation. If a clot blocks a major artery,
it can obstruct blood flow and cause tissue death in the form of a stroke or
heart attack. Recent studies from the Netherlands
[https://www.thrombosisresearch.com/article/S0049-3848(20)30120-1/fulltext] and 
China [https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3550025] have also
noted an increased incidence of stroke and blood clotting-related complications
among adult COVID-19 patients.

Worries about burdening the healthcare system or thoughts that "it can't happen
to me" might have caused some of the Mount Sinai patients to defer medical
attention. Their stories serve as a cautionary tale for other young adults
navigating the pandemic: be prepared to recognize and respond to stroke symtoms
during this time of elevated risk.



BE FAST to recognize stroke symptoms
Every second counts in recognizing a stroke, as a vessel-blocking clot can cause
millions of brain cells to die per minute. The BE FAST acronym is any easy way
to remember stroke symptoms and the need to take action. Memorize the
information below, and know that one does not have to be experiencing all
symptoms to be having a stroke.

Balance loss including unsteadiness, tripping, or falling
Eyesight changes like blurred vision, double vision, or vision loss
Facial drooping or inability to maintain a symmetrical smile
Arm weakness presenting as clumsiness or partial to total inability to move
Slurred speech including difficulty forming words or speaking altogether
Time to call 911!



Monitor COVID-19 symptoms and know the emergency warning signs
The CDC states that most cases of COVID-19 are mild
[https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html] and
recommends monitoring symptoms of the condition. Individuals who are
experiencing severe or concerning symptoms or suspect exposure to COVID-19 are
advised to contact their healthcare provider immediately for further direction.

COVID-19 symptoms:
 * Cough
 * Shortness of breath
 * Fever
 * Chills
 * Repeated shaking with chills
 * Muscle pain
 * Headache
 * Sore throat
 * New loss of taste or smell

The CDC also describes emergency warning signs of severe illness. If you are
experiencing any of the symptoms below, call 911 immediately.

Seek medical attention for emergency warning signs:
 * Trouble breathing
 * Persistent chest pain or pressure
 * New-onset confusion or difficulty to wake
 * Blue-tinged lips or face



Always take an ambulance during an emergency
If you experience stroke symptoms or COVID-19 emergency warning signs, opt for
ambulance transport to the hospital instead of self-transport. Delay in
hospitalization during a medical emergency is associated with increased
mortality across health conditions
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464671/].

Research examining acute stroke patients' motives for self-transport to the
hospital [https://www.ahajournals.org/doi/10.1161/str.50.suppl_1.WMP93] sheds
light on why some defer calling 911. Subjects cited the desire to go to a
particular hospital, not realizing the situation was an emergency, and belief
that car transport would be faster among their reasons to drive themselves or
get a ride.

Ambulance transport is the fastest and safest route to the hospital. Do not
gamble with your prognosis or the lives of others on the road by taking a car.
Although this advice is important for all age groups, it is increasingly
relevant for adults under age 50. Knowing the symptoms and correct response to
COVID-19-related emergencies can make the difference between life and death.

Further Reading:
How to Spot and Prevent Blood Clots
[https://newsinhealth.nih.gov/2017/01/how-spot-prevent-deep-vein-thrombosis]
What to Do If You Have COVID-19 and When to Call 911
[https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html]