Research Online Tele-Rehabilitation Program in People After a Stroke Living at Home

Research and Clinical Aspects of the Project Study of Home Based Tele-Rehabilitation Program for Patients With Stroke

Telerehabilitation refers to the use of Information and Communication Technologies (ICT) to provide rehabilitation services to people remotely in their homes or other environments. By using ICT, patient access to care can be improved and the reach of clinicians can extend beyond the physical walls of a traditional healthcare facility, thus expanding continuity of care to persons with disabling conditions. The concept of telecare, when telerehabilitation is used to deliver services to patients in their homes or other living environments, empowers and enables individuals to take control of the management of their medical needs and interventions by enabling personalized care, choice and personal control Research Goal and Objectives

1. To investigate the clinical feasibility and usability of the Gertner Tele-Motion-Rehab system in post-stroke patients, in their homes.

2. To evaluate Gertner Tele-Motion-Rehab system clinical improvement within the patient's home in terms of:

   1. function of the weak upper extremity
   2. performance of ADL

Inclusion Criteria:

• 6-72 months post stroke
• Sitting balance intact (ability to go beyond the midline of the body)
• Moderate impairment of the affected upper extremity determined by range of motion (ROM); shoulder flexion and abduction must be more than 45 degrees with mild to moderate compensations; elbow flexion should be about 45 degrees and trunk movement of about 10 cm.
• Basic ability to independently use the tele-system via touching virtual objects on the screen.
• Having a personal computer (at least Intel i3 processor, with Win7 operating system),Internet access (10MBps) and a large computer monitor (at least 26") at home.
• Caregiver, available when needed, toprovide support throughout the intervention.

Exclusion Criteria:

• Other medical conditions limiting participation in low-intensity exercise training.
• Major receptive aphasia and screening criteria consistent with dementia (Mini-MentalState score <24).
• Untreated major depression.
• Presence of unilateral spatial neglect as determined by star cancellation (score less than 51).
• Hemianopsia
• Apraxia (limb and ideomotor)
• Other medical conditions that affect the central or peripheral nervous system
• Ataxia