Abstract Details

Title Social Factors Related to Home-Based Telerehabilitation After Stroke

Topic Neuro-rehabilitation

Presentation(s) P7 - Poster Session 7 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-006

Objective We evaluated social networks to identify which factors might be important to achieve gains in a 12-week stroke telerehabilitation program.

Background Many patients do not receive high doses of activity-based rehabilitation therapy after stroke for reasons that include access, cost, and low compliance. Home-based telerehabilitation (TR) may be useful for addressing these issues. Social support influences stroke outcomes, and social networks can affect engagement in therapy programs.

Design/Methods Adults with stroke and arm motor deficits saw a licensed OT/PT who performed a live exam then supervised home-based TR (6 days/week, 1 hour/day) through games, exercises, and education over 12 weeks. After 6 weeks of therapy, each patient’s social network was mapped and measured, producing measures of network size, density, and constraint. These measures were used to test 2 hypotheses: that social network measures (1) are associated with the Medical Outcomes Study Social Support Survey (MOS-SSS), an established measure of social support, and (2) are positively related to the primary endpoint, arm motor gains (change in score on the 66-point arm motor Fugl-Meyer scale (FM)).

Results Patients (n=13) were median age 61 and 129 days post-stroke. Median FM score at baseline was 46, and showed a significant (p=0.002) increase of 6 [IQR = 2.5-12.5] points over 12 weeks. Enrollees had relatively large social networks (mean=8.31). Social network density, but not network size or constraint, were related to social support (MOS-SSS; r=0.69, p=0.018) and arm motor gains (r=0.63, p=0.02).

Conclusions High doses of home-based TR for 12 weeks is feasible and improves motor outcomes. In this pilot study with limited sample size, social network density, which reflects connections in the network divided by the number of all possible connections, was validated against the MOS-SSS and was related to achieving arm motor gains in response to an intensive course of telerehabilitation.

Authors/Disclosures
Sophia Raefsky, MD PRESENTER	Dr. Raefsky has nothing to disclose.
	No disclosure on file
Vu Le	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Benjamin Vanderschelden	Mr. Vanderschelden has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Steven C. Cramer, MD, FAAN	Dr. Cramer has received personal compensation for serving as an employee of University of California. An immediate family member of Dr. Cramer has received personal compensation for serving as an employee of University of California. Dr. Cramer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alevian, BrainQ, Helius, Insight Global, Janssen Global Services, Medtronic, Mobia, Myomo, and Simcere. Dr. Cramer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MUSC. Dr. Cramer has or had stock in Alevian, Constant Therapeutics, Panaxium, and TRCare. The institution of Dr. Cramer has received research support from NIH; PCORI; Veterans Administration.
Amar Dhand, MD, DPhil	Dr. Dhand has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for ECHAS, LLC. Dr. Dhand has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Ultress Quinn. The institution of Dr. Dhand has received research support from NIH. Dr. Dhand has received intellectual property interests from a discovery or technology relating to health care.

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