title: Home-based telesurveillance and rehabilitation after stroke: a real-life study.
abstract: BACKGROUND
  After discharge from in-hospital rehabilitation, post-stroke patients should have the opportunity to continue the rehabilitation through structured programs to maintain the benefits acquired during intensive rehabilitation treatment.
  
  
  OBJECTIVE
  The primary objective was to evaluate the feasibility of implementing an home-based telesurveillance and rehabilitation (HBTR) program to optimize the patient's recovery by reducing dependency degree.
  
  
  METHODS
  Post-stroke patients were consecutively screened. Data were expressed as mean ±  standard deviation (SD). 26 patients enrolled: 15 were sub-acute (time since stroke: 112 ± 39 days) and 11 were chronic (time since stroke: 470 ± 145 days). For 3 months patients were followed at home by a nurse-tutor, who provided structured phone support and vital signs telemonitoring, and by a physiotherapist (PT) who monitored rehabilitation sessions by videoconferencing.
  
  
  RESULTS
  23 patients completed the program; 16.7 ± 5.2 phone contacts/patient were initiated by the nurse and 0.9 ± 1.8 by the patients. Eight episodes of atrial fibrillation that required a change in therapy were recorded in two patients. Physiotherapists performed 1.2 ± 0.4 home visits, 1.6 ± 0.9 phone calls and 4.5 ± 2.8 videoconference-sessions per patient. At least three sessions/week of home exercises were performed by 31% of patients, two sessions by 54%. At the end of the program, global functional capacity improved significantly (P < 0.001), in particular, static (P < 0.001) and dynamic (P = 0.0004) postural balance, upper limb dexterity of the paretic side (P = 0.01), and physical performance (P = 0.002). Symptoms of depression and caregiver strain also improved.
  
  
  CONCLUSIONS
  The home-based program was feasible and effective in both sub-acute and chronic post-stroke patients, improving their recovery, and maintaining the benefits reached during inpatient rehabilitation.
authors.affiliation: a Telemedicine Service , Fondazione Salvatore Maugeri, IRCCS, Lumezzaxsrne , Brescia , Italy.
authors.forename: Palmira
authors.initials: P
authors.lastname: Bernocchi
authors.affiliation: b Neurological Rehabilitation Department , Fondazione Salvatore Maugeri, IRCCS , Lumezzaxsrne, Brescia , Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Vanoglio
authors.affiliation: a Telemedicine Service , Fondazione Salvatore Maugeri, IRCCS, Lumezzaxsrne , Brescia , Italy.
authors.forename: Doriana
authors.initials: D
authors.lastname: Baratti
authors.affiliation: b Neurological Rehabilitation Department , Fondazione Salvatore Maugeri, IRCCS , Lumezzaxsrne, Brescia , Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Morini
authors.affiliation: c Psychological Service , Fondazione Salvatore Maugeri, IRCCS , Lumezzane, Brescia , Italy.
authors.forename: Silvana
authors.initials: S
authors.lastname: Rocchi
authors.affiliation: b Neurological Rehabilitation Department , Fondazione Salvatore Maugeri, IRCCS , Lumezzaxsrne, Brescia , Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Luisa
authors.affiliation: a Telemedicine Service , Fondazione Salvatore Maugeri, IRCCS, Lumezzaxsrne , Brescia , Italy.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Scalvini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071939:Stroke Rehabilitation; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome; D049269:Videoconferencing
keywords: Physical and rehabilitation medicine; Stroke; Telehealth; Telemedicine; Telenursing; Video-conferencing