Introduction:
Evidence-based stroke rehabilitation in developing countries is limited, leaving best practice guidelines unmet. Virtual care (VC), has successfully facilitated the delivery and access to stroke rehabilitation across numerous settings. VC offers a promising solution to bridge the stroke rehabilitation gap by delivering individualised, evidence-based rehabilitation.
This case study explores the feasibility and effectiveness of VC in designing and implementing an early stroke rehabilitation program in a rural developing country.
Method:
Case study:
A 77-year-old female, presented to a rural southeast Asian hospital with sudden left sided weakness, left facial droop, and slurred speech, scoring 7 on the National Institute of Health Stroke Scale (NIHSS). A CT scan confirmed a right thalamic intracerebral haemorrhage. Following Intensive Care admission she was stepped-down to high dependency, ward-based care on day 2. VC rehabilitation commenced on day 3.
A neuro-rehabilitation-trained occupational therapist in metropolitan Australia collaborated with the patient’s family through VC. Family-recorded videos of the NHISS and completion of basic functional tasks informed individualised, evidence-based rehabilitation assessment and treatment plan. This included upper limb therapy, cognitive rehabilitation strategies and functional activities of daily living retraining. Instructional videos sent to the family included text-based support and weekly video feedback, enabling specific and tailored grading of therapy.
Results:
The patient was discharged home on day 11 with family support and a community physiotherapist delivering complementary daily rehabilitation. By day 34, she regained premorbid function, resuming activities such as playing the piano, with no adverse events reported.
Conclusion:
This case highlights VC’s potential to deliver effective, evidence-based, individualised, early stroke rehabilitation in an under-resourced, developing country.
Relevance to clinical practice:
Access to neuro-rehabilitation-trained staff and strong informal supports to implement the therapy program ensured the success of this virtual model of care. This model offers a scalable, patient-centred solution for improving global stroke outcomes.