Grant: Project Grant

Stroke impacts nearly 400,000 Canadians annually. Three quarters of stroke survivors will live with minor to severe impairments or disabilities; which require rehabilitation care representing >$3.6 billion for the Canadian economy. Enhancing stroke rehabilitation care delivery can reduce those costs while optimizing patient outcomes and allowing patients to return home earlier following the stroke event. Strong evidence supports initiating rehabilitation as soon as the patient's medical status has stabilized; however, the need to travel to access rehabilitation, the lack of interprofessional communication among service providers, and the failure to engage the patient/families in the decision making process, limit access to optimal services. This intervention will entail participants receiving rehabilitation care through remote, live treatment sessions with an interdisciplinary group of clinicians (called telerehabilitation). The aim of this application is to evaluate whether telerehabilitation could provide patients who have had stroke the opportunity to return home safely after their acute hospital stay, encourage patient (and family) engagement in rehabilitation care, and overcome challenges of access to interprofessional rehabilitation care. The process of care, clinical outcomes and costs will be captured for 296 patients, half of whom will be offered telerehabilitation. Through qualitative interviews, the research team will uncover and describe contextual factors (both personal and environmental) that will facilitate the delivery of stroke rehabilitation care using a telerehabilitation platform (for whom and how does it work). Given stark contrasts between the Canadian stroke care recommendations and actual rehabilitation practice, and little robust data to support change, this study represents a unique, highly relevant, and innovative opportunity to minimize gaps in both knowledge and practice.