Acceptability of Telerehabilitation: Experiences and Perceptions by Individuals with Stroke and Caregivers in an Early Supported Discharge Program.

INTRODUCTION: Telerehabilitation (TR) is a promising method for facilitating the delivery and access to post-stroke rehabilitation services. OBJECTIVE: The aim of this study was to explore the acceptability of TR and factors influencing its adoption by individuals with stroke and caregivers. METHODS: A qualitative descriptive approach was used. Six individuals with stroke and three caregivers participated in individual online interviews. An abductive thematic analysis was employed to analyze the qualitative data, using the Unified Theory of Acceptance and Use of Technology 2 (UTAUT-2) model. RESULTS: Participants reported positive experiences with TR, resulting in improvements in functional abilities, such as manual dexterity, balance, and positive interactions with therapists. They found the technology easy to learn and use, facilitating engagement in TR. Participants' prior experiences with technology, along with support from caregivers and therapists, facilitated acceptance and the use of TR. The COVID-19 pandemic also motivated participants to accept TR. However, technical issues, unstable internet connections, and lack of feedback were barriers to the use of TR. CONCLUSION: Despite existing obstacles, TR can be used to provide rehabilitation services for individuals with stroke. Addressing these barriers is necessary to promote the widespread and effective use of TR in the context of stroke recovery.

Perceived impacts of a first wheelchair on social participation.

PURPOSE: To document perceived impacts in users' daily activities and social roles (social participation) following the acquisition of a first manual or powered wheelchair. METHODS: A qualitative design with a phenomenological approach was used. Semi-structured interviews were conducted. An interview guide was developed based on the 12 social participation categories in the Disability Creation Process (DCP) conceptual model as themes underlying the questions: 'What has changed in your daily life since you got your new wheelchair?' and 'What has not changed in your daily life that you thought you would do differently with your new wheelchair?' RESULTS AND DISCUSSION: The average age of the ten participants was 64.3 years (±16.3) and 90% had received a manual wheelchair. Four main themes emerged from the detailed analysis: changes in daily activities, expectations not met, impacts on social roles and emotional changes. The participants considered the changes in daily activities to be generally positive. Expectations not met mainly related to outdoor mobility. The participants had not anticipated the impacts on social roles and emotional changes, which demonstrate the complexity of human occupation. CONCLUSION: Getting a wheelchair is a major and complex event in a person's life.

Impact of wheelchair acquisition on social participation.

PURPOSE: Efficient mobility could be a prerequisite to carrying out many daily activities and social roles (social participation). The aim of this study was to assess the impact of wheelchair acquisition on social participation. METHODS: Single group pre/post design where the intervention was the acquisition of a wheelchair paid for by the provincial government. Data were collected retrospectively from the participants' medical files. Individuals were excluded if they received an assistive device other than a wheelchair or contacted the centre only for wheelchair repairs. Social participation was measured using the Reintegration to Normal Living Index (RNLI) questionnaire. RESULTS: The sample (n = 42) had a mean age of 64.2 +/- 18.5 years, and 50% of them (n = 21) did not have a wheelchair before the intervention. The total RNLI scores pre- (46.9/100 +/- 24.7) and post-acquisition (29.7/100 +/- 18.5) showed a significant improvement in participation (p < 0.001). No difference was found between those who had their first wheelchair (n = 21) compared with replacement. Single-item analysis of the RNLI showed a significant difference for 5 of the 11 items. Age and diagnosis were significantly correlated (p < 0.05) with some of the items. CONCLUSION: Social participation improved significantly following wheelchair acquisition although confounding variables may have contributed to this improvement.