Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 28:10:20552076241252263.
doi: 10.1177/20552076241252263. eCollection 2024 Jan-Dec.

NeuroRehabilitation OnLine: Description of a regional multidisciplinary group telerehabilitation innovation for stroke and neurological conditions using the Template for Intervention Description and Replication checklist

Suzanne Ackerley  1   2 , Neil Wilson  1 , Paul Boland  1 , Rosemary Peel  3 , Louise Connell  2   4
Affiliations

NeuroRehabilitation OnLine: Description of a regional multidisciplinary group telerehabilitation innovation for stroke and neurological conditions using the Template for Intervention Description and Replication checklist

Suzanne Ackerley et al. Digit Health. .

Abstract

Background: Providing recommended amounts of rehabilitation for stroke and neurological patients is challenging. Telerehabilitation is viable for delivering rehabilitation and an acceptable adjunct to in-person therapy. NeuroRehabilitation OnLine (NROL) was developed as a pilot and subsequently operationalised as a regional innovation embedded across four National Health Service (NHS) Trusts.

Objective: To describe the NROL innovation to assist future implementation and replication efforts.

Methods: The Template for Intervention Description and Replication (TIDieR) checklist, with guidance from the TIDieR-Telehealth extension, was used to describe NROL. The description was developed collaboratively by clinical academics, therapists, managers and researchers. Updated Consolidated Framework for Implementation Research domains were used to describe the context in which the innovation was delivered.

Results: NROL delivers online group-based real-time neurorehabilitation with technology assistance. It incorporates multidisciplinary targeted therapy and peer support to complement existing therapy. Procedures, materials and structure are detailed to demonstrate how NROL is embedded within a healthcare system. NROL uses existing NHS therapy workforce alongside dedicated NROL roles, including an essential technology support role. Selection of NROL groups is dependent on patient needs. The NROL innovation is tailored over time in response to feedback. NROL described here is successfully integrated within a regional stroke and neurorehabilitation network, aligns with local and national strategies and capitalises on an existing clinical-academic partnership.

Conclusion: This comprehensive description of a regional NROL innovation, and clarification of core components, should facilitate other healthcare settings to adapt and implement NROL for their context. Continuous evaluation alongside implementation will ensure maximal impact for neurorehabilitation.

Keywords: Telerehabilitation; brain injury; digital health; implementation; neurological; rehabilitation; stroke.

PubMed Disclaimer

Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
NROL core components. Six core components are identified for the integration of NROL within an existing healthcare system. These components should be consistently implemented for NROL but the processes to achieve them should be adapted to fit local conditions.
See this image and copyright information in PMC

References

    1. Lohse KR, Lang CE, Boyd LA. Is more better? Using metadata to explore dose-response relationships in stroke rehabilitation. Stroke 2014; 45: 2053–2058. - PMC - PubMed
    1. Schneider EJ, Lannin NA, Ada L, et al. Increasing the amount of usual rehabilitation improves activity after stroke: a systematic review. J Physiother 2016; 62: 182–187. - PubMed
    1. French B, Thomas LH, Coupe J, et al. Repetitive task training for improving functional ability after stroke. Cochrane Database Syst Rev 2016; 11: Cd006073. - PMC - PubMed
    1. Sentinel Stroke National Audit Programme. The Road to Recovery. The Ninth SSNAP Annual Report. . London: King's College London, 2022.
    1. Cochrane Rehabilitation. Telerehabilitation Services for Stroke. London: Cochrane Library. 2024. Available from: https://rehabilitation.cochrane.org/telerehabilitation-servicesstroke#:∼: text=Telerehabilitation%20%28telerehab%29%20is%20a%20way%20for%20professionals%20to,devices%20%28sensors%20such%20as%20pedometers%2C%20potentiometers%2Fencoders%2C%20myographic%2C%(2024, accessed 22 January 2024).

LinkOut - more resources