Oral Presentation Asia Pacific Stroke Conference 2024

Models of community-based rehabilitation low-resource settings: a scoping review (107565)

Yudi Hardianto 1 2 , Elizabeth Lynch 3 , Andi Masyitha Irwan 4 , Thosen Kandasamy 3 , Tara Purvis 1 , Michele Callisaya 5 6 , Richard I Lindley 7 8 , Dorcas Gandhi 9 , Ning Liu 10 , Noor Azah Abd Aziz 11 , Jeyaraj Pandian 12 , Dominique A Cadilhac 1 13
  1. Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
  2. Department of Physiotherapy, Faculty of Nursing, Hasanuddin University, Makassar, South Sulawesi, Indonesia
  3. College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
  4. Department of Gerontological Nursing, Faculty of Nursing, Hasanuddin University, Makassar, South Sulawesi, Indonesia
  5. Peninsula Clinical School, Central Clinical School, Monash University, Frankston, VIC, Australia
  6. Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
  7. The George Institute for Global Health, Barangaroo, NSW, Australia
  8. University of Sydney, Camperdown, NSW, Australia
  9. College of Physiotherapy, Department of Neurology, Christian Medical College and Hospital, Ludhiana, Punjab, India
  10. The Nursing Faculty, Zhu Hai Campus, Zunyi Medical University, Zhu Hai, Guangdong, China
  11. Department of Family Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
  12. Department of Neurology, Christian Medical College and Hospital, Ludhiana, Punjab, India
  13. Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia

Background/Aims

Accessible and affordable rehabilitation is needed in low-resource settings for the growing number of survivors of stroke. We aimed to scope available literature about community-based rehabilitation services delivered in low-resource settings.

Methods 

Six databases (e.g., MEDLINE, PsycINFO, CINAHL) were searched to identify relevant articles published between 01/01/2012 and 31/12/2022. Studies were included if community-based rehabilitation interventions were evaluated in low-resource settings for people aged 18+ years, within the first year of stroke, who were discharged home. One author extracted results from included papers using a template, a second author confirmed extraction by cross-checking extracted data for first five studies.

Results 

Thirty-one studies (2,372 abstracts screened) were included, comprising 6,788 participants from 13 countries throughout Asia, Africa, and South America. Various rehabilitation models were identified, including self-management and exercises, caregiver-delivered, transitional care, and technology-assisted interventions. The delivery models included face-to-face, telehealth (phone or video), SMS, mobile app, virtual reality or mixed strategies. Interventions were usually delivered at home (n=26), community health centres (n=3) and community rehabilitation services (n=2), but also in community health centres, and community rehabilitation services. Interventions ranged in duration from 2 weeks to 27 months, with the frequency from twice a day to fortnightly. Family caregivers were frequently involved (n=17). Barthel Index was commonly used to measure the outcome of the intervention (n=19).

Conclusion

Community-based rehabilitation in low-resource settings varies widely in terms of models, modes of delivery, frequency, duration, providers, and settings. Home-based rehabilitation therapies involving family caregivers are the most common intervention type reported.