<div class="section">
<a class="named-anchor" id="S1">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d4359748e145">Background</h5>
<p id="P2">The greatest burden from stroke-related disability is borne by Low-and-Middle
Income
countries (LMICs) where access to rehabilitation after stroke is severely challenged.
Tele-rehabilitation could be a viable avenue to address unmet rehabilitation needs
in LMICs.
</p>
</div><div class="section">
<a class="named-anchor" id="S2">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d4359748e150">Objectives</h5>
<p id="P3">To assess the burden of post-stroke physical deficits, rates of utilization
of physiotherapy
services, and perceptions of tele-rehabilitation among recent Ghanaian stroke survivors.
</p>
</div><div class="section">
<a class="named-anchor" id="S3">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d4359748e155">Methods</h5>
<p id="P4">Using a consecutive sampling strategy, 100 stroke survivors attending an
outpatient
Neurology clinic in a Ghanaian tertiary medical center were enrolled into this cross-sectional
study. After collecting basic demographic data, clinical history on stroke type, severity
and level of disability, we administered the validated 20-item Functional Independence
Measure questionnaire to evaluate functional status of study participants and an 8-item
questionnaire to assess participants’ attitudes towards telemedicine administered
rehabilitation intervention.
</p>
</div><div class="section">
<a class="named-anchor" id="S4">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d4359748e160">Results</h5>
<p id="P5">Mean ± SD age of study participants was 57.2 ± 13.3 years of which 51.0%
were males
with a mean duration of stroke of 1.3 ± 2.2 years. 53% had Modified Rankin scores
of ≥3, 57% were fully independent and only 27% reported utilizing any physiotherapy
services. Barriers to access to physiotherapy included financial constraints due to
cost of physiotherapy services and transportation as well as premature discharge from
physiotherapy to avoid overburdening of available physiotherapy services. These factors
led to the limited provision of rehabilitative therapy. Participants held positive
views of the potential for tele-rehabilitation interventions (80–93%). However, while
85% owned mobile phones, only 35% had smart phones.
</p>
</div><div class="section">
<a class="named-anchor" id="S5">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d4359748e165">Conclusion</h5>
<p id="P6">Despite, a high burden of residual disability, only about 1 out of 4 stroke
patients
in this Ghanaian cohort was exposed to post-stroke physiotherapy services, largely
due to relatively high costs and limited health system resources. These Ghanaian stroke
patients viewed the potential role of Tele-rehabilitation as positive, but this promising
intervention needs to be formally tested for feasibility, efficacy and cost-effectiveness.
</p>
</div>