Development and Feasibility of a Telerehabilitation Programme Combined with or without Transcranial Direct Current Stimulation tDCS Among Older Adults with Post-Stroke Mild Cognitive Impairment

Abstract

Objective: Stroke rehabilitation is clinically and economically complex and requires a long-term commitment from patients and their support systems. Therefore, there is a need for an intervention that addresses the cost and accessibility needs of stroke survivors and their caregivers. This study aimed to gain expert consensus on the feasibility of Brunnstrom Movement Therapy (BRS) telerehabilitation for older adult patients with post-stroke mild cognitive impairment. Methods: A Delphi study was conducted to provide a BRS telerehabilitation programme for older adult patients with post-stroke mild cognitive impairment. The stages involved were literature review, items-modelling, expert review, and video modelling of the consented items. The feasibility of the video was tested among selected patients. Results: Consensus on the structure and content of the BRS telerehabilitation with and without tDCS was achieved in three rounds. The final telerehabilitation programme comprised eight exercise regimens, including repetition and progression of the exercise programme. The programmes had a good feasibility score among the study participants. The USE questionnaire data revealed high scores for the telerehabilitation programme, with usefulness at 89.28%, ease of use at 88.52%, ease of learning at 93.25%, and satisfaction at 89.80%. When combined with tDCS, the programme's usefulness increased to 93%, ease of use to 90%, ease of learning remained high at 92%, and retention was at 91%. Conclusion: The BRS telerehabilitation programme was developed for older adult patients with post-stroke mild cognitive impairment, with experts’ consensus that it is feasible to use among older adult patients with post-stroke mild cognitive impairment.

Keywords

• Stroke
• Telerehabilitation
• tDCS
• Older adults