Nurse-led telerehabilitation intervention to improve stroke efficacy: Protocol for a pilot randomized feasibility trial

Background: The prevalence of stroke continues to rise in low-middle income countries. The continual rise in stroke cases and increasing prevalence on post-acute needs represent a crucial call for increased accessibility and utilization of rehabilitation services. Aim: The primary objective of the study is to test the feasibility (recruitment, retention rates, cost and participant satisfaction) of a nurse-led telerehabilitation intervention in improving self-efficacy among stroke survivors. The findings of the trial are intended for use in a future larger study. Methods: Participants would be recruited at the University of Ghana Hospital and randomized into an intervention group and a control group after being stratified based on age and type of stroke. Participants aged [≥] 18 years, diagnosed stroke at most 12months prior the recruitment and requiring moderate level of assistance would be considered for eligibility. Participants in the intervention group would undergo initial and continuous assessments for identification of problems and needs. Based on individual needs, participants would receive various nursing rehabilitation therapies in appropriate domains (cognitive, physical, emotional, and nursing education) combined with treatment as usual for 6 months. Participants in the controlled group would only receive treatment as usual (physiotherapy and follow-up with a medical officer). A follow-up evaluation would be conducted immediately, 30 days and 90 days after the intervention. Discussion: Providing stroke rehabilitation services in low-resource settings presents a significant challenge due to limited infrastructure and a lack of trained healthcare professionals. The current study has the potential of contributing to the growing body of evidence on the impact of telerehabilitation services in mitigating these challenges in low-resource settings.