London, United Kingdom 2013 31 Rehabilitation and reorganisation after stroke Home Internet Access amongst Stroke Survivors: More must be done! C. McInnes1, E. McCann2, E. Feely3, S. Sneddon4, M. Barber5 NHS Lanarkshire Stroke Services, North Lanarkshire, UNITED KINGDOM1, NHS Lanark-shire Stroke Services, , UNITED KINGDOM2, NHS Lanarkshire Stroke Services, , 3, NHS La-narkshire Stroke Services, , UNITED KINGDOM4, NHS Lanarkshire Stroke Services, , UNITED KINGDOM5 Background Eighty three per cent of UK adults have internet access. Video-based home telemedicine, including stroke telerehabilitation, is developing as a potential intervention, especially in rural areas. Psycho-logical and language interventions are possible models. However, these interventions depend on high speed internet access in the home environment. We were concerned that as stroke patients are older and may have higher levels of social deprivation than the population average, they may not have internet access at home. Methods Stroke patients discharged from two stroke units were contacted at home via telephone (3 attempts were made by clinicians) and asked if they had internet access, how it was accessed, how frequently it was used and if they had utilised it for healthcare information or would wish to do so in the future. We determined deprivation based on the Scottish Index of Multiple Deprivation. Results We identified 187 patients. Median age was 75 (IQR 68–79) and half were female. Fifty-four had died or been transferred to interim care, 56 were unable to be contacted by telephone, 5 declined/ were unable to answer questions. The remainder (72) agreed to undertake the survey. Twenty-five (35%) of these patients had access to the internet at home, most via a laptop. Of those that did have access, 44% used it at least once per week and half of these (n =11) had used, or would wish to use, the internet to access health care information. This was a deprived population, with over 50% (n=37) ranked in the 3 most deprived deciles of the Scottish population. Conclusions In this group home internet access rates were low, suggesting that video-based home telemedicine would currently not be applicable to the majority of stroke patients in this area. Internet access facil-ities (including the provision of equipment and training) would have to be improved, especially in more deprived areas, if these telerehabilitation interventions are to be evaluated and introduced. E-Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 587 30 Rehabilitation and reorganisation after stroke Determinants of practical walking in recovering stroke patients Y. Ichinosawa1, A. Matsunaga2, S. Shimizu3, G. Wang4, T. Nakanishi5, N. Takemura6, K. Taira7, M. Hamakawa8, H. Miura9, R. Shimose10 Dept. of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, JAPAN1, Dept. of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, JAPAN2, Kitasato University, School of Allied Health Sciences, Sagamihara, JAPAN3, Kitasato Clinical Research Center, Kitasato University School of Medicine, Sagamihara, JAPAN4, Okinawa Rehabilitation Center Hospital, Okinawa, JAPAN5, Okinawa Reha-bilitation Center Hospital, Okinawa, JAPAN6, Okinawa Rehabilitation Center Hospital, Okinawa, JAPAN7, Okinawa Rehabilitation Center Hospital, Okinawa, JAPAN8, Funabashi Rehabilitation Hospital, Funabashi, JAPAN9,Dept. of Rehabilitation Sciences, Graduate School of Medical Scienc-es, Kitasato University, Sagamihara, JAPAN10 Background: Walking ability is an important factor for returning to community and home in post-stroke patients. Although many studies predict the possibility of independent walking in stroke pa-tients, factors required for practical walking remain unclear. This study aimed to identify factors associated with practical walking based on prospective observational data from recovering stroke patients. Methods: Participants were a consecutive series of patients with stroke hemiparesis who received inpatient rehabilitation therapy at the Okinawa Rehabilitation Center Hospital from January 2011 to October 2012, and who were observed continuously for at least 6 months from stroke onset. Exclu-sion criteria were dementia, orthopedic disease, or requiring assistance in 10-meter walking. In total, 72 patients were eligible for inclusion. Clinical characteristics including age, sex, stroke type, affect-ed side, and duration from stroke onset were collected. Motor function of affected (Stroke Impair-ment Assessment Set SIAS) and unaffected (leg strength) lower limbs, self-selected comfortable gait speed (CGS), and balance (Berg Balance Scale BBS) were measured continuously. We also assessed whether patients can ambulate independently to all places around the hospital ward with-out a wheelchair. Cox proportional hazards regression was used to assess the contribution of motor function, CGS, and BBS to practical walking ability. Results: Crude hazard ratios (HRs) for practical walking per increase in SIAS, CGS, and BBS were 1.24 (95% confidence interval 95%CI, 1.12-1.36; P<0.01), 1.05 (95%CI, 1.03-1.06; P<0.01), and 1.06 (95%CI, 1.03-1.08; P<0.01), respectively. After adjusting for clinical characteristics, HRs for practical walking per increase in SIAS and CGS were 1.15 (95%CI, 1.03-1.29; P=0.02) and 1.02 (95%CI, 1.00-1.05; P<0.05), respectively. Conclusion: CGS and affected limb function are both useful parameters for predicting practical walking in recovering stroke patients.
Karger_ESC London_2013
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