Abstract WP131: Global Landscape of Stroke Rehabilitation: Access and Challenges

Abstract

Background: Stroke is a leading cause of long-term disability worldwide. Timely and adequate rehabilitation is crucial for post-stroke recovery, but access is limited due to an overburdened healthcare system, medical personnel shortages, and insurance barriers. Rehabilitation access is especially limited for stroke survivors in rural and low-income regions. Innovative solutions like telerehabilitation are needed to expand access. This study examines current rehabilitation practices, costs, and global telerehabilitation models, as well as barriers to rehabilitation utilization. Methods: We conducted an online survey aimed at stroke care providers, affiliated societies, and partner organizations to collect comprehensive data on the availability and practices of post-stroke rehabilitation and telerehabilitation across various regions. Results: A total of 523 responses were collected from 62 different countries (Fig1), with the majority of respondents being physicians (66.7%), followed by physiotherapists (15.7%). Most respondents reported working in urban areas (82.9%) and were primarily employed in public community hospitals (40.5%), with a significant portion also working in academic institutions (35.3%). Regarding experience, 45.1% of respondents had over 10 years of experience in the stroke field. Telerehabilitation services for stroke were not offered by most of the surveyed sites (71.1%). Among those that did provide telerehabilitation, most sessions were individualized for a single patient (34.7%), followed by sessions involving two patients (24.8%). Notably, 18.36% of the sites offered sessions for groups of more than 10 patients at a time. The frequency of sessions varied, with the majority offering a single session per week (30.6%), followed by two sessions per week (20%), while only 8% provided sessions five days a week. On average, the duration of these sessions ranged from 31 to 60 minutes (53.1%). The most reported barriers to providing adequate telerehabilitation services included the availability of electronic hardware devices (12.9%) and internet access (12.9%). Other significant barriers included poor video call quality (10.4%) and the lack of clear guidelines and protocols (9.2%). Conclusion: The survey results provide a comprehensive overview of current practices and availability of post-stroke rehabilitation and telerehabilitation, highlighting the global burden of post-stroke disability due to limited access to rehabilitation.