Feasibility of group telerehabilitation for individuals with chronic acquired brain injury: integrating clinical care and research

Abstract

Background

Acquired brain injury (ABI) is a leading cause of lifelong disability, but access to treatment in the chronic stages has significant barriers. Group-based, remotely delivered neurorehabilitation reduces costs, travel barriers, and infection risk; however, its feasibility for patients with ABI is not well-established.

Objectives

To investigate the feasibility of remotely group-based cognitive and mood therapies for persons with chronic ABI.

Methods

Three hundred and eighty-eight adults with chronic ABI participated in group tele-neurorehabilitation modules comprising Cognitive Behavioral Therapy, Goal Management Training^®, Relaxation and Mindfulness Skills Training, and/or a novel Concussion Education & Symptom Management program. Assessments comprised quantitative metrics, surveys, as well as qualitative semi-structured interviews in a subset of participants.

Results

High retention, adherence, and satisfaction were observed. Facilitators of treatment included accessibility, cost-effectiveness, and convenience. Adoption of technology was high, but other people’s technological interruptions were a barrier. Self-reported benefits specific to group-based format included improved mood, stress management, coping, interpersonal relationships, cognitive functioning, and present-mindedness.

Conclusions

The present study examined chronic ABI patients’ perceptions of telerehabilitation. Patients found remotely delivered, group-based mood, and cognitive interventions feasible with easy technology adoption. Group format was considered a benefit. Recommendations are provided to inform design of remotely delivered ABI programs.

Implications for Rehabilitation

• Group-based mood and cognitive telerehabilitation is feasible for persons with chronic acquired brain injury, with high reported satisfaction.

• Screening for technical proficiency and providing ongoing technical support improves therapy adherence and retention.

• Integration of clinical care and research is feasible for delivering remote therapies to persons with brain injury.

Keywords:

• Neurorehabilitation
• group therapy
• acquired brain injury
• mindfulness
• cognitive behavioral therapy
• telemedicine
• goal management training
• concussion

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, Walter & Maria Schroeder Institute for Brain Innovation & Recovery, Saunderson Family, and Joseph and Antoinette Sorbara Foundation.