Optimizing Recovery: An Opportunity to Improve Access to Post-stroke Rehabilitation Care in Rural Settings

Area of Science:

• Neurology
• Rehabilitation Medicine
• Health Services Research

Background:

• Post-stroke spasticity (PSS) significantly impacts patient function, quality of life, and healthcare costs.
• Botulinum toxin (BTX) injections are an effective PSS treatment but require specialized care and in-person visits, creating access barriers for rural patients.

Observation:

• A 59-year-old male with severe PSS following a thalamic stroke experienced functional decline and depression after discharge to a rural area.
• Lack of access to timely BTX injections due to rural residence led to worsening spastic hemiparesis and impaired activities of daily living (ADLs).

Findings:

• Re-establishing care allowed the patient to initiate BTX injections, addressing his severe PSS.
• A novel post-stroke telehealth follow-up protocol was developed and implemented for continuous virtual monitoring between in-person BTX treatments.

Implications:

• Telemedicine can bridge the healthcare gap for rural populations with PSS, improving access to essential treatments like BTX injections.
• The developed telehealth protocol offers a sustainable model for delivering consistent care to underserved rural communities, enhancing patient outcomes and quality of life.