The Use of Web-Based Resources to Facilitate Stroke Rehabilitation: A Scoping Review

PURPOSE: The purpose of this scoping review was twofold: (1) to summarize and identify gaps in the existing literature on the use of online resources for stroke rehabilitation and (2) to summarize and analyze the content of active online resources focused on stroke rehabilitation. The number of Internet users has risen from 738 million in 2000 to 3.2 billion in 2015 (Davidson, 2015). The use of the Internet has also become commonplace among health professionals; over 85% of surveyed medical students and physicians reported using mobile Internet devices to assist in the treatment of their patients (Wallace, Clark, & White, 2012). As the use of the Internet and the prevalence of stroke increases, Internet sources can become a vital tool for stroke survivors, caregivers, and health professionals to obtain information and facilitate carryover from rehabilitation services.

METHOD: CINAHL, EBSCO, ProQuest, PsycINFO, and PubMed databases were used to search for articles with the following key terms: stroke, rehabilitation, web, Internet, online, resources, support, and recovery. Inclusion criteria included articles published in English between 1996 and 2016 that used online resources for stroke rehabilitation. Articles were excluded if the focus was on mobile phone applications, gaming systems, robotics, or telerehabilitation. The initial search yielded 1,441 articles, but further examination reduced the final analysis to 10 articles.

Google Chrome and Safari browsers were used to search for active websites related to stroke rehabilitation with the following key words: stroke, resources, website, recovery, support, Internet, rehabilitation, caregiver, survivor, community, organization, and information. The following inclusion criteria were used: content was in English, primary focus was stroke rehabilitation, current entry was within the past 24 mo, and author or organization was listed. Websites were excluded if the primary focus was to sell a product or if they were a single YouTube video or web page. To manage the volume of Internet data, findings were limited to the first seven pages. The initial search triggered 2,800 hits, but further examination resulted in 44 websites in the final analysis.

RESULTS: The literature suggests that patients and clinicians support the use of online resources to facilitate stroke recovery. Websites are useful for providing information on medical aspects and physical symptoms of stroke. Online education does not appear to be sufficient to address poststroke sexual dysfunction and depression. Active website content reflected research findings and often provided education about stroke (risk factors, prevention, stroke types, secondary impairments). Personal stories, participation in the stroke community, and social support were also common. Mental health, particularly depression, was addressed in only a third of the websites.

DISCUSSION: The Internet offers a virtual platform for stroke survivors, caregivers, and clinicians to communicate 24 hr a day, and it enables stroke survivors to share and receive support from one another. Web-based resources are not a substitute for in-person clinical visits but may be effective as a supplement to clinical services. Further research is needed to understand what aspects of mental health are suited for online platforms as well as the best way to use websites as a supplement to in-person visits.

CONCLUSION: The use of online resources in stroke rehabilitation is rapidly growing. The current research is limited but supports the use of websites to provide supplemental education on stroke recovery; however, online resources are not a substitute for in-person clinical visits. This project explored how everyday technology can support patients, family, and caregivers to facilitate stroke rehabilitation in the community.

References

Davidson, J. (2015, May 26). Here’s how many Internet users there are. TIME.com. Retrieved from http://time.com/money/3896219/internet-users-worldwide

Wallace, S., Clark, M., & White, J. (2012). ‘It’s on my iPhone’: Attitudes to the use of mobile computing devices in medical education, a mixed-methods study. BMJ Open, 2(4), 1–7. https://doi.org/10.1136/bmjopen-2012-001099