A new, first-of-its-kind app is now available to support clinicians with decisions on best practice rehabilitation strategies for patients with arm impairment due to stroke.
The ViaTherapy app, developed through a worldwide collaboration of stroke rehab researchers co-led by Drs. Mark Bayley, Medical Director, Brain and Spinal Cord Rehab Program, Toronto Rehab and Steven Wolf of Emory University, is the result of a five-year process which aimed to make the Stroke Rehabilitation Guidelines more accessible to clinicians.
ViaTherapy translates the guidelines to a decision-making algorithm for occupational therapists and physiotherapists to use with their patients.
"The right treatment for a patient today may not be the right treatment for them in three weeks," says Dr. Bayley. "In a sports setting, a good coach will always progress training as the player gets better. We tried to capture how a clinician should also evolve therapy to involve new treatments depending on how far along the patient is in their recovery."
The app's internal algorithm considers information inputted by the clinician: how long it has been since the patient's stroke, how severe their impairment is and whether they have any additional medical conditions. Based on these factors, it offers a list of suggestions of which rehabilitation exercises would best promote progress for the patient, such as assessments of certain movements and electrical stimulation for motor recovery.
According to Dr. Bayley, earlier research showed that because clinicians commit a large portion of their workdays to patient care, they often don't have the capacity to search the literature for evidence-based therapies, or didn't necessarily have the confidence to evaluate existing research on their own.
"After processing vast amounts of rehab literature, we created this app which would close that gap," says Dr. Steven Wolf, Professor, Department of Rehabilitation Medicine, Emory University School of Medicine. "ViaTherapy will assist clinicians in recalling established therapies and learning about new ones."
From experience using the app personally and with Occupational Therapy students, Debbie Hebert, Clinic Lead for the Rocket Family Upper Extremity Clinic at Toronto Rehab, says this is a great tool for clinicians of all experience levels.
"It saves you a step – instead of looking through the evidence, it brings you to it right away which allows you to go into the techniques," says Hebert, who is also the Practice Lead in Occupational Therapy at Toronto Rehab.
"It doesn't take the art of physiotherapy or occupational therapy away in any way," she says. "The choice is still up to the clinician. This just helps you make sure you're considering all of the treatment options for your particular patient."
While the app is only available for stroke patients with upper extremity movement loss, Dr. Bayley sees an opportunity to one day expand it to various areas of rehabilitation medicine.
"This type of application has the potential to support clinicians who work with patients with Multiple Sclerosis, spinal cord injury and many other conditions that limit movement," he says. "In order to give the patient the best treatment available, this is how rehabilitation medicine should present its guidelines."