Brain injury rehab forced online by Covid, with surprising results

The Covid-19 pandemic has left many of us feeling trapped, but consider the impact on people with severe brain injuries who were already trapped by their condition.

Every year, thousands of people acquire brain injuries through stroke, accidents, tumours and assaults. Overnight, the pandemic cut off access to the face-to-face rehabilitation patients urgently need so they can live a normal life again.

It could have been a disaster but new research shows the temporary solutions put in place because of the virus have worked better than anyone imagined. New vistas for treating patients have opened up, so much so that one charity is putting “tele-rehab” on a permanent footing.

Three-quarters of those who used online services provided by Acquired Brain Injury Ireland (ABII) during the pandemic said they benefited from the experience, according to its research.

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Two-thirds found it easy to make the switch to online rehab, and a similar proportion expressed the wish to continue to use the technology as part of their future treatment.

Forced online

Deirdre O’Brien is one of 1,200 patients who was forced to go online for her rehab therapy from ABII once the pandemic hit a year ago.

The challenge of recovering from a stroke three years ago was made even greater when she and her husband contracted Covid-19 (though they were never tested) and had to spend a month in isolation.

“After two weeks in bed, I felt very weak and I was stiff as a board,” she recalls. “If I don’t keep up the exercises, my walking and hand and arm movement start to regress.”

From being a rare phone user, she is now "constantly on Zoom". She does the charity's exercise classes twice a week, as well as sessions in mindfulness and a baking class, all from her home near the Phoenix Park in Dublin. She also joins her friends in their Zumba class, attends Pilates and wellness classes with the National Rehabilitation Hospital and fits in regular sing-songs and poetry readings.

With staff from Connolly Hospital Blanchardstown and the HSE stroke unit staying in regular contact, the 64-year-old says she is “doing really well. I’ve continued to make progress and my walking is much better.”

ABII’s services highlight the important role of not-for-profits in providing help for patients. Ireland has less than half the number of rehab beds required for the population and a “dearth” of long-term community supports, according to a report to be published on Monday.

Neuro-rehabilitation services have deteriorated further since poor levels of access were reported in 2015, the Neurological Alliance of Ireland report finds, and the pandemic has worsened the situation.

Permanent footing

ABII is putting its online services on a permanent footing, with funding from Comic Relief. The Rehabilitation Anywhere project adds video conferencing and other digital media apps to existing services to provide a lifeline for acquired brain injury patients across the country.

"This may not have been on the agenda before the health crisis, but through the creative responses of our teams, and the adaptability of the individuals we work with, we have uncovered a new neuro-rehabilitation solution that really works," says Dr Karen Foley, national services manager at ABII.

“Looking ahead to a post-Covid world, there is clearly a significant role for technology to play alongside our face-to-face services.”