One in six people will have a stroke in their lifetime, according to Public Health England, while two thirds of stroke survivors leave hospital with a disability.

The road to recovering lost or damaged functions can be long and arduous; and is likely to involve a cast of healthcare professionals in a range of settings.

Optimising outcomes against the many complexities of post-stroke rehab – plus resource pressures and the disparate nature of some services – is a major UK healthcare challenge.

Stroke Active believes it has the tonic for smoother and more positive journeys from the immediate aftermath of a stroke back towards normality, or the closest possible point.

Its app, named Innovation of the Year Award at the 2019 European Neuro Convention, aims to improve patient self-management, as well as communication among stroke professionals.

It also empowers all parties with a clear set of tasks and supports remote monitoring of the patient’s progress.

Managing director Erika Pearce says: “My father-in-law suffered a severe stroke in April 2017.

“We moved him into a private rehab facility and he’s now recovered to the point where he’s living independently.

“It’s clear to us that without this intensive rehab he wouldn’t be leading the life he is now.

“While the in-patient rehab team were fantastic, they only have a certain amount of resource and the same is true of a lot of community teams.

“Stroke affects over a hundred thousand people in the UK each year and we wanted to tackle some of these long-standing issues.

“These include the need for patient self-management through a clear rehab program, the gap between in-patient and out-patient rehab, the difficulty in finding local therapists with neuro experience, the strain placed on family members and the absence of a readily available multi-disciplinary platform.

“The response thus far has been fantastic.”

Certainly self-management has been identified as an area of concern by the NHS.

In the stroke part of its Long Term Plan, announced in January, it states the need for “more support with self-management and navigation post-stroke for patients and carers”.

The Stroke Association’s landmark State of the Nation paper, meanwhile, points to some of the other issues Stroke Active has in its sights.

It reports that only three out of 10 stroke survivors who need a six month assessment of their health and social care needs receive one.

It also shows that four out of 10 hospitals in England, Wales and Northern Ireland have a shortage of stroke consultants – and that only around half of stroke survivors are discharged from hospital having being assessed for all appropriate therapies and with agreed goals for their rehabilitation.

Of course, the stroke survivor’s family can also face immense challenges – which Stroke Active is also aiming to alleviate.

Stroke Association data shows that 40 per cent of stroke carers feel exhausted, while as many as a third of them receive no emotional support following their loved one’s stroke.

Perhaps the connectedness Stroke Active potentially gives the carers to professionals, as well as the patient, may help to feel better supported.

The patient is able to choose up to two representatives, including family members or carers, to access the app and help to support their rehabilitation.

Users set themselves up as a patient/representative or as a therapist, with two different dashboards for each group. Therapists are required to enter their HCPC number when registering.

Patients or their representatives are given access to a directory of neuro physios, occupational therapists (OTs) and speech and language therapists (SLTs) closest to their postcode.

By pressing ‘Connect’, that patient will appear in the list of pending connection requests on that therapist’s dashboard.

Once connected and after an initial assessment, the therapist can set daily or weekly tasks for the patient to complete.

The patient can tick these off on their ‘Task Manager’ and the whole team can track their progress.

Each patient’s message board allows them and all team members to communicate with each other on that patient’s progress, ask questions and post web link.

“We’ve also included a video function which allows more complex exercises to be recorded and labelled on a patient’s device and played back at their leisure,” says Erika.

Several years of development preceded the launch Stroke Active in January 2019.

“We engaged a third party developer on the project two years ago.

“We spoke to a cross section of patients, family members, neuro physios, OTs and speech and SLTs throughout the development of Stroke Active and continue to do so with the intention of continually improving the platform.

“Stroke Active has been entirely self funded and we placed huge emphasis on GDPR compliance… We are in the process of formally announcing NHS trials with several Trusts.

“The aim of these trials is to quantify the benefits of using Stroke Active through empirical as well as anecdotal evidence.

“We’re engaged with many other national organisations who have been enthusiastic and supportive.

“Aside from the problems we’re already addressing, there may be other ancillary benefits to using Stroke Active.

“We’ll be looking for evidence of this during the NHS Trials too. Patient’s mental health has only recently begun to be discussed.

“Having a support network of qualified therapists and family members who can all respond remotely and efficiently would seem to be helpful.”

Erika believes there is also scope to expand the app beyond stroke care for use with other conditions.

“It’s become clear that the problems we’re trying to address through Stroke Active are common to other conditions requiring neuro-rehab.

“There’s been substantial interest from the field of acquired brain injury.

“Any lack of organisation during the first few months of a brain injury occurs at the worst possible time. We don’t pretend that Stroke Active is for every neuro-rehab patient.

“We’ve tried to make the app as intuitive as possible; my father in law accepts he’s useless with all forms of technology and he finds Stroke Active very easy to use.

“The therapists we’ve spoken to also find the patient dashboard very user friendly.

“Ultimately, the funding pressures on the NHS are significant and the provision of patient care varies dramatically from Trust to Trust.

“Many patients turn to private practitioners for help. Stroke Active can be used by both NHS and private therapists.”

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