Social Network Structure Is Related to Functional Improvement From Home-Based Telerehabilitation After Stroke

Authors

Archana Podury, Harvard Medical School
Sophia M. Raefsky, University of California, Irvine
Lucy Dodakian, University of California, Irvine
Liam McCafferty, Brigham and Women's Hospital
Vu Le, University of California, Irvine
Alison McKenzie, Chapman UniversityFollow
Jill See, University of California, Irvine
Robert J. Zhou, University of California, Irvine
Thalia Nguyen, University of California, Irvine
Benjamin Vanderschelden, University of California, Irvine
Gene Wong, University of California, Irvine
Laila Nazarzai, University of California, Irvine
Jutta Heckhausen, University of California, Irvine
Steven C. Cramer, University of California, Irvine
Amar Dhand, Harvard Medical School

Document Type

Article

Publication Date

2-2-2021

Abstract

Objective: Telerehabilitation (TR) is now, in the context of COVID-19, more clinically relevant than ever as a major source of outpatient care. The social network of a patient is a critical yet understudied factor in the success of TR that may influence both engagement in therapy programs and post-stroke outcomes. We designed a 12-week home-based TR program for stroke patients and evaluated which social factors might be related to motor gains and reduced depressive symptoms.

Methods: Stroke patients (n = 13) with arm motor deficits underwent supervised home-based TR for 12 weeks with routine assessments of motor function and mood. At the 6-week midpoint, we mapped each patient's personal social network and evaluated relationships between social network metrics and functional improvements from TR. Finally, we compared social networks of TR patients with a historical cohort of 176 stroke patients who did not receive any TR to identify social network differences.

Results: Both network size and network density were related to walk time improvement (p = 0.025; p = 0.003). Social network density was related to arm motor gains (p = 0.003). Social network size was related to reduced depressive symptoms (p = 0.015). TR patient networks were larger (p = 0.012) and less dense (p = 0.046) than historical stroke control networks.

Conclusions: Social network structure is positively related to improvement in motor status and mood from TR. TR patients had larger and more open social networks than stroke patients who did not receive TR. Understanding how social networks intersect with TR outcomes is crucial to maximize effects of virtual rehabilitation.

Comments

This article was originally published in Frontiers in Neurology, volume 12, in 2021. https://doi.org/10.3389/fneur.2021.603767

This scholarship is part of the Chapman University COVID-19 Archives.

Recommended Citation

Podury A, Raefsky SM, Dodakian L, et al. Social network structure is related to functional improvement from home-based telerehabilitation after stroke. Front Neurol. 2021;12:603767. https://doi.org/10.3389/fneur.2021.603767

Peer Reviewed

1

Copyright

The authors

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This work is licensed under a Creative Commons Attribution 4.0 License.