# data[].attributes.body
Haleem, A., Javaid, M., Singh, R. P., & Suman, R. (2021). Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sensors International, 2(2), 100117. https://doi.org/10.1016/j.sintl.2021.100117

Hege, I., Tolks, D., Kuhn, S., & Shiozawa, T. (2020). Digital skills in healthcare. GMS Journal for Medical Education, 37(6), Doc63. https://doi.org/10.3205/zma001356

Hwang, N.-K., Park, J.-S., & Chang, M.-Y. (2021). Telehealth Interventions to Support Self-Management in Stroke Survivors: A Systematic Review. Healthcare, 9(4), 472. https://doi.org/10.3390/healthcare9040472

Lin, S. H., & Dionne, T. P. (2018). Interventions to Improve Movement and Functional Outcomes in Adult Stroke Rehabilitation: Review and Evidence Summary. Journal of Participatory Medicine, 10(1), e3. https://doi.org/10.2196/jopm.8929

Maeder, A. J., & Wilson, L. S. (2017). Chapter 25 Evaluating Telehealth Interventions. In www.ncbi.nlm.nih.gov. University of Victoria. https://www.ncbi.nlm.nih.gov/books/NBK481616/

May, C., Mort, M., Mair, F., & Williams, T. (2001). Factors affecting the adoption of telehealthcare in the United Kingdom: the policy context and the problem of evidence. Health Informatics Journal, 7(3-4), 131–134. https://doi.org/10.1177/146045820100700304

Meinert, E., Alturkistani, A., Brindley, D., Knight, P., Wells, G., & de Pennington, N. (2018). Weighing benefits and risks in aspects of security, privacy and adoption of technology in a value-based healthcare system. BMC Medical Informatics and Decision Making, 18(1). https://doi.org/10.1186/s12911-018-0700-0

Moorman, B. A., & Cockle, R. A. (2013). Medical Device Integration Using Mobile Telecommunications Infrastructure. Biomedical Instrumentation & Technology, 47(3), 224–232. https://doi.org/10.2345/0899-8205-47.3.224

Naqvi, I. A., Cheung, Y. K., Strobino, K., Li, H., Tom, S. E., Husaini, Z., Williams, O. A., Marshall, R. S., Arcia, A., Kronish, I. M., & Elkind, M. S. V. (2022). TASC (Telehealth After Stroke Care): a study protocol for a randomized controlled feasibility trial of telehealth-enabled multidisciplinary stroke care in an underserved urban setting. Pilot and Feasibility Studies, 8, 81. https://doi.org/10.1186/s40814-022-01025-z

NHS. (2019). Service specification for early supported discharge. https://www.england.nhs.uk/london/wp-content/uploads/sites/8/2019/07/str-service-spec-esd-062015.pdf

NICE. (2010, June 29). Overview | Stroke in Adults | Quality Standards | NICE. Nice.org.uk; NICE. https://www.nice.org.uk/Guidance/QS2

NICE. (2013, June 12). Support and follow-up | Information for the public | Stroke rehabilitation in adults | Guidance | NICE. Nice.org.uk; NICE. https://www.nice.org.uk/guidance/cg162/ifp/chapter/Support-and-follow-up

NICE. (2016, April 12). Quality Statement 2: Intensity of Stroke Rehabilitation | Stroke in Adults | Quality Standards | NICE. Www.nice.org.uk. https://www.nice.org.uk/guidance/qs2/chapter/Quality-statement-2-Intensity-of-stroke-rehabilitation

NICE. (2018). Principles for Putting evidence-based Guidance into Practice. NICE. https://www.nice.org.uk/Media/Default/About/what-we-do/Into-practice/Principles-for-putting-evidence-based-guidance-into-practice.pdf

NICE. (2022, January). What is the prevalence of stroke and TIA in the UK? NICE. https://cks.nice.org.uk/topics/stroke-tia/background-information/prevalence/

Ninnis, K., Van Den Berg, M., Lannin, N. A., George, S., & Laver, K. (2018). Information and communication technology use within occupational therapy home assessments: A scoping review. British Journal of Occupational Therapy, 82(3), 141–152. https://doi.org/10.1177/0308022618786928

ONS. (2022, August 5). What Actions Are People Taking Because of the Rising Cost of living? - Office for National Statistics. Www.ons.gov.uk. https://www.ons.gov.uk/peoplepopulationandcommunity/personalandhouseholdfinances/expenditure/articles/whatactionsarepeopletakingbecauseoftherisingcostofliving/2022-08-05

ONS. (2023). Cost of living insights - Office for National Statistics. Www.ons.gov.uk. https://www.ons.gov.uk/economy/inflationandpriceindices/articles/costoflivinginsights/spending

Pandit, A. A., Mahashabde, R. V., Brown, C. C., Acharya, M., Shoults, C. C., Eswaran, H., & Hayes, C. J. (2023). Association between broadband capacity and telehealth utilization among Medicare Fee-for-service beneficiaries during the COVID-19 pandemic. Journal of Telemedicine and Telecare, 1357633X2311660. https://doi.org/10.1177/1357633x231166026

Parsons, J. G. M., Plant, S. E., Slark, J., & Tyson, S. F. (2016). How active are patients in setting goals during rehabilitation after stroke? A qualitative study of clinician perceptions. Disability and Rehabilitation, 40(3), 309–316. https://doi.org/10.1080/09638288.2016.1253115

Pentland, D., Kantartzis, S., Clausen, M., & Witemyre, K. (2018a). Occupational therapy and complexity: defining and describing practice. In RCOT. https://www.rcot.co.uk/sites/default/files/OT%20and%20complexity.pdf

Pentland, D., Kantartzis, S., Clausen, M., & Witemyre, K. (2018b). Occupational therapy and complexity: defining and describing practice. In RCOT (p. 12). https://www.rcot.co.uk/sites/default/files/OT%20and%20complexity.pdf

Rangachari, P., Mushiana, S. S., & Herbert, K. (2021). A Narrative Review of Factors Historically Influencing Telehealth Use across Six Medical Specialties in the United States. International Journal of Environmental Research and Public Health, 18(9), 4995. https://doi.org/10.3390/ijerph18094995

RCOT. (2022). Digital occupational therapy - RCOT. Www.rcot.co.uk. https://www.rcot.co.uk/practice-resources/occupational-therapy-topics/digital-first-occupational-therapy

RCOT. (2023). Assessments and Outcome Measures - RCOT. Www.rcot.co.uk. https://www.rcot.co.uk/practice-resources/occupational-therapy-topics/assessments-and-outcome-measures

Rowland, T. J., Cooke, D. M., & Gustafsson, L. A. (2008). Role of occupational therapy after stroke. Annals of Indian Academy of Neurology, 11(1), 99–107.

Sim, S., Barr, C. J., & George, S. (2014). Comparison of equipment prescriptions in the toilet/bathroom by occupational therapists using home visits and digital photos, for patients in rehabilitation. Australian Occupational Therapy Journal, 62(2), 132–140. https://doi.org/10.1111/1440-1630.12121

Snoswell, C. L., Taylor, M. L., Comans, T. A., Smith, A. C., Gray, L. C., & Caffery, L. J. (2020). Determining if Telehealth Can Reduce Health System Costs: Scoping Review. Journal of Medical Internet Research, 22(10), e17298. https://doi.org/10.2196/17298

Sobhi-Gharamaleki, N., & Rajabi, S. (2010). Efficacy of life skills training on increase of mental health and self esteem of the students. Procedia - Social and Behavioral Sciences, 5, 1818–1822. https://doi.org/10.1016/j.sbspro.2010.07.370

South Carolina ETV. (2022, August 9). Telerehabilitation Improves Access to Specialty Stroke Care. Www.youtube.com. https://www.youtube.com/watch?v=aZdDxi0SDac

Stroke Association. (2012). Occupational therapy after stroke. https://www.stroke.org.uk/sites/default/files/occupational_therapy_after_stroke.pdf

Stroke Association . (2019). Rebuilding lives after stroke Work after stroke Background. https://www.stroke.org.uk/sites/default/files/jn_1920.276a_-_pps_-_work_after_stroke.pdf

The Kings Fund. (2021, February 26). NHS waiting times. The King’s Fund. https://www.kingsfund.org.uk/projects/positions/nhs-waiting-times

Totten, A. M., McDonagh, M. S., & Wagner, J. H. (2020). The Evidence Base for Telehealth: Reassurance in the Face of Rapid Expansion During the COVID-19 Pandemic. In PubMed. Agency for Healthcare Research and Quality (US). https://www.ncbi.nlm.nih.gov/books/NBK557174/

Townsend, E., & A.Wilcock, A. (2004). Occupational Justice and Client-Centred Practice: A Dialogue in Progress. Canadian Journal of Occupational Therapy, 71(2), 75–87. https://doi.org/10.1177/000841740407100203

Wilcock, A. A. (1998). An occupational perspective of health. Slack, Inc.

Wilcock, A., & Townsend, E. (2000). Occupational terminology interactive dialogue. Journal of Occupational Science, 7(2), 84–86. https://doi.org/10.1080/14427591.2000.9686470

‌

# data[].attributes.body
Abildgaard, J. S., Saksvik, P. Ø., & Nielsen, K. (2016). How to Measure the Intervention Process? An Assessment of Qualitative and Quantitative Approaches to Data Collection in the Process Evaluation of Organizational Interventions. Frontiers in Psychology, 7. https://doi.org/10.3389/fpsyg.2016.01380

Allison, B. A., Rea, S., Mikesell, L., & Perry, M. F. (2021). Adolescent and parent perceptions of telehealth visits: A mixed-methods study. Journal of Adolescent Health, 70(3). https://doi.org/10.1016/j.jadohealth.2021.09.028

Appleby, E., Gill, S. T., Hayes, L. K., Walker, T. L., Walsh, M., & Kumar, S. (2019). Effectiveness of telerehabilitation in the management of adults with stroke: A systematic review. PLOS ONE, 14(11), e0225150. https://doi.org/10.1371/journal.pone.0225150

Bakas, T., Jessup, N. M., McLennon, S. M., Habermann, B., Weaver, M. T., & Morrison, G. (2015). Tracking patterns of needs during a telephone follow-up programme for family caregivers of persons with stroke. Disability and Rehabilitation, 38(18), 1780–1790. https://doi.org/10.3109/09638288.2015.1107767

Bashir, A. (2020). Stroke and Telerehabilitation: A Brief Communication. JMIR Rehabilitation and Assistive Technologies, 7(2), e18919. https://doi.org/10.2196/18919

Battineni, G., Baldoni, S., Chintalapudi, N., Sagaro, G. G., Pallotta, G., Nittari, G., & Amenta, F. (2020). Factors affecting the quality and reliability of online health information. DIGITAL HEALTH, 6, 205520762094899. https://doi.org/10.1177/2055207620948996

Blachman, N. L., Lee, Y. S., Arcila‐Mesa, M., Ferris, R., & Chodosh, J. (2021). The impact of a Friendly Telephone Calls program on visits with physicians during pandemic. Journal of the American Geriatrics Society, 69(11), 3061–3063. https://doi.org/10.1111/jgs.17403

Blundell, N., Clarke, A., & Mays, N. (2010). Interpretations of referral appropriateness by senior health managers in five PCT areas in England: a qualitative investigation. Quality and Safety in Health Care, 19(3), 182–186. https://doi.org/10.1136/qshc.2007.025684

Breckenridge, J., & Jones, D. (2015). Evaluation in everyday occupational therapy practice: Should we be thinking about treatment fidelity? British Journal of Occupational Therapy, 78(5), 331–333. https://doi.org/10.1177/0308022614562583

Brubacher, S. P., Gilligan, C., Burrows, K. S., & Powell, M. B. (2019). Information Gathering in Investigative and Medical Interviewing: Drawing Parallels Across Contexts. Health Communication, 1–8. https://doi.org/10.1080/10410236.2019.1700884

Caffery, L. J., Farjian, M., & Smith, A. C. (2016). Telehealth interventions for reducing waiting lists and waiting times for specialist outpatient services: A scoping review. Journal of Telemedicine and Telecare, 22(8), 504–512. https://doi.org/10.1177/1357633x16670495

Calcaterra, V., Verduci, E., Vandoni, M., Rossi, V., Di Profio, E., Carnevale Pellino, V., Tranfaglia, V., Pascuzzi, M. C., Borsani, B., Bosetti, A., & Zuccotti, G. (2021). Telehealth: A Useful Tool for the Management of Nutrition and Exercise Programs in Pediatric Obesity in the COVID-19 Era. Nutrients, 13(11), 3689. https://doi.org/10.3390/nu13113689

Carrington, M., & Shahidul Islam, Md. (2022). The Use of Telehealth to Perform Occupational Therapy Home Assessments: An Integrative Literature Review. Occupational Therapy in Health Care, 1–16. https://doi.org/10.1080/07380577.2022.2056779

Chua, V., Koh, J. H., Koh, C. H. G., & Tyagi, S. (2022). The Willingness to Pay for Telemedicine Among Patients With Chronic Diseases: Systematic Review. Journal of Medical Internet Research, 24(4), e33372. https://doi.org/10.2196/33372

Clark, F. A., Parham, D., Carlson, M. E., Frank, G., Jackson, J., Pierce, D., Wolfe, R. J., & Zemke, R. (1991). Occupational science: academic innovation in the service of occupational therapy’s future. The American Journal of Occupational Therapy : Official Publication of the American Occupational Therapy Association, 45(4), 300–310. https://doi.org/10.5014/ajot.45.4.300

Collier, R. (2017). NHS ransomware attack spreads worldwide. Canadian Medical Association Journal, 189(22), E786–E787. https://doi.org/10.1503/cmaj.1095434

Collins , B. (2020). Technology and innovation for long-term health conditions. The Kings Fund .

Cunningham, P., Turton, A. J., Van Wijck, F., & Van Vliet, P. (2016). Task-specific reach-to-grasp training after stroke: development and description of a home-based intervention. Clinical Rehabilitation, 30(8), 731–740. https://doi.org/10.1177/0269215515603438

Eroğlu, M. (2020). Occupational therapy assessment and treatment approach in patients with subacute and chronic stroke: A single-blind, prospective, randomized clinical trial. Turkish Journal of Physical Medicine and Rehabilitation, 66(3), 316–328. https://doi.org/10.5606/tftrd.2020.4321

Gajarawala, S., & Pelkowski, J. (2020). Telehealth benefits and barriers. The Journal for Nurse Practitioners, 17(2), 218–221. https://doi.org/10.1016/j.nurpra.2020.09.013

Gallagher, M., Muldoon, O. T., & Pettigrew, J. (2015). An Integrative Review of Social and Occupational Factors Influencing Health and Wellbeing. Frontiers in Psychology, 6(1281). https://doi.org/10.3389/fpsyg.2015.01281

Geller, S. (2020). Cultivating online therapeutic presence: strengthening therapeutic relationships in teletherapy sessions. Counselling Psychology Quarterly, 34(3-4), 1–17. https://doi.org/10.1080/09515070.2020.1787348

Goldstein, F., & Glueck, D. (2016). Developing Rapport and Therapeutic Alliance During Telemental Health Sessions with Children and Adolescents. Journal of Child and Adolescent Psychopharmacology, 26(3), 204–211. https://doi.org/10.1089/cap.2015.0022

GOV.UK. (2018, August 7). Outcome evaluation: evaluation in health and wellbeing. GOV.UK. https://www.gov.uk/guidance/evaluation-in-health-and-wellbeing-outcome

# data[].attributes.body
Occupational alienation is the feeling of disconnectedness and feeling meaningless in life (Townsend & A. Wilcock, 2004). If someone’s basic life skills have been removed from them due to an illness it will create these feelings. This can trigger other complications such as depression and socially disconnecting with others (Sobhi-Gharamaleki & Rajabi, 2010). An example of this an individual not participating in family days out due to having poor mobility as a result of a stroke. Another occupational injustice that can be avoided from using goal setting within this service is occupational deprivation. This term is used to describe a person being deprived of taking part in meaningful activities due to factors out of their control (Wilcock, 1998). An example of this within stroke rehabilitation is a patient not being able to feed their grandchild due to having minimal activity in their upper right limb, more specifically the left hand.

# data[].attributes.body
Occupational injustice is defined as an individual experiencing barriers impacting their participation or performance within their chosen occupations (Wilock and Townsend, 2000). There are multiple types of occupational injustice that individuals can encounter from having suffered a stroke.

# data[].attributes.body
Occupational Science is the belief that human beings are occupational beings. Occupations are things that matter to individuals and these are unique to everyone human (Clarke et al., 1991). A key objective in occupational science is to understand why occupations are important, the obstacles that may interfere with participation of occupations, as well as the relationship between occupations and health (Gallagher et al., 2015).

# data[].attributes.body
A negative that may arise from using telecommunication within stroke rehabilitation is the building of rapport between patients and healthcare professionals will be limited due to the lack of face-to-face contact. It was concluded in a study by Goldstein & Glueck, (2016) that there is not enough evidence to support the building of a good relationship with patients using telecommunication techniques. Geller, (2020) also backs this point with signifying that more research needs to be made to gather a true interpretation. Although a mixed method study piloted by Allison et al., (2021) presented evidence that challenges Goldstein & Glueck (2016) findings exclaiming through survey’s both adolescents and their parents found to have built a positive therapeutic relationship with a paediatrician during video call visits. Even though this supports the building of therapeutic relationships through telecommunications, it cannot be generalised to stroke rehabilitation as the study was conducted using adolescents instead of adults.

# data[].attributes.body
Telehealth services are found to be a modernised way of communicating and providing care to service users in need (Calcaterra et al., 2021). Due to this the adoption of these services has had a slow progression because of political factors (May et al., 2001). For services to be implemented within healthcare there must be evidence that supports the implementation of the service. This is known as evidence-based practice (NICE, 2018). However, due to the lack of policies behind telehealth services, there is limited funding for research to be generated to provide support on the use of telehealth (May et al., 2001). Even though there is some evidence-based practice to support the use of telehealth majority of studies conducted are done on a small scale implying that generalisation to the rest of the UK is impacted (Totten et al., 2020).

# data[].attributes.body
As previously mentioned to use telehealth services within stroke rehabilitation patients must have suitable devices such as a computer and broadband that would allow for this to happen (Pandit et al., 2023). A third of stroke survivors of working age do not return to work due to the impacts they have experienced post-stroke therefore meaning there are financial implications to that person’s household (Stroke Association , 2019). Due to financial implications experienced some stroke patients may find difficulties with acquiring suitable devices that would allow telehealth services to function (Chua et al., 2022). Currently, in the UK there is a cost-of-living crisis that has affected 89% of adults in the UK population (ONS, 2022) and because of this, it has been reported that 68% of adults have decreased their spending on non-essential items (ONS, 2023). With a high proportion of stroke survivors already having financial concerns post-stroke, the cost-of-living crisis impacts this further.

# data[].attributes.body
During this final stage of the OT process the OT will establish if the patients’ rehabilitation goals have been met and if further rehabilitation is necessary from the community neuro team (NHS, 2019). Currently, this discharge process is done face-to-face after the patient attending an appropriate time of ESD (NHS, 2019). Follow ups are performed through phone calls by a therapist. This is done so that the service user can provide an update on how they are managing in their home environment and if anything, more needs to be done to aid with completing ADL’s (NICE, 2016). This action could also be done through using video calling if necessary to the patient or the therapist (Naqvi et al., 2022).

# data[].attributes.body
The evaluation section of the OT process is used to evaluate if the interventions provided are progressing a patient back to their baseline (Abildgaard et al., 2016). During this section outcome measures could be used to do this (GOV.UK, 2018). An example of an outcome measure could be re-assessing a patient in a washing and dressing assessment to see if they can now reach and grab the shampoo bottle due to the quality of the reach and grasp task provided. It gives OT’s a clear guide on if interventions need to be adjusted for the benefit of the patient (Breckenridge & Jones, 2015). To use telecommunications during this stage it would be difficult to gather information on if interventions have worked due to accuracy not being available unless the session was performed face to face (Maeder & Wilson, 2017). However, patients and OT’s could benefit from having phone calls between the intervention and evaluation stage for reassurance of if the intervention needs adapting earlier than planned or if the intervention is purely not appropriate in that specific stage of recovery (Bakas et al., 2015).

# data[].attributes.body
Interventions are used in stroke rehabilitation to help return patients back to their baseline (Lin & Dionne, 2018). For example, if a service user has weakness in the left upper limb and is struggling to wash and dress in a PADL assessment, interventions can be provided to build strength and sensation in both the hand and the arm. Interventions that may be used to do this are reach and grasp tasks or sensation stimulation tasks (Cunningham et al., 2016). These interventions provided by OT’s during the ESD stage could be provided and performed using video calling if applicable (Hwang et al., 2021). By doing this more patients that may be isolated from accessing services could be seen more regular by therapists (Appleby et al., 2019).

# data[].attributes.body
- What are assessments used for (RCOT, 2023).
- Common assessments used by an OT in stroke rehabilitation (Eroğlu, 2020).
- What types of telecommunication are already used in this part of the process (Sim et al., 2014)?
- What types of telecommunication could be used in this part of the process (Carrington & Shahidul Islam, 2022)?
- Potential negatives of using telecommunication during this part of the process (Ninnis et al., 2018).

# data[].attributes.body
Reason for referral and screening sections are the first parts of the OT process. They are traditionally used to identify the appropriateness of the service for each specific service user (Blundell et al., 2010). The information would be gathered during this time concentrating on previous medical history, the patient's baseline pre-stroke, the home environment and anything else that seems important (Pentland et al., 2018b). This information can be gathered from allied healthcare professionals (AHP’s) within the hospital and from the patient themselves if applicable. Information gathering is key when screening a service user as it identifies potential risks or barriers that may come apparent during the OT process (Brubacher et al., 2019). Currently, this part of the process is achieved by either face-to-face meetings or reading documentation. Using telecommunication strategies such as video calling would be beneficial during this part of the process as it would give OT’s the chance to gather high-quality (Haleem et al., 2021) information effectively to accelerate the process of the patient being discharged back home.

# data[].attributes.body
OT Process

# data[].attributes.body
Even though there are opportunities that can be taken from using telecommunications within stroke rehabilitation there are also some threats. Becoming heavily reliant on telecommunications to provide care can detrimental due to the unreliability of technology. There are issues could arise from using telecommunications such as Skype and Teams to have consultations and therapy sessions with patients. Issues such as poor internet connections or low quality of technological devices could result in inefficient meetings between healthcare staff and patients (Battineni et al., 2020). Another threat that may arise from using telecommunications is concerns raised about privacy and security of patients and staff (Meinert et al., 2018). In 2017 a cyber-attack that had affected 80 NHS trusts and more than 600 different NHS organisations in England had occurred due to the trust using Microsoft Windows as their computer system. This specific attack had interrupted the use of computers, patient care and the use of medical equipment putting patients a risk (Collier, 2017). This increase concerns that the likelihood of patient and staff data being beached to be a high risk (Meinert et al., 2018).

# data[].attributes.body
Using telecommunications within stroke rehabilitation there are opportunities that could develop that would enhance services. For example, it gives healthcare professionals the chance to progress their technology skills that are essential to a working life (Hege et al., 2020). These skills can then be transferred to other departments and roles within a hospital such as therapy teams who see outpatients (RCOT, 2022) and surgical consultants meeting with patients who have had recent surgery (Collins , 2020). Allowing for these skills to grow waiting times that have deepened since the coronavirus pandemic could reduce. In March 2022 it was found that around 300,000 people in the UK would be looking at waiting more than a year to receive planned care by the NHS (The Kings Fund, 2021). By advocating for a more digital NHS patients can be seen more efficiently by healthcare staff reducing the waiting list time (Caffery et al., 2016).

# data[].attributes.body
In this video a man is interviewed after using Telehealth during his stroke rehabilitation journey (South Carolina ETV, 2022).

# data[].attributes.attachment_link.title
Telerehabilitation Improves Access to Specialty Stroke Care

# data[].attributes.body
Goals are established from the indication of the baseline assessment conducted within the first 72 hours of the patient’s diagnosis (NICE, 2010) and from this, it means the goals created are specific to the patient's needs. The patient will be included in the goal-setting stage so they are aware of the targets that they can work towards within therapy sessions (Parsons et al., 2016). An example of a therapy session that is goal focused is to complete a washing and dressing assessment with minimal assistance from staff or to make a hot drink using a standard sequencing pattern. These are also identified as basic life skills that are meaningful and beneficial to the well-being of the patient.

# data[].attributes.body
The role of an OT within this service is vital due to delivering therapy sessions around building basic life skills that may have been impacted as the result of the stroke (Rowland et al.,2008). Therapy sessions will be if necessary focused around both physical and mental implications and will always be specific to the patient (Stroke Association, 2012). Occupation therapists work within the MDT to provide high quality rehabilitation to stroke patients through SMART goal setting (Stroke Association, 2012).

# data[].attributes.body
Stroke rehabilitation is a highly required service due to around 100,000 cases of strokes occurring each year in the UK (NICE, 2022). It has been found that strokes are beginning to occur at a younger age with the average age of males going from 70 to 68 and the average age of females going from 74 to 73 between the years of 2007 and 2016 (NICE, 2022). Within this service, there are many allied health professionals (AHP) working together to produce high-quality rehabilitation to stroke survivors. This includes occupational therapists. It is compulsory that intense stroke rehabilitation is provided in the hospital or community by a therapist for a minimum of 45 minutes a day, 5 days a week in the first 6 months post-stroke (NICE, 2016). If in the community, the Early Supported Discharge (ESD) team will provide this rehabilitation in the homes of patients who have had a stroke. Due to the high number of patients that experience a stroke and the generally low staffing numbers within the NHS, it is difficult to hit these requirements set out by NICE.

# data[].attributes.body
The telecommunications model is used in health care for many reasons. During the COVID-19 pandemic this method was used in high proportions to provide care to service users in a safe way (Blachman et al., 2021). It has found to be cost effective, efficient in increasing participation and efficient in increasing accessibility to patients who may not have the resources to be connected with healthcare (Marwaa et al., 2020). It is being recognised as a method to be used within stroke rehabilitation as patients are increasingly becoming more advanced with using technology (Kim & Kim, 2022).