Content » Vol 51, Issue 9

Original report

Factors associated with willingness to use eRehabilitation after stroke: A cross-sectional study among patients, informal caregivers and healthcare professionals

Berber Brouns, Jorit J.L. Meesters, Manon M. Wentink, Arend J. de Kloet , Henk J. Arwert , Liesbeth W. Boyce, Thea P.M. Vliet Vlieland, Leti van Bodegom-Vos
Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands. E-mail:
DOI: 10.2340/16501977-2586


Objective: Despite the increasing availability of
eRehabilitation, its use remains limited. The aim of this study was to assess factors associated with willingness to use eRehabilitation.
Design: Cross-sectional survey.
Subjects: Stroke patients, informal caregivers, health-care professionals.
Methods: The survey included personal characteristics, willingness to use eRehabilitation (yes/no) and barri-ers/facilitators influencing this willingness (4-point scale). Barriers/facilitators were merged into factors. The association between these factors and willingness to use eRehabilitation was assessed using logistic regression analyses.
Results: Overall, 125 patients, 43 informal caregivers and 105 healthcare professionals participated in the study. Willingness to use eRehabilitation was positively influenced by perceived patient benefits (e. g. reduced travel time, increased motivation, better outcomes), among patients (odds ratio (OR) 2. 68; 95% confidence interval (95% CI) 1. 34–5. 33), informal caregivers (OR 8. 98; 95% CI 1. 70–47. 33) and healthcare professionals (OR 6. 25; 95% CI 1. 17–10. 48). Insufficient knowledge decreased willingness to use eRehabilitation among pa-tients (OR 0. 36, 95% CI 0. 17–0. 74). Limitations of the study include low response rates and possible response bias.
Conclusion: Differences were found between patients/informal caregivers and healthcare professionals. Ho-wever, for both groups, perceived benefits of the use of eRehabilitation facilitated willingness to use eRehabili-tation. Further research is needed to determine the benefits of such programs, and inform all users about the potential benefits, and how to use eRehabilitation.

Lay Abstract

The use of digital eRehabilitation after stroke (e.g. in serious games, e-consultation and education) is increasing. However, the use of eRehabilitation in daily practice is limited. As a first step in increasing the use of
eRehabilitation in stroke care, this study examined which factors influence the willingness of stroke patients, informal caregivers and healthcare professionals to use eRehabilitation. Beliefs about the benefits of eRehabilitation were found to have the largest positive impact on willingness to use eRehabilitation. These benefits included reduced travel time, increased adherence to therapy or motivation, and better health outcomes. The willingness to use eRehabilitation is limited by a lack of knowledge about how to use eRehabilitation.


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