Abstract TP322: Beyond the Clinic: Early Outcomes from a Fully Virtual Outpatient Stroke Rehabilitation Model

Stroke is a leading cause of disability, with ~800,000 cases annually in the U.S. Upper extremity (UE) dysfunction affects 85% of survivors, creating personal, economic, and caregiver burdens. Mobility issues affect at least 60% of survivors. Access to rehabilitation remains limited, especially in underserved populations where transportation and caregiver demands impede therapy. Conventional occupational therapy (OT) often falls short of delivering the high-dose, high-intensity rehabilitation (HDHIR) needed for motor recovery, while programs like constraint-induced movement therapy face feasibility barriers. Emerging evidence, including the VIGoROUS trial, supports alternative models that reduce therapist time yet achieve meaningful outcomes—paving the way for virtual approaches like Imago Rehab. This study evaluates the cost-effectiveness and clinical efficacy of Imago Rehab’s fully virtual OT and PT program relative to established HDHIR models (Ward, Daly). Methods: Observational cohort study of adults post-stroke enrolled ≥90 days in virtual OT (2x/week) or ≥60 days in virtual PT (2x/week). Exclusion criteria: severe cognitive/communication impairments. Recruitment was via physician referral and online outreach. Standardized measures included Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL), 5x Sit to Stand, and Timed Up and Go, assessed pre- and post-intervention. Costs were tracked through CPT billing data. Results: Nineteen patients with chronic stroke were tracked and showed significant functional gains: +12 points UE FMA, +1.6 MAL, –15.5s 5x Sit to Stand, –15.1s Timed Up and Go after 8–12 weeks. All participants received personalized home programs with adherence tracking. Conclusions: Imago Rehab’s virtual model delivers meaningful motor and functional improvements at substantially lower cost than in-person HDHIR programs. Eliminating clinic overhead and equipment needs supports value-based care, while reducing transportation and caregiver strain increases accessibility. A 1:1 therapy model enhances engagement and patient-centered care. Value&Impact: Results demonstrate that meaningful gains can be achieved with fewer direct therapy hours, emphasizing behavioral self-management and aligning with contemporary rehabilitation models. Imago Rehab’s virtual approach offers an innovative, scalable solution to bridge care gaps and improve long-term outcomes for stroke survivors. Further research should confirm sustainability across broader populations.