ABSTRACT NUMBER: ESOC2026A1343 OUTCOMES OF HOME-BASED STRUCTURED TELE-REHABILITATION PROGRAM USING WHATSAPP MODEL FOR POST-STROKE PATIENTS: ANALYSIS FROM THE IMPETUS STROKE STUDY

Abstract Background and aims Rehabilitation services in developing countries are constrained by limited guidelines, low policy priority, workforce shortages, poor awareness, and financial and transport barriers. This study proposed and evaluated a low-cost, accessible tele-rehabilitation model for post-stroke patients in resource-limited settings. Methods IMPETUS-Stroke was a multicentric, prospective, multiphase, mixed-methods, quasi-experimental implementation study across 23 medical colleges in India. As part of the rehabilitation component, a WhatsApp-based tele-rehabilitation program was introduced for post-stroke patients after discharge. Tailored audio-visual training materials and short rehabilitation videos were developed with experts to support home-based therapy by patients and caregivers. Five structured video-sessions were delivered on days 7, 15, 30, and at 2 and 3 months post-discharge. Outcomes were assessed at discharge and post-intervention using the Barthel Index, Stroke Rehabilitation Assessment of Movement (STREAM), and Modified Rankin Scale (mRS). Results A total of 458 post-stroke patients (mean age 58.9 ± 14.1 years; 69% males) were enrolled; 62.2% had ischemic stroke. Mean session duration was 13-16 minutes. Completion rate was 53%, with non-completion due caregiver unavailability (12.0%), loss to follow up (10.0%), death (8.3%), unwillingness to participate (7.6%), lack of tele-communication devices (4.2%) and internet access (3.5%). Significant improvements were observed (P < 0.001): Barthel Index increased from 30 (IQR: 10-55) to 70 (IQR: 35-90), STREAM from 15 (IQR: 2-36) to 40 (IQR: 17-65), and mRS decreased from 5 (IQR: 4-6) to 3 (IQR: 1-4). Conclusions WhatsApp-based tele-rehabilitation is feasible and associated with significant functional gains after stroke. Randomized trials and systematic evaluation of implementation barriers are needed to optimize scalability in resource-constrained settings. Conflict of interest Shweta Gupta: Nothing to disclose.