NeuroRehabilitation OnLine (NROL): Description of a multidisciplinary group telerehabilitation innovation for stroke and neurological conditions using the TIDieR checklist

BackgroundProviding recommended amounts of rehabilitation for stroke and neurological patients is challenging. Telerehabilitation is viable for delivering rehabilitation and an acceptable adjunct to in-person therapy. NeuroRehabilitation OnLine (NROL) was developed as a pilot and subsequently operationalised as a regional innovation embedded across four National Health Service (NHS) Trusts. ObjectiveTo describe the NROL innovation to assist future implementation and replication efforts. MethodsThe Template for Intervention Description and Replication (TIDieR) checklist, with guidance from the TIDieR-Telehealth extension, was used to describe NROL. The description was developed collaboratively by clinical-academics, therapists, managers, and researchers. Updated Consolidated Framework for Implementation Research domains were used to describe the context in which the innovation was delivered. ResultsNROL delivers online group-based real-time neurorehabilitation with technology assistance. It incorporates multidisciplinary targeted therapy and peer support to complement existing therapy. Procedures, materials and structure are detailed to demonstrate how NROL is embedded within a healthcare system. NROL uses existing NHS therapy workforce alongside dedicated NROL roles, including an essential technology support role. Selection of NROL groups is dependent on patient need. The NROL innovation is tailored over time in response to feedback. NROL described here is situated within a regional stroke and neurorehabilitation network, aligns with local and national strategies, and capitalises on an existing clinical-academic partnership. ConclusionThis comprehensive description of a regional NROL innovation, and clarification of core components, should facilitate other healthcare settings to adapt and implement NROL for their context. Continuous evaluation alongside implementation will ensure maximal impact for neurorehabilitation.