Telerehabilitation Decision Support System: Pilot Testing Protocol

Inclusion Criteria

• •Age 40-80 years
• •community dwelling able to walk 500-m independently or with a stick
• •Depression subscale on Hospital Anxiety and Depression Scale \<10/21 (14-item questionnaire)
• •No significant visual impairment (as self-reported by participants)
• •Willing to comply with study procedures, proposed training and testing regime
• •With capacity to consent
• •No acute musculoskeletal or other injuries that would prevent participation in a structured exercise program
• •Is not currently, and has not in the past 8-weeks received any falls/balance/vestibular and/or cognitive rehabilitation.
• •Does not any implanted medical devices or a cardiac pacemaker.
• •Does not have any other co-existing neurological conditions (ie. Multiple sclerosis, Parkinson's disease, neuropathy etc.)
• •Does not have any language or communication deficits impairing their ability to communicate and/or express their thoughts.
• •Has at least one functional hand for grip function and computer use.
• •Fulfilling all of the criteria from one of the below sub-groups
• •STROKE COHORT who will fulfil the additional criteria:
• •Individuals with diagnosis of focal ischaemic or haemorrhagic stroke, as confirmed by a clinical letter.
• •Onset \>/= 3 months prior to study.
• •Montreal Cognitive Assessment (MoCA) score n \>/=23
• •At risk of falls (i.e. Functional Gait Assessment FGA score \</=22/30; FGA is a validated quick balance task assessment) AND/OR having experienced a fall(s) in the last 12 months
• •MCI COHORT who will fulfil the additional criteria:
• •Individuals with new or existing formal diagnosis of MCI, according to the International Classification of Disease 10 (ICD10) , as confirmed by a clinical letter.
• •At risk of falls (FGA \</= 22/30) AND/OR having experienced a fall(s) in the last 12 months.
• •VESTIBULAR COHORT who will fulfill the additional criteria
• •Montreal Cognitive Assessment (MoCA) score n \>/=23
• •Individuals with a diagnosis of a vestibular disorder (peripheral and/or mixed peripheral and central):
• •Peripheral vestibular disorder in which the balance problem lies in the vestibular/balance system within the inner ear.
• •Mixed vestibular disorder in which the balance problem lies in the vestibular/balance system within the inner ear (peripheral) and involving the nerves or neuronal network in the brain/brainstem responsible for balance (central).
• •Chronic dizziness and/or unsteadiness (\>/= 3 months duration) that started at the time or after the vestibular disorder diagnosis.
• •Dizziness handicap inventory (DHI \>34) AND/OR At risk of falls (FGA \</=22/30)
• •LONG COVID-19 COHORT who will fulfill the additional criteria:
• •Montreal Cognitive Assessment (MoCA) score n \>/=23
• •Individuals with laboratory confirmed diagnosis of Covid (\>/=6 months prior to study onset), as confirmed by a clinical letter.
• •Who have been diagnosed with long Covid, as confirmed by a clinical letter.
• •Who have chronic dizziness and/or unsteadiness which started after the Covid illness (self-report by the patient; duration \</=3 months).
• •Dizziness handicap inventory (DHI \>34) AND/OR At risk of falls (FGA \</=22/30)
• •Unable to provide a clinical letter confirming diagnosis.
• •For those with stroke, no visual spatial neglect.