Evidence base
22 studies
Stroke telerehabilitation review
1,937 participants
Included in the 2020 Cochrane review
Virtual occupational therapy consultation in California
Support between and beyond therapy
When therapy ends or isn't enough, knowing what to do next can feel overwhelming. This is where I help.
This service is designed for those who are:
- Transitioning between therapy services
- Recently discharged and need structured guidance at home
- Looking to continue progress beyond traditional care
Request a Consultation
Use the link below to request an appointment.
Not sure if this is the right fit?
I'm happy to answer questions before you book.
WHY THIS APPROACH WORKS
Research-backed virtual care in the home environment.
Stroke telerehabilitation research supports telehealth as an effective option, with outcomes comparable to in-person care in key areas while allowing treatment to focus on real-life routines at home.
Main finding
Similar outcomes to in-person therapy
Pooled comparisons found similar outcomes for daily activities, balance, and upper-limb function.
Why it matters
Designed for real-life carryover
Work on dressing, cooking, routines, and safety in your actual home environment—not a clinic setting.
Sources: Cochrane Review (2020), OT Telehealth Systematic Review (2025), Chen et al. (2015).
SERVICES
Virtual occupational therapy consultation for neurological recovery.
Virtual, 90 minutes
Neuro Consultation
A comprehensive occupational therapy consultation focused on improving functional performance, independence, and daily routines following neurological injury or illness.
- Functional assessment of daily activities and routines
- Upper extremity assessment
- Cognitive and visual screening
- Identification of barriers to independence and functional carryover
- Personalized strategies to support function at home
- Equipment recommendations (if applicable)
Includes a written summary with individualized recommendations and a personalized home program. Particularly helpful for individuals transitioning between or following discharge.
Ideal if you're unsure what to focus on next or feel progress has stalled.
Virtual, 90 minutes
Home Safety & Accessibility Evaluation
A comprehensive evaluation of your home environment to improve safety, accessibility, and independence after illness or injury.
- Assessment of home setup for safety and accessibility
- Identification of fall risks and environmental barriers
- Recommendations for modifications, equipment, and positioning
- Practical strategies to support independence and caregiver safety
Includes a written summary with personalized recommendations based on real-time observation in your home environment.
Especially helpful after hospital or rehab discharge.
Virtual, 60 minutes
Follow-Up Sessions
- Progress tracking
- Program updates
- Ongoing support
Services are informed by over 15 years of clinical experience across hospital, outpatient, and home-based neurorehabilitation settings.
For continued guidance, accountability, and program adjustments.
About
About Sarah
Sarah Ernst McPeak is an occupational therapist with over 15 years of experience in neurological rehabilitation across acute care, inpatient rehabilitation, outpatient, and home/community-based settings. She has worked with leading organizations including Stanford Health Care and Rehab Without Walls, specializing in helping individuals recover and function safely in real-world environments.
- Advanced training in neurorehabilitation (NDT)
- Extensive experience supporting complex recovery transitions
- Lecturer and fieldwork educator
Specialized Expertise
- Certified in Neuro-Developmental Treatment (NDT) for adults with stroke and brain injury
- Clinical specialist in neurorehabilitation technology (Saebo), focused on upper extremity recovery
- Certified in Physical Agent Modalities
- Certified Ergonomic Assessment Specialist
WHAT TO EXPECT
You will leave with clear next steps for continued progress.
What to expect
- Interactive and practical
- Focused on your real home environment
- Designed to create clear next steps
- A personalized plan
- Exercises and strategies
- Services are private pay (not billed to insurance), allowing for flexible, individualized care.
Contact
Have Questions?
If you're unsure whether this is the right fit or would like to discuss your needs before scheduling, you're welcome to reach out directly at sarah@otconsult.org.