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Lin WTM, Lin BS, Lee IJ, Lee SH. Development of a Smartphone-Based mHealth Platform for Telerehabilitation. IEEE Trans Neural Syst Rehabil Eng 2022; 30:2682-2691. [PMID: 36063516 DOI: 10.1109/tnsre.2022.3204148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Telerehabilitation is becoming increasingly valuable as a method for expanding medical services. The smartphone-based mHealth platform (SMPT) has been developed to provide high-quality remote rehabilitation through a smartphone and inertial measurement units. The SMPT uses smartphone as a main platform with connection to medical backend server to provide telerehabilitation. Patients would be referred to therapists to receive a tutorial of exercise technique prior to conducting their home exercise. Once patients begin their home exercises, they can report any problems instantly through the SMPT. The medical staff can adjust the exercise program according to patient feedback and the data collected by the SMPT. After completing the exercise program, patients visit their clinician for re-evaluation. A Service User Technology Acceptability Questionnaire from both medical professional and public perspective revealed a high level of agreement on enhanced care, increased accessibility, and satisfaction and a moderate level of agreement on the use of this platform as a substitute for traditional rehabilitation. Concerns about privacy and discomfort were low in the medical professional and public groups. Concerns about care personnel were also significantly different between the two groups. The SMPT is a promising system for providing telerehabilitation as an adjunct to traditional rehabilitation, which may result in improved outcomes compared with those achieved when using traditional rehabilitation alone.
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Renard M, Gaboury I, Michaud F, Tousignant M. The acceptability of two remote monitoring modalities for patients waiting for services in a physiotherapy outpatient clinic. Musculoskeletal Care 2022; 20:616-624. [PMID: 35142425 DOI: 10.1002/msc.1622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/25/2022] [Accepted: 01/29/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Access to public rehabilitation services for patients with non-urgent conditions - which suffer mainly from musculoskeletal disorders - is problematic around the world. Remote rehabilitation services are recognized as effective means to increase accessibility. Patient acceptability is an important element in the successful implementation of such clinical innovations and has not yet been studied thoroughly in this context. Thus, the aim of this study was to evaluate and compare the acceptability of two remote consultation modalities - phone and teleconsultation - for patients waiting for public outpatient non-urgent rehabilitation services. METHODS We conducted a qualitative descriptive study nested within a randomized clinical trial in which participants received either phone or teleconsultation follow-ups with a physiotherapist after a first systematic face-to-face evaluation. Semi-structured interviews were conducted with participants of both groups selected with purposive sampling. Sekhon's acceptability metaframework was used and interviews were transcribed and coded with thematic analysis. ETHIC APPROVAL The research protocol was approved by the Research Ethics Board of the Centre intégré universitaire de santé et de services sociaux - Centre hospitalier universitaire de Sherbrooke (CIUSSS de l'Estrie - CHUS) (#2019-2919). RESULTS Twenty participants were recruited. Results show both follow-up modalities have a good level of acceptability for participants; however, teleconsultation stands out because its visual dimension offers higher quality human contact and satisfactorily meets greater needs for support. CONCLUSION Systematic in-person assessment and advice combined with telephone or teleconsultation follow-up can contribute to diversifying the services offered in physiotherapy outpatient clinics. Offering a range of service modalities with different resource requirements may shorten wait times. Such an approach seems to be well accepted by patients, especially with teleconsultation. CLINICALTRIALS gov ID: NCT03991858.
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Affiliation(s)
- Marianne Renard
- Research Centre on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (CIUSSS de l'Estrie CHUS), Sherbrooke, Quebec, Canada
| | - Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Faculty of Medecine and Health Sciences, Université de Sherbrooke, Longueuil, Quebec, Canada
| | - François Michaud
- Department of Electrical Engineering and Computer Engineering, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Michel Tousignant
- Research Centre on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (CIUSSS de l'Estrie CHUS), Sherbrooke, Quebec, Canada
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Sanchez-Ramirez DC, Pol M, Loewen H, Choukou MA. Effect of telemonitoring and telerehabilitation on physical activity, exercise capacity, health-related quality of life and healthcare use in patients with chronic lung diseases or COVID-19: A scoping review. J Telemed Telecare 2022:1357633X221122124. [PMID: 36045633 PMCID: PMC9434200 DOI: 10.1177/1357633x221122124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Telemonitoring and telerehabilitation can support home-based pulmonary rehabilitation (PR) and benefit patients with lung diseases or COVID-19. This study aimed to (1) identify which telemonitoring and telerehabilitation interventions (e.g. videoconferencing) are used to provide telehealth care for people with chronic respiratory conditions or COVID-19, and (2) provide an overview of the effects of telemonitoring and telerehabilitation on exercise capacity, physical activity, health-related QoL (HRQoL), and healthcare use in patients with lung diseases or COVID-19. METHODS A search was performed in the electronic databases of Ovid MEDLINE, EMBASE, and Cinahl through 15 June 2021. Subject heading and keywords were used to reflect the concepts of telemonitoring, telerehabilitation, chronic lung diseases, and COVID-19. Studies that explored the effect of a telerehabilitation and/or telemonitoring intervention, in patients with a chronic lung disease such as asthma, chronic obstructive pulmonary diseases (COPD), or COVID-19, and reported the effect of the intervention in one or more of our outcomes of interest were included. Excluding criteria included evaluation of new technological components, teleconsultation or one-time patient assessment. RESULTS This scoping review included 44 publications reporting the effect of telemonitoring (25 studies), telerehabilitation (8 studies) or both (11 studies) on patients with COPD (35 studies), asthma (5 studies), COPD and asthma (1 study), and COVID-19 (2 studies). Patients who received telemonitoring and/or telerehabilitation had improvements in exercise capacity in 9 out of 11 (82%) articles, better HRQoL in 21 out of 25 (84%), and fewer health care use in 3 out of 3 (100%) articles compared to pre-intervention. Compared to controls, no statistically significant differences were found in the intervention groups' exercise capacity in 5 out 6 (83%) articles, physical activity in 3 out of 3 (100%) articles, HRQoL in 21 out of 25 (84%) articles, and healthcare use in 15 out of 20 (75%) articles. The main limitation of the study was the high variability between the characteristics of the studies, such as the number and age of the patients, the outcome measures, the duration of the intervention, the technological components involved, and the additional elements included in the interventions that may influence the generalization of the results. CONCLUSION Telemonitoring and telerehabilitation interventions had a positive effect on patient outcomes and appeared to be as effective as standard care. Therefore, they are promising alternatives to support remote home-based rehabilitation in patients with chronic lung diseases or COVID-19.
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Affiliation(s)
- Diana C Sanchez-Ramirez
- Department of Respiratory Therapy, Rady
Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Margriet Pol
- Department of Occupational Therapy,
Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied
Sciences, The Netherlands
| | - Hal Loewen
- Neil John Maclean Health Sciences
Library, University of Manitoba, Canada
| | - Mohamed-Amine Choukou
- Department of Occupational Therapy,
Rady Faculty of Health Science, University of Manitoba, Canada
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Lam AK, Fung OH, Kwan C, Cheung JP, Luk KD, Chiu AY, Descarreaux M, Szeto GP, Wong AY. The Concerns and Experiences of Patients With Lumbar Spinal Stenosis Regarding Prehabilitation and Recovery After Spine Surgery: A Qualitative Study. Arch Rehabil Res Clin Transl 2022; 4:100227. [PMID: 36545515 PMCID: PMC9761253 DOI: 10.1016/j.arrct.2022.100227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objectives To improve our understanding of patients' perspectives regarding: (1) the decision-making and prehabilitation before lumbar spinal stenosis (LSS) surgery and (2) their postoperative experiences. Design Qualitative research with semi-structured interviews. Setting General community. Participants Individuals who received (N=10) and who did not receive (N=15) prehabilitation before LSS surgery were recruited at the 6-month postoperative follow-up (8 females; average age: 67.7±6.7 years) by purposive sampling. Additionally, 1 participant invited her daughter to accompany her in an interview. Interventions Not applicable. Main Outcome Measures Concerns and experiences of patients with LSS regarding prehabilitation and recovery after spine surgery. Results Thematic analysis was conducted to identify 4 themes inductively: (1) sources of information about LSS surgery; (2) factors affecting the surgical decision-making; (3) attitudes toward prehabilitation; and (4) postoperative recovery. All participants desired to have more preoperative education to inform their surgical decision-making. There were mixed opinions regarding the perceived benefits of prehabilitation because some individuals hesitated to participate in prehabilitation because of their symptoms, or the cost or time of traveling. Many participants expected some or even complete relief of LSS-related symptoms after surgery. However, not all participants experienced the expected postoperative improvements. Some participants only experienced temporary symptomatic relief, while others experienced new postoperative symptoms. Patients generally found that postoperative exercises taught by physiotherapists were useful although their compliance decreased over time. Conclusions Our study highlights the need for better preoperative LSS education. Because face-to-face prehabilitation or postoperative rehabilitation may not be feasible for all patients, future studies should explore whether online-based prehabilitation or postoperative rehabilitation may benefit certain patient subgroups.
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Affiliation(s)
- Alan K.H. Lam
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China,Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Olivia H.Y. Fung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Crystal Kwan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Jason P.Y. Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Keith D.K. Luk
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Alice Y.Y. Chiu
- Department of Physiotherapy, Duchess of Kent Children's Hospital, Hong Kong SAR, China
| | - Martin Descarreaux
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Grace P.Y. Szeto
- School of Medical and Health Sciences, Tung Wah College, Hong Kong SAR, China
| | - Arnold Y.L. Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China,Corresponding author Arnold Y.L. Wong, PhD, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, SAR, China.
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Anghelescu A. Telerehabilitation: A Practical Remote Alternative for Coaching and Monitoring Physical Kinetic Therapy in Patients with Mild and Moderate Disabling Parkinson's Disease during the COVID-19 Pandemic. PARKINSON'S DISEASE 2022; 2022:4370712. [PMID: 35979169 PMCID: PMC9377913 DOI: 10.1155/2022/4370712] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/27/2022] [Accepted: 07/22/2022] [Indexed: 11/18/2022]
Abstract
Background The COVID-19 pandemic imposed social/physical distancing, lockdown measures, and forced reorientation of the rehabilitation programs for people with Parkinson's disease (PD). Epidemiologic safety measures boosted remote exercise-based treatment. Objectives Remote delivery of rehabilitation care services is not typically used in our department. Therefore, this study aimed to assess and implement a telehealth physical rehabilitation program tailored for outpatients with idiopathic PD and slight or medium functional limitations. Methods A prospective study was performed on a group of outpatients with idiopathic PD, selected from the database of the neurorehabilitation clinic of the Emergency Teaching Hospital "Bagdasar-Arseni." We studied 17 patients (5 women and 12 men), aged between 54-70 years (average 65.9 ± 4.87), with a disease history of 7.3 ± 3.6 (years), with mild or moderate disabling clinical forms, quantified by an average Hoehn and Yahr score of 2.3 ± 0.35 (limits 1.5-3). All patients underwent pharmacologic treatment with unchanged doses throughout the study. No patients had disabling osteoarticular problems (all could walk independently) and had no significant psycho-cognitive dysfunction. Patients were supervised and coached online in tandem by the therapist and physician. In addition, a family member assisted and supervised the patient's performance and coordinated the technical electronic procedures. Walking biodynamics was assessed by timing "6-meters walking" and "Get up and walk 3 meters" (TUG) tests. Each person attended ten sessions of motor telerehabilitation procedures (2 per week) lasting 50 minutes each during social distancing (October-December 2021). Results None of the patients was at increased risk of falling. They all improved their locomotor performance, reflected in a significant decrease in TUG duration (the initial average time improved from 13.50 seconds to 10.57). The telerehabilitation program also significantly improved the average walking speed (initially, 44.5 cm/sec and finally, it raised to 56.8 cm/sec). Discussion. The TUG and "6-meters walking" tests are helpful tools for a global biodynamic remote assessment of PD patients. Limitations of the study: a small group of selected patients, restrictive working conditions (due to epidemiological social/physical restrictions and no direct physiotherapist-patient contact), and need for supervision by an attendant to assist the subject and perform the audio-video transmission. Further studies are necessary to identify the optimal web-based model of care and boost the implementation of this modern neurorehabilitation concept. Conclusions Telemedicine turned the virtual space into a new reality and may compensate for the restrictions imposed on face-to-face meetings in pandemic conditions. Moreover, with modern telecommunication techniques, a regular and individualized physical kinetic rehabilitation program can be performed even in pandemic conditions. Remote delivery of kinetic motor programs was appropriate for selected groups of PD patients.
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Affiliation(s)
- Aurelian Anghelescu
- “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Neurorehabilitation Clinic, Teaching Emergency Hospital “Bagdasar-Arseni”, Berceni Av., No. 12, Postal Code: 041915, 4th Sector, Bucharest, Romania
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106
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Calvo-Paniagua J, Díaz-Arribas MJ, Valera-Calero JA, Gallardo-Vidal MI, Fernández-de-las-Peñas C, López-de-Uralde-Villanueva I, del Corral T, Plaza-Manzano G. A tele-health primary care rehabilitation program improves self-perceived exertion in COVID-19 survivors experiencing Post-COVID fatigue and dyspnea: A quasi-experimental study. PLoS One 2022; 17:e0271802. [PMID: 35926004 PMCID: PMC9352012 DOI: 10.1371/journal.pone.0271802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/24/2022] [Indexed: 11/19/2022] Open
Abstract
Background Current evidence suggests that up to 70% of COVID-19 survivors develop post-COVID symptoms during the following months after infection. Fatigue and dyspnea seem to be the most prevalent post-COVID symptoms. Objective To analyze whether a tele-rehabilitation exercise program is able to improve self-perceived physical exertion in patients with post-COVID fatigue and dyspnea. Methods Sixty-eight COVID-19 survivors exhibiting post-COVID fatigue and dyspnea derived to four Primary Health Care centers located in Madrid were enrolled in this quasi-experimental study. A tele-rehabilitation program based on patient education, physical activity, airway clearing, and breathing exercise interventions was structured on eighteen sessions (3 sessions/week). Self-perceived physical exertion during daily living activities, dyspnea severity, health-related quality of life and distance walked and changes in oxygen saturation and heart rate during the 6-Minute walking test were assessed at baseline, after the program and at 1- and 3-months follow-up periods. Results Daily living activities, dyspnea severity and quality of life improved significantly at all follow-ups (p<0.001). Additionally, a significant increase in oxygen saturation before and after the 6-Minute Walking test was found when compared with baseline (P<0.001). Heart rate adaptations at rest were found during the follow-up periods (P = 0.012). Lower perceived exertion before and after the 6-Minute Walking test were also observed, even if larger distance were walked (P<0.001). Conclusion Tele-rehabilitation programs could be an effective strategy to reduce post-COVID fatigue and dyspnea in COVID-19 survivors. In addition, it could also reduce the economic burden of acute COVID-19, reaching a greater number of patients and releasing Intensive Unit Care beds for prioritized patients with a severe disease. Study registration The international OSF Registry registration link is https://doi.org/10.17605/OSF.IO/T8SYB.
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Affiliation(s)
- José Calvo-Paniagua
- Gerencia Asistencial Atención Primaria de Madrid, Centro de Salud Dr. Castroviejo, Madrid, Spain
| | - María José Díaz-Arribas
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
- * E-mail:
| | - Juan Antonio Valera-Calero
- VALTRADOFI Research Group, Department of Physical Therapy, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, Spain
| | | | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Ibai López-de-Uralde-Villanueva
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Tamara del Corral
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
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107
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Influence de la crise sanitaire COVID-19 sur la perception de la télérééducation dans la population des kinésithérapeutes français, une étude qualitative. KINÉSITHÉRAPIE, LA REVUE 2022. [PMCID: PMC8498688 DOI: 10.1016/j.kine.2021.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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108
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Li G, Zhang X, Zhang G. How the 5G Enabled the COVID-19 Pandemic Prevention and Control: Materiality, Affordance, and (De-)Spatialization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158965. [PMID: 35897336 PMCID: PMC9332237 DOI: 10.3390/ijerph19158965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 12/04/2022]
Abstract
5G, the most disruptive innovation, had played a significant role in the COVID-19 pandemic prevention and control. However, as a novel technology and context, we have little knowledge about how 5G enabled pandemic prevention and control. This study collected 212 cases and conducted qualitative research to explore how the 5G worked in prevention and control. Based on the concepts of materiality and affordance, we grounded two affordances of spatialization and de-spatialization from the data. Spatialization provides non-contact ways to complete the tasks which are supposed to be completed in contact, and de-spatialization provides remote operations to complete the tasks which are supposed to be completed on-site. Spatialization and de-spatialization enabled the diagnosis and treatment of the infectors to relieve the unbalance of medical staff, cutting the infectious route to contain the viral spread, and logistic supply to support the prevention and control. Our study offers theoretical contributions to digital pandemic prevention and control, and the literature on 5G also offers practical implications.
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Begnoche BR, David Butler C, Carson PH, Darr A, Jenkins MT, Le T, McDaniel RB, Mourad H, Shipman CJ, Stratton TP, Tran K, Wong KK. ASHP Statement on Telehealth Pharmacy Practice. Am J Health Syst Pharm 2022; 79:1728-1735. [PMID: 35866463 DOI: 10.1093/ajhp/zxac188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | | | | | - Trinh Le
- UNC Health Care, Raleigh, NC, USA
| | | | | | | | | | | | - Kong Kit Wong
- VA Capitol Health Care Network (VISN 5), Washington, DC, USA
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Herold F, Theobald P, Gronwald T, Rapp MA, Müller NG. Going digital - a commentary on the terminology used at the intersection of physical activity and digital health. Eur Rev Aging Phys Act 2022; 19:17. [PMID: 35840899 PMCID: PMC9287128 DOI: 10.1186/s11556-022-00296-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022] Open
Abstract
In recent years digital technologies have become a major means for providing health-related services and this trend was strongly reinforced by the current Coronavirus disease 2019 (COVID-19) pandemic. As it is well-known that regular physical activity has positive effects on individual physical and mental health and thus is an important prerequisite for healthy aging, digital technologies are also increasingly used to promote unstructured and structured forms of physical activity. However, in the course of this development, several terms (e.g., Digital Health, Electronic Health, Mobile Health, Telehealth, Telemedicine, and Telerehabilitation) have been introduced to refer to the application of digital technologies to provide health-related services such as physical interventions. Unfortunately, the above-mentioned terms are often used in several different ways, but also relatively interchangeably. Given that ambiguous terminology is a major source of difficulty in scientific communication which can impede the progress of theoretical and empirical research, this article aims to make the reader aware of the subtle differences between the relevant terms which are applied at the intersection of physical activity and Digital Health and to provide state-of-art definitions for them.
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Affiliation(s)
- Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476, Potsdam, Germany.
| | - Paula Theobald
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476, Potsdam, Germany
| | - Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany
| | - Michael A Rapp
- Research Focus Cognitive Sciences, Division of Social and Preventive Medicine, University of Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany
| | - Notger G Müller
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476, Potsdam, Germany
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111
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Improvement in motor symptoms, physical fatigue, and self-rated change perception in functional motor disorders: a prospective cohort study of a 12-week telemedicine program. J Neurol 2022; 269:5940-5953. [PMID: 35809125 PMCID: PMC9552134 DOI: 10.1007/s00415-022-11230-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 11/14/2022]
Abstract
Background Functional motor disorders (FMDs) are highly disabling conditions associated with long-term disability, poor quality of life, and economic burden on health and social care. While multidisciplinary 5-days rehabilitation programs have been shown to reduce motor and non-motor symptoms, long-term management and monitoring in FMDs remain an unmet need. Aim To compare a 12-weeks telemedicine program against a 12-weeks self-management program after a 5-days rehabilitation program for improving motor, non-motor symptoms, quality of life, and perception of change in patients with FMDs. Methods The study population was 64 consecutive patients with a definite diagnosis of FMDs who underwent a 5-days in-person rehabilitation program followed by either a self-management (the first 32 patients) or a telemedicine program (the latter 32 patients). Validated measures of motor and non-motor symptoms such as fatigue and pain, quality of life, perception of change, gait, and postural control were recorded before (T0), after completion of rehabilitation (T1), and then again at 3 months (T2). Results Improvement at 3-month follow-up assessment of motor symptoms (p < 0.001), physical fatigue (p = 0.028), and self-rated change perception (p = 0.043) was greater in the telemedicine group. No different between-groups effect was found on other dimensions of fatigue, pain, physical and mental health, and gait and postural control. Conclusions Long-term management and expert monitoring of patients with FMDs via telemedicine may enhance long-term outcomes in motor symptoms and physical fatigue, with a positive long-term impact on self-rated health perception of change.
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112
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Qvarfordt M, Nilsson E, Nilsson L. Healthcare professionals’ experiences in telehabilitation: a qualitative study (Preprint). JMIR Hum Factors 2022; 10:e40690. [PMID: 37074772 PMCID: PMC10157457 DOI: 10.2196/40690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 02/17/2023] [Accepted: 02/26/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND The use of digital communication in Swedish health care has increased in an effort to make health care more accessible. At the organizational level, trust in digitalization has stabilized, but a certain degree of skepticism regarding technology appears to exist among health care employees. OBJECTIVE This study aimed to explore health care professionals' (HCPs) experiences of digital communication with patients and colleagues in a habilitation context. METHODS Qualitative content analysis was used to analyze data derived from individual interviews. RESULTS The results revealed that there were mixed feelings regarding the digital format used at the habilitation center. Although some skepticism remained regarding the digital format, there seemed to be a parallel understanding of the motives and benefits of digitalization. Hence, positive aspects, such as increased health care accessibility, were identified. However, emphasis was placed on the considerations required to make digital consultations appropriate for each patient. CONCLUSIONS Managing a workday influenced by the balance between digital and physical demands forces HCPs to adjust to the digital format and new ways of working. This requires HCPs to consider whether digital means are appropriate for communication in individual patient-specific cases.
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Affiliation(s)
- Maria Qvarfordt
- eHealth Institute, Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
| | - Evalill Nilsson
- eHealth Institute, Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
| | - Lina Nilsson
- eHealth Institute, Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
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Christy B, Mahalakshmi M, Aishwarya TV, Jayaraman D, Das AV, Rani PK. Guidelines in establishing telerehabilitation services for people with vision impairment. Indian J Ophthalmol 2022; 70:2397-2400. [PMID: 35791119 PMCID: PMC9426198 DOI: 10.4103/ijo.ijo_1899_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Telerehabilitation is a viable option to provide continuum of rehabilitation intervention in situations like the ongoing pandemic. Presently, there is no policy guidelines to the minimum standard of telerehabilitation. This paper describes procedures for telerehabilitation for people with blindness and low vision from the evidence-based practices from a premier eye institute in South India. The suggested guidelines can help develop and replicate similar models of telerehabilitation to reach people in need in difficult situations like COVID 19 pandemic.
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Affiliation(s)
- Beula Christy
- Head of the Department, Institute for Vision Rehabilitation, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Mojjada Mahalakshmi
- Rehabilitation consultant, Institute for Vision Rehabilitation, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - T V Aishwarya
- Helpline Counsellor, Institute for Vision Rehabilitation, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Deiva Jayaraman
- Rehabilitation Consultant, Institute for Vision Rehabilitation, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Anthony Vipin Das
- Consultant Ophthalmologist, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Padmaja Kumari Rani
- Network Head, Tele-Ophthalmology, Consultant - Smt. Kanuri Santamma Retina Vitreous Service, LV Prasad Eye Institute, Hyderabad, Telangana, India
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Abstract
The telerehabilitation of patients with neurological lesions has recently assumed significant importance due to the COVID-19 pandemic, which has reduced the possibility of access to healthcare facilities by patients. Therefore, the possibility of exercise for these patients safely in their own homes has emerged as an essential need. Our efforts aim to provide an easy-to-implement and open-source methodology that provides doctors with a set of simple, low-cost tools to create and manage patient-adapted virtual reality telerehabilitation batteries of exercises. This is particularly important because many studies show that immediate action and appropriate, specific rehabilitation can guarantee satisfactory results. Appropriate therapy is based on crucial factors, such as the frequency, intensity, and specificity of the exercises. Our work’s most evident result is the definition of a methodology that allows the development of rehabilitation exercises with a limited effect in both economic and implementation terms, using software tools accessible to all.
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115
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Zheng J, Hou M, Liu L, Wang X. Knowledge Structure and Emerging Trends of Telerehabilitation in Recent 20 Years: A Bibliometric Analysis via CiteSpace. Front Public Health 2022; 10:904855. [PMID: 35795695 PMCID: PMC9251196 DOI: 10.3389/fpubh.2022.904855] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Telerehabilitation, as an effective means of treatment, is not inferior to traditional rehabilitation, and solves the problem of many patients who do not have access to hospital-based training due to costs and distance. So far, the knowledge structure of the global use of telerehabilitation has not been formed. This study aimed to demonstrate the state of emerging trends and frontiers concerning the studies of telerehabilitation through bibliometric software. Methods Literature about telerehabilitation from 2000 to 2021 was retrieved from the Web of Science Core Collection. We used CiteSpace 5.8.R3 to analyze the publication years, journals/cited journals, countries, institutions, authors/cited authors, references, and keywords. Based on the analysis results, we plotted the co-citation map to more intuitively observe the research hotspots and knowledge structure. Results A total of 1,986 records were obtained. The number of annual publications gradually increased over the investigated period. The largest increase occurred between 2019 and 2020. J TELEMED TELECARE was the most prolific and the most cited journal. The United States was the most influential country, with the highest number of publications and centrality. The University of Queensland was the most productive institution. The author Tousignant M ranked the highest in the number of publications and Russell TG ranked the first in the cited authors. Respectively, the articles published by Cottrell MA and Russell TG ranked the first in the frequency and centrality of cited references. The four hot topics in telerehabilitation were “care”,“stroke”, “telemedicine” and “exercise”. The keyword “stroke” showed the strongest citation burst. The two frontier keywords were “physical therapy” and “participation”. The keywords were clustered to form 21 labels. Conclusion This study uses visualization software CiteSpace to provide the current status and trends in clinical research of telerehabilitation over the past 20 years, which may help researchers identify new perspectives concerning potential collaborators and cooperative institutions, hot topics, and research frontiers in the research field. Bibliometric analysis of telerehabilitation supplements and improves the knowledge field of telemedicine from the concept of rehabilitation medicine and provides new insights into therapists during the COVID-19 pandemic.
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Affiliation(s)
- Jiaqi Zheng
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Meijin Hou
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fuzhou, China
| | - Lu Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiangbin Wang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- *Correspondence: Xiangbin Wang
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Toohey K, Paterson C, Moore M, Hunter M. Towards best practice in the delivery of prescribed exercise via telehealth for individuals diagnosed with cancer: A randomised controlled trial protocol. Contemp Clin Trials 2022; 119:106833. [PMID: 35718307 PMCID: PMC9380644 DOI: 10.1016/j.cct.2022.106833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/07/2022] [Accepted: 06/11/2022] [Indexed: 11/26/2022]
Abstract
Introduction There is a plethora of evidence supporting the therapeutic effects of regular exercise for individuals diagnosed with cancer, particularly during active treatment. The COVID-19 pandemic has complicated delivery of face-to-face exercise programs for individuals with cancer, particularly as this cohort is at much higher risk of morbidity and mortality. The proposed randomised controlled trial explores best practice and assesses the feasibility of exercise programs delivered via Telehealth for individuals diagnosed with cancer. Methods Participants (n = 160) must have a current cancer diagnosis, must be undergoing active treatment, receive medical clearance, and have access to a smart device to participate in supervised exercise. Participants will be randomly assigned (two arms; 1:1) to supervised exercise delivered via Telehealth (Coviu) or usual care (receiving physical activity guidelines). Telehealth arm participants will receive an individualised program according to their health status, comorbidities, and exercise history, delivered weekly for eight weeks by an Accredited Exercise Physiologist in a group setting. Outcome measures will assess feasibility, psychological wellbeing, quality of life, symptom management, physical activity and fitness levels. A Telehealth arm participant sub-sample will have the opportunity to share their experience and feedback via an online interview at the intervention completion. Ethics and dissemination Outcomes from this study will create evidence to inform best practice for the safe delivery of exercise via Telehealth for individuals diagnosed with cancer. Evidence will be published in peer-reviewed journals and may be presented at national and international conferences. Ethics approval was obtained at the University of Canberra (Project ID: 4604. Version 2: 1st March 2022). Trial registration number: ANZCTR: ACTRN12620001054909. Universal Trial Number: U1111–1256-4083.
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Affiliation(s)
- Kellie Toohey
- Faculty of Health, University of Canberra, Bruce 2617, ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce 2617, Australia.
| | - Catherine Paterson
- Faculty of Health, University of Canberra, Bruce 2617, ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce 2617, Australia; Robert Gordon University, Aberdeen AB10 7QB, Scotland, UK
| | - Melanie Moore
- Faculty of Health, University of Canberra, Bruce 2617, ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce 2617, Australia
| | - Maddison Hunter
- Faculty of Health, University of Canberra, Bruce 2617, ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce 2617, Australia
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Chen N, Fong DYT, Wong JYH. Trends in Musculoskeletal Rehabilitation Needs in China From 1990 to 2030: A Bayesian Age-Period-Cohort Modeling Study. Front Public Health 2022; 10:869239. [PMID: 35784203 PMCID: PMC9240767 DOI: 10.3389/fpubh.2022.869239] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/29/2022] [Indexed: 01/07/2023] Open
Abstract
Background Disability and medical expenses caused by musculoskeletal disorders in China had a great impact on the global health and economy. Rehabilitation is essential for dealing with musculoskeletal disorders. However, China's musculoskeletal rehabilitation needs remain unknown. This study aimed to examine the secular trends for musculoskeletal rehabilitation needs in China from 1990 to 2030. Methods Data on musculoskeletal rehabilitation needs were extracted from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) repository. Estimated annual percentage changes (EAPCs) were calculated to reflect fluctuations in the age-standardized rates. The Bayesian age-period-cohort models were used to project rehabilitation needs. Results The number of prevalent cases and years lived with disability (YLD) counts in need of musculoskeletal rehabilitation increased greatly in China from 1990 to 2019. There will be 465.9 million Chinese people in need of rehabilitation, with the age-standardized prevalence rate increasing to 21,151.0 [2.5–97.5% predictive interval (95% PI) 14,872.6–27,429.3] per 100,000 persons in 2030. Similarly, the YLD counts will increase to 40.1 million, with the age-standardized YLD rate increasing to 1,811.2 (95% PI 1,232.5–2,390.0) per 100,000 persons in 2030. Conclusions Increasing trends in musculoskeletal rehabilitation needs were found from 1990 to 2019, which will be anticipated through 2030. Rehabilitation is suggested to be integrated into primary care settings.
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Leochico CFD, Perez MFJ, Mojica JAP, Ignacio SD. Telerehabilitation Readiness, Knowledge, and Acceptance of Future Physiatrists in the Philippines: An Online Survey During the COVID-19 Pandemic. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:921013. [PMID: 36188950 PMCID: PMC9397946 DOI: 10.3389/fresc.2022.921013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022]
Abstract
Background Clinical, educational, and research interest in telerehabilitation has not been widely explored until the COVID-19 pandemic. Amid the enduring pandemic, telerehabilitation remains part of the daily service, academic, and research responsibilities of residents in various training institutions worldwide. Objective To determine the Rehabilitation Medicine residents' current levels of telerehabilitation readiness, knowledge, and acceptance, their pattern of beliefs about telerehabilitation, and the factors affecting their readiness. Methods All bona fide residents from all training institutions in the Philippines were invited to participate in an online survey evaluating the following constructs: technological readiness (using the Technological Readiness Index or TRI 2.0); telerehabilitation knowledge (using an original multiple-choice examination); and telerehabilitation acceptance (using the Unified Theory of Acceptance and Use of Technology questionnaire). A pre-test and pilot test were conducted. The TRI responses were classified according to technology adoption segments to determine the respondents' pattern of beliefs about telerehabilitation. Results Sixty-two residents participated (86.1% response rate). They had good telerehabilitation readiness (3.3 ± 0.4 out of 5), fair telerehabilitation knowledge (2.1 ± 1.1 out of 5), and excellent telerehabilitation acceptance (4.5 ± 0.6 out of 5). The majority were classified either as telerehabilitation skeptics (38.7%), pioneers (19.4%), or explorers (19.4%). The factors that significantly influenced telerehabilitation readiness were optimism, innovativeness, discomfort, and insecurity (p < 0.05). Conclusion Despite having favorable levels of telerehabilitation readiness and acceptance, the Rehabilitation Medicine residents showed fair telerehabilitation knowledge. Our results suggest the need for formal education and training on virtual rehabilitation care during residency.
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Affiliation(s)
- Carl Froilan D. Leochico
- Department of Rehabilitation Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Department of Physical Medicine and Rehabilitation, St. Luke's Medical Center, Global City, Philippines
- *Correspondence: Carl Froilan D. Leochico ; orcid.org/0000-0003-2928-2083
| | - Marc Francis J. Perez
- Department of Rehabilitation Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Jose Alvin P. Mojica
- Department of Rehabilitation Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Sharon D. Ignacio
- Department of Rehabilitation Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Department of Physical Medicine and Rehabilitation, St. Luke's Medical Center, Global City, Philippines
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Mora‐Traverso M, Molina‐Garcia P, Prieto‐Moreno R, Borges‐Cosic M, Cruz Guisado V, Pino Algarrada R, Moreno‐Ramírez P, Gomez‐Jurado G, Gomez Tarrias C, Hidalgo Isla M, Jimenez Andrés P, Linares Gago M, Lirola‐Liebanas A, Mesa‐Ruiz A, Muñoz‐Garach A, Salazar‐Graván S, Estevez‐Lopez F, Martín‐Matillas M, Ariza‐Vega P. An m‐Health telerehabilitation and health education program on physical performance in patients with hip fracture and their family caregivers: Study protocol for the ActiveHip+ randomized controlled trial. Res Nurs Health 2022; 45:287-299. [DOI: 10.1002/nur.22218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Marta Mora‐Traverso
- Biohealth Research Institute (ibs.Granada) Physical Medicine and Rehabilitation Service Virgen de las Nieves University Hospital Granada Spain
| | - Pablo Molina‐Garcia
- Biohealth Research Institute (ibs.Granada) Physical Medicine and Rehabilitation Service Virgen de las Nieves University Hospital Granada Spain
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences Sport and Health University Research Institute (iMUDS), University of Granada Granada Spain
| | - Rafael Prieto‐Moreno
- Department of Physical and Sport Education, PA‐HELP “Physical Activity for HEaLth Promotion” Research Group, Faculty of Sports Sciences University of Granada Granada Spain
| | - Milkana Borges‐Cosic
- Department of Physical and Sport Education, PA‐HELP “Physical Activity for HEaLth Promotion” Research Group, Faculty of Sports Sciences University of Granada Granada Spain
- Department of Physical Education, Faculty of Education Sciences University of Cádiz Cádiz Spain
| | - Victor Cruz Guisado
- Department of Physical Medicine and Rehabilitation University Hospital Jerez de la Frontera Cadiz Spain
| | - Rogelio Pino Algarrada
- Department of Physical Medicine and Rehabilitation University Hospital Puerto Real Cadiz Spain
| | - Paz Moreno‐Ramírez
- Department of Physical Medicine and Rehabilitation University Hospital Virgen de las Nieves Granada Spain
| | - Gema Gomez‐Jurado
- Department of Physical Medicine and Rehabilitation University Hospital Virgen de las Nieves Granada Spain
| | - Consuelo Gomez Tarrias
- Department of Physical Medicine and Rehabilitation University Hospital Virgen de las Nieves Granada Spain
| | - Margarita Hidalgo Isla
- Department of Physical Medicine and Rehabilitation University Hospital Puerto Real Cadiz Spain
| | - Patricia Jimenez Andrés
- Department of Physical Medicine and Rehabilitation University Hospital Jerez de la Frontera Cadiz Spain
| | - Marta Linares Gago
- Department of Physical Medicine and Rehabilitation University Hospital Puerto Real Cadiz Spain
| | - Ana Lirola‐Liebanas
- Department of Physical Medicine and Rehabilitation University Hospital Virgen de las Nieves Granada Spain
| | - Antonio Mesa‐Ruiz
- Department of Physical Medicine and Rehabilitation University Hospital Virgen de las Nieves Granada Spain
| | - Araceli Muñoz‐Garach
- Department of Endocrinology and Nutrition University Hospital Virgen de las Nieves Granada Spain
| | - Susana Salazar‐Graván
- Department of Physical Medicine and Rehabilitation University Hospital Virgen de las Nieves Granada Spain
| | - Fernando Estevez‐Lopez
- Department of Child and Adolescent Psychiatry/Psychology Erasmus MC University Medical Center Rotterdam The Netherlands
| | - Miguel Martín‐Matillas
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences Sport and Health University Research Institute (iMUDS), University of Granada Granada Spain
| | - Patrocinio Ariza‐Vega
- Biohealth Research Institute (ibs.Granada) Physical Medicine and Rehabilitation Service Virgen de las Nieves University Hospital Granada Spain
- Department of Physical and Sport Education, PA‐HELP “Physical Activity for HEaLth Promotion” Research Group, Faculty of Sports Sciences University of Granada Granada Spain
- Department of Physiotherapy, Faculty of Health Science University of Granada Granada Spain
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Liu Y, Guo S, Yang Z, Hirata H, Tamiya T. A Home-based Tele-rehabilitation System with Enhanced Therapist-patient Remote Interaction: A Feasibility Study. IEEE J Biomed Health Inform 2022; 26:4176-4186. [PMID: 35594225 DOI: 10.1109/jbhi.2022.3176276] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
As a promising alternative to hospital-based manual therapy, robot-assisted tele-rehabilitation therapy has shown significant benefits in reducing the therapist's workload and accelerating the patient's recovery process. However, existing telerobotic systems for rehabilitation face barriers to implementing appropriate therapy treatment due to the lack of effective therapist-patient interactive capabilities. In this paper, we develop a home-based tele-rehabilitation system that implements two alternative training methods, including a haptic-enabled guided training that allows the therapist to adjust the intensity of therapeutic movements provided by the rehabilitation device and a surface electromyography (sEMG)-based supervised training that explores remote assessment of the patient's kinesthetic awareness. Preliminary experiments were conducted to demonstrate the feasibility of the proposed alternative training methods and evaluate the functionality of the developed tele-rehabilitation system. Results showed that the proposed tele-rehabilitation system enabled therapist-in-the-loop to dynamically adjust the rehabilitation intensity and provided more interactivity in therapist-patient remote interaction.
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121
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Özel M, Kaya Ciddi P. The effectiveness of telerehabilitation-based structured exercise therapy for chronic nonspecific neck pain: A randomized controlled trial. J Telemed Telecare 2022:1357633X221095782. [PMID: 35570728 DOI: 10.1177/1357633x221095782] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The aim of this research was to investigate the effects of telerehabilitation-based remote supervised or unsupervised structured exercise therapy on pain, disability, and quality of life related to chronic nonspecific neck pain. METHOD The study was designed as a single-blinded randomized controlled trial. Sixty-six eligible chronic nonspecific neck pain patients were randomized across three groups: remote supervised group (RSG, n = 22), unsupervised group (UG, n = 22), and waitlist control group (CG, n = 22). Progressive structured exercise therapy program was delivered weekly to patients in remote supervised group and unsupervised group to perform four days a week for four weeks. Remote supervised group was supervised by videoconference and text message. Pain, disability, and quality of life of participants were assessed at baseline, week 2, and post-therapy. RESULTS Post-therapy pain and disability total change scores were -3.64 (95% CI -4.85 to -2.42) and -7.27 (95% CI -11.05 to -3.50) for remote supervised group compared with a change of -2.44 (95% CI -3.46 to -1.43) and -5.77 (95% CI -8.54 to -3.01) for unsupervised group, respectively. Post-therapy, quality of life improvements were greater for remote supervised group than unsupervised group overall (general health; remote supervised group: 19.01 (95% CI 6.86 to 31.16), unsupervised group: 12.50 (95% CI 4.79 to 20.21), and physical health; remote supervised group: 18.35 (95% CI 10.35 to 26.35), unsupervised group: 7.31 (95% CI 0.01 to 14.60)). Significant improvements in psychological health and environment-telerehabilitation for remote supervised group were not seen for unsupervised group and outcomes differences did not reach significance for control group (p > 0.05) post-therapy, except environment-telerehabilitation. DISCUSSION Structured exercise therapy can improve chronic nonspecific neck pain outcomes when remotely supervised or unsupervised. Structured exercise therapy content and frequent communication are important for remote chronic nonspecific neck pain management.
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Affiliation(s)
- Merve Özel
- Physiotherapy and Rehabilitation Department, Medipol University, Health Sciences Institute, Istanbul, Turkey
| | - Pınar Kaya Ciddi
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, 218502Istanbul Medipol University, Istanbul, Turkey
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Tsang MP, Man GCW, Xin H, Chong YC, Ong MTY, Yung PSH. The effectiveness of telerehabilitation in patients after total knee replacement: A systematic review and meta-analysis of randomized controlled trials. J Telemed Telecare 2022:1357633X221097469. [PMID: 35549756 DOI: 10.1177/1357633x221097469] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Total knee replacement is a commonly adopted surgical intervention to reduce physical limitations and pain in advanced-stage knee osteoarthritis. However, these patients may experience physical dysfunction to limit their access during conventional rehabilitation after total knee replacement. The use of telemedicine may be the promising solution. This study aims to compare the effectiveness of telerehabilitation with conventional in-person rehabilitation in patients who underwent a total knee replacement. METHODS For this systematic review on randomized controlled trials, PubMed, Medline, EMBASE, Cochrane Library, ScienceDirect and CINAHL databases were searched for eligible articles published between 1 January 2003 and 28 February 2022. The eligibility criteria were patients who underwent total knee replacement, randomized controlled trials and publications in English. The main outcome measures were focused on pain and physical function. Reference lists of relevant studies were also manually checked to find additional studies. Two independent reviewers conducted study selection separately. PEDro scale was used to assess the methodological quality of the included randomized controlled trials. A meta-analysis was performed on the collected data. Review Manager (RevMan, version 5.3) was used for all analyses. RESULTS A total of 11 studies met the eligibility criteria and included 1825 participants in the systematic review. Overall, the results revealed that the effectiveness of telerehabilitation is comparable to conventional in-person rehabilitation in improving various pain and functional outcomes in patients who underwent a total knee replacement. In the meta-analysis with the fixed-effects model, no significant difference was found in the improvement of pain and physical function in patients with knee osteoarthritis compared with conventional rehabilitation (Standardized Mean Difference (SMD) -0.15, 95% CI -0.47 to 0.16, P = 0.34 and SMD -0.04, 95% CI -0.19 to 0.12, P = 0.62, respectively). In addition, the utilization of hospital resources and costs were significantly lower in telerehabilitation when compared with in-person rehabilitation. CONCLUSION Telerehabilitation was comparable to conventional in-person rehabilitation in improving clinical outcomes following total knee replacement. However, it might be a more preferable alternative rehabilitation intervention for patients following total knee replacement given the significantly lower cost of telerehabilitation.
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Affiliation(s)
- Mei Po Tsang
- Physiotherapy Department, 71150Tai Po Hospital, New Territory, Hong Kong
- Department of Orthopaedics & Traumatology, Faculty of Medicine, 26451The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Gene Chi Wai Man
- Department of Orthopaedics & Traumatology, Faculty of Medicine, 26451The Chinese University of Hong Kong, Shatin, Hong Kong
| | - He Xin
- Department of Orthopaedics & Traumatology, Faculty of Medicine, 26451The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yau Chun Chong
- Department of Orthopaedics & Traumatology, 36664Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - Michael Tim-Yun Ong
- Department of Orthopaedics & Traumatology, Faculty of Medicine, 26451The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Patrick Shu-Hang Yung
- Department of Orthopaedics & Traumatology, Faculty of Medicine, 26451The Chinese University of Hong Kong, Shatin, Hong Kong
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Voorn MJJ, Bongers BC, van Kampen-van den Boogaart VEM, Driessen EJM, Janssen-Heijnen MLG. Feasibility of Rehabilitation during Chemoradiotherapy among Patients with Stage III Non-Small Cell Lung Cancer: A Proof-of-Concept Study. Cancers (Basel) 2022; 14:cancers14102387. [PMID: 35625990 PMCID: PMC9139205 DOI: 10.3390/cancers14102387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 12/15/2022] Open
Abstract
Rehabilitation during chemoradiotherapy (CHRT) might (partly) prevent reduction in physical fitness and nutritional status and could improve treatment tolerance in patients with stage III non-small cell lung cancer (NSCLC). The aim of this proof-of-concept study was to investigate the feasibility of a multimodal program for rehabilitation during CHRT. A home-based multimodal rehabilitation program (partly supervised moderate-intensity physical exercise training and nutritional support) during CHRT was developed in collaboration with patients with stage III NSCLC and specialized healthcare professionals. A predetermined number of six patients with stage III NSCLC (aged > 50 years) who underwent CHRT and participated in this program were monitored in detail to assess its feasibility for further development and optimization of the program. The patient’s level of physical functioning (e.g., cardiopulmonary exercise test, six-minute walking test, handgrip strength, body mass index, fat free mass index, energy and protein intake) was evaluated in order to provide personalized advice regarding physical exercise training and nutrition. The program appeared feasible and well-tolerated. All six included patients managed to perform the assessments. Exercise session adherence was high in five patients and low in one patient. The performed exercise intensity was lower than prescribed for all patients. Patients were motivated to complete the home-based rehabilitation program during CHRT. Preliminary effects on physical and nutritional parameters revealed relatively stable values throughout CHRT, with inter-individual variation. Supervised and personalized rehabilitation in patients with stage III NSCLC undergoing CHRT seems feasible when the intensity of the physical exercise training was adjusted to the possibilities and preferences of the patients. Future research should investigate the feasibility of a supervised and personalized rehabilitation program during CHRT with a low-to-moderate exercise intensity with the aim to prevent physical decline during CHRT.
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Affiliation(s)
- Melissa J. J. Voorn
- Department of Clinical Epidemiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands; (E.J.M.D.); (M.L.G.J.-H.)
- Adelante Rehabilitation Centre, 5912 BL Venlo, The Netherlands
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
- Correspondence: ; Tel.: +31-77-320-6905
| | - Bart C. Bongers
- Department of Nutrition and Movement Sciences, (NUTRIM) School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands;
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
| | | | - Elisabeth J. M. Driessen
- Department of Clinical Epidemiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands; (E.J.M.D.); (M.L.G.J.-H.)
| | - Maryska L. G. Janssen-Heijnen
- Department of Clinical Epidemiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands; (E.J.M.D.); (M.L.G.J.-H.)
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
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Factors influencing the delivery of telerehabilitation for stroke: A systematic review. PLoS One 2022; 17:e0265828. [PMID: 35544471 PMCID: PMC9094559 DOI: 10.1371/journal.pone.0265828] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 03/08/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Despite the available evidence regarding effectiveness of stroke telerehabilitation, there has been little focus on factors influencing its delivery or translation from the research setting into practice. There are complex challenges to embedding telerehabilitation into stroke services and generating transferable knowledge about scaling up and routinising this service model. This review aimed to explore factors influencing the delivery of stroke telerehabilitation interventions, including platforms, technical requirements, training, support, access, cost, usability and acceptability. Methods MEDLINE, EMBASE, CINAHL, Web of Science and Cochrane Library and Central Registry of Clinical Trials were searched to identify full-text articles of randomised controlled trials (RCTs) and protocols for RCTs published since a Cochrane review on stroke telerehabilitation services. A narrative synthesis was conducted, providing a comprehensive description of the factors influencing stroke telerehabilitation intervention delivery. Results Thirty-one studies and ten protocols of ongoing studies were included. Interventions were categorised as synchronous telerehabilitation (n = 9), asynchronous telerehabilitation (n = 11) and tele-support (n = 11). Telephone and videoconference were the most frequently used modes of delivery. Usability and acceptability with telerehabilitation were high across all platforms, although access issues and technical challenges may be potential barriers to the use of telerehabilitation in service delivery. Costs of intervention delivery and training requirements were poorly reported. Conclusions This review synthesises the evidence relating to factors that may influence stroke telerehabilitation intervention delivery at a crucial timepoint given the rapid deployment of telerehabilitation in response to the COVID-19 pandemic. It recommends strategies, such as ensuring adequate training and technical infrastructure, shared learning and consistent reporting of cost and usability and acceptability outcomes, to overcome challenges in embedding and routinising this service model and priorities for research in this area.
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Bezuidenhout L, Joseph C, Thurston C, Rhoda A, English C, Conradsson DM. Telerehabilitation during the COVID-19 pandemic in Sweden: a survey of use and perceptions among physiotherapists treating people with neurological diseases or older adults. BMC Health Serv Res 2022; 22:555. [PMID: 35473602 PMCID: PMC9038993 DOI: 10.1186/s12913-022-07968-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/20/2022] [Indexed: 12/26/2022] Open
Abstract
Background Telerehabilitation, i.e. rehabilitation at a distance using Information and Communication Technology (ICT), is a promising avenue for improving health among people with neurological diseases or older adults who often experience limited access to services. Still, little is known about physiotherapists’ use, perceptions and needs with regards to telerehabilitation services. Aims To describe physiotherapists use and perceptions of, as well as needs for, telerehabilitation services for the rehabilitation of people with neurological diseases or older adults in Sweden. Methods In this cross-sectional study, an author-created survey was sent out to members of the Swedish Association of Physiotherapists including questions about the use and perceptions of existing telerehabilitation services (e.g. telephone, internet-based applications and mobile applications) as well as needs of future telerehabilitation services. The results were presented descriptively as numbers and percentages. Results Three hundred seven physiotherapists were included in this study with 139 (45%) treating people with neurological diseases and 168 (55%) treating older adults. Most respondents did not provide telerehabilitation before (74%) or during (51%) the COVID-19 pandemic. Telephone, which was predominantly used for administrative tasks, was the most frequent utilised ICT used by 68% of the physiotherapist using ICTs several days/week. Few respondents used internet-based applications (12%), mobile applications (3%) or SMS services (8%) and videoconferencing (3%). A majority of the respondents were interested in ICT (78%), felt comfortable using ICT (57%) and were interested in learning how ICT can be used in rehabilitation (92%). Still, few respondents perceived that people with neurological diseases or older adults can use existing ICTs for rehabilitation purposes (18%) and that existing reimbursement system within health care facilitates remote rehabilitation (16%). Important functionality of future ICT perceived by physiotherapists covered patient communication (e.g. chat, SMS and video), assessments (e.g. digital surveys and assessment of physical activity) and treatment (e.g. exercise prescription). Conclusion While physiotherapists had an overall positive perception to use and willingness to learn about telerehabilitation, few used telerehabilitation services before nor during the COVID-19 pandemic and they also perceived multilevel barriers for implementation, ranging from patients ability to use ICT to existing reimbursement systems within health care. Our findings emphasize the need to strengthen the expertise regarding remote services among physiotherapists. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07968-6.
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Affiliation(s)
- Lucian Bezuidenhout
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Faculty of Community and Health Sciences; Deanery, University of the Western Cape, Bellville, South Africa
| | - Conran Joseph
- Department of Health and Rehabilitation Sciences, Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa
| | - Charlotte Thurston
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Anthea Rhoda
- Faculty of Community and Health Sciences; Deanery, University of the Western Cape, Bellville, South Africa
| | - Coralie English
- School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia
| | - David Moulaee Conradsson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden. .,Medical unit Occupational therapy & Physiotherapy, Theme Women's Health and Allied Health Professional, Karolinska University Hospital, Stockholm, Sweden.
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Vieira AGDS, Pinto ACPN, Garcia BMSP, Eid RAC, Mól CG, Nawa RK. Telerehabilitation improves physical function and reduces dyspnoea in people with COVID-19 and post-COVID-19 conditions: a systematic review. J Physiother 2022; 68:90-98. [PMID: 35414491 PMCID: PMC8994568 DOI: 10.1016/j.jphys.2022.03.011] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/22/2022] [Accepted: 03/28/2022] [Indexed: 12/12/2022] Open
Abstract
QUESTION How effective and safe is telerehabilitation for people with COVID-19 and post-COVID-19 conditions? DESIGN Systematic review of randomised trials. PARTICIPANTS People with COVID-19 and post-COVID-19 conditions. INTERVENTION Any type of telerehabilitation. OUTCOME MEASURES Satisfaction, quality of life, adverse events, adherence to telerehabilitation, dyspnoea, functional performance, readmissions, mortality, pulmonary function and level of independence. RESULTS Database searches retrieved 2,962 records, of which six trials with 323 participants were included in the review. Breathing exercises delivered via telerehabilitation improved 6-minute walk distance (MD 101 m, 95% CI 61 to 141; two studies), 30-second sit-to-stand test performance (MD 2.2 repetitions, 95% CI 1.5 to 2.8; two studies), Multidimensional Dyspnoea-12 questionnaire scores (MD -6, 95% CI -7 to -5; two studies) and perceived effort on the 0-to-10 Borg scale (MD -2.8, 95% CI -3.3 to -2.3; two studies), with low certainty of evidence. Exercise delivered via telerehabilitation improved 6-minute walk distance (MD 62 m, 95% CI 42 to 82, four studies), 30-second sit-to-stand test performance (MD 2.0 repetitions, 95% CI 1.3 to 2.7; two studies) and Multidimensional Dyspnoea-12 scores (MD -1.8, 95% CI -2.5 to -1.1; one study), with low certainty of evidence. Adverse events were almost all mild or moderate and occurred with similar frequency in the telerehabilitation group (median 0 per participant, IQR 0 to 2.75) as in the control group (median 0 per participant, IQR 0 to 2); Hodges-Lehmann median difference 0 (95% CI 0 to 0), with low certainty of evidence. CONCLUSION Telerehabilitation may improve functional capacity, dyspnoea, performance and physical components of quality of life and does not substantially increase adverse events. REGISTRATION PROSPERO CRD42021271049.
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Affiliation(s)
| | - Ana Carolina Pereira Nunes Pinto
- Evidence-Based Health Program, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Biological and Health Sciences Department, Universidade Federal do Amapá (UNIFAP), Amapá, Brazil
| | | | | | - Caroline Gomes Mól
- Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Ricardo Kenji Nawa
- Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil.
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127
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Dragusanu M, Troisi D, Villani A, Prattichizzo D, Malvezzi M. Design and Prototyping of an Underactuated Hand Exoskeleton With Fingers Coupled by a Gear-Based Differential. Front Robot AI 2022; 9:862340. [PMID: 35425814 PMCID: PMC9001897 DOI: 10.3389/frobt.2022.862340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
Exoskeletons and more in general wearable mechatronic devices represent a promising opportunity for rehabilitation and assistance to people presenting with temporary and/or permanent diseases. However, there are still some limits in the diffusion of robotic technologies for neuro-rehabilitation, notwithstanding their technological developments and evidence of clinical effectiveness. One of the main bottlenecks that constrain the complexity, weight, and costs of exoskeletons is represented by the actuators. This problem is particularly evident in devices designed for the upper limb, and in particular for the hand, in which dimension limits and kinematics complexity are particularly challenging. This study presents the design and prototyping of a hand finger exoskeleton. In particular, we focus on the design of a gear-based differential mechanism aimed at coupling the motion of two adjacent fingers and limiting the complexity and costs of the system. The exoskeleton is able to actuate the flexion/extension motion of the fingers and apply bidirectional forces, that is, it is able to both open and close the fingers. The kinematic structure of the finger actuation system has the peculiarity to present three DoFs when the exoskeleton is not worn and one DoF when it is worn, allowing better adaptability and higher wearability. The design of the gear-based differential is inspired by the mechanism widely used in the automotive field; it allows actuating two fingers with one actuator only, keeping their movements independent.
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Affiliation(s)
- Mihai Dragusanu
- Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
| | - Danilo Troisi
- Information Engineering Department, University of Pisa, Pisa, Italy
| | - Alberto Villani
- Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
| | - Domenico Prattichizzo
- Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genova, Italy
| | - Monica Malvezzi
- Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
- *Correspondence: Monica Malvezzi,
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A Scoping Review for Usage of Telerehabilitation among Older Adults with Mild Cognitive Impairment or Cognitive Frailty. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074000. [PMID: 35409683 PMCID: PMC8997970 DOI: 10.3390/ijerph19074000] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 12/12/2022]
Abstract
Older adults are vulnerable towards cognitive frailty that can lead to adverse health outcomes and telerehabilitation appears to be a potential platform to reverse cognitive frailty among older adults. The aim of this coping review is to identify the usage of telerehabilitation and its common platform of delivery among older adults with mild cognitive impairment (MCI) or cognitive frailty (CF). Articles published from January 2015 until October 2020 were selected. Out of the 1738 articles retrieved, six studies were identified. Two articles were randomized controlled trials, one was a pilot study and three were qualitative studies. The outcome suggests that telerehabilitation may improve the quality of life among participants as well as it can be a useful and supportive digital platform for health care. Some types of technologies commonly used were smartphones or telephones with internet, television-based assistive integrated technology, mobile application and videoconference. Telerehabilitation utilization in managing cognitive frailty among older adults is still limited and more research is required to evaluate its feasibility and acceptability. Although telerehabilitation appears to be implemented among older adults with MCI and CF, some social support is still required to improve the adherence and effectiveness of telerehabilitation. Future research should focus on the evaluation of acceptance and participants’ existing knowledge towards telerehabilitation to achieve its target.
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129
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de Brito SAF, Scianni AA, Peniche PDC, Faria CDCDM. Measurement properties of outcome measures used in neurological telerehabilitation: A systematic review protocol. PLoS One 2022; 17:e0265841. [PMID: 35312708 PMCID: PMC8936471 DOI: 10.1371/journal.pone.0265841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
Several measurement tools commonly used in face-to-face neurological rehabilitation have been used in telerehabilitation. However, it is not known whether these tools have adequate measurement properties and clinical utility. This systematic review aims to investigate the measurement properties and the clinical utility of measurement tools used in telerehabilitation in individuals with neurological diseases. A systematic review to investigate the measurement properties and clinical utility of measurement tools used in telerehabilitation in individuals with neurological conditions will be conducted. This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. this systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on 28 May 2021 (registration number: CRD42021257662). Electronic searches will be performed in following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE Ovid), Excerpta Medica Database (Embase Classic + Embase Ovid), Physiotherapy Evidence Database (PEDro), Scientific Electronic Library Online (Scielo), and Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). Two trained independent reviewers will select the studies according to the inclusion criteria, and will also extract the data, evaluate the clinical utility and methodological quality. The relevant data such as design, participants, settings, and mode of administration, measurement properties, and clinical utility will be summarized. Disagreements between reviewers will be resolved by consensus or by the decision of a third independent reviewer. Hand searches of other relevant studies will be employed. The COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist and the clinical utility scale will be used to assess the methodological quality and clinical utility of these tools, respectively. This systematic review will provide information regarding the measurement properties and the clinical utility of the measurement tools used in neurological telerehabilitation. This information will be useful to assist health professionals in choosing adequate measurement tools and planning new research studies.
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Affiliation(s)
| | - Aline Alvim Scianni
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paula da Cruz Peniche
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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130
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A Telerehabilitation Approach to Chronic Facial Paralysis in the COVID-19 Pandemic Scenario: What Role for Electromyography Assessment? J Pers Med 2022; 12:jpm12030497. [PMID: 35330496 PMCID: PMC8949994 DOI: 10.3390/jpm12030497] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 02/05/2023] Open
Abstract
There is a lack of data on patient and diagnostic factors for prognostication of complete recovery in patients with peripheral facial palsy. Thus, the aim of this study was to evaluate the role of a telerehabilitave enhancement through the description of a case report with the use of short-wave diathermy and neuromuscular electrical stimulation combined to facial proprioceptive neuromuscular facilitation (PNF) rehabilitation in unrecovered facial palsy, in a COVID-19 pandemic scenario describing a paradigmatic telerehabilitation report. A 43-year-old woman underwent a facial rehabilitation plan consisting of a synergistic treatment with facial PNF rehabilitation, short-wave diathermy, and neuromuscular electrical stimulation (12 sessions lasting 45 min, three sessions/week for 4 weeks). Concerning the surface electromyography evaluation of frontal and orbicularis oris muscles, the calculated ratio between amplitude of the palsy side and normal side showed an improvement in terms of movement symmetry. At the end of the outpatient treatment, a daily telerehabilitation protocol with video and teleconsultation was provided, showing a further improvement in the functioning of a woman suffering from unresolved facial paralysis. Therefore, an adequate telerehabilitation follow-up seems to play a fundamental role in the management of patients with facial palsy.
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131
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Park S, Tang A, Pollock C, Sakakibara BM. Telerehabilitation for lower extremity recovery poststroke: a systematic review and meta-analysis protocol. BMJ Open 2022; 12:e055527. [PMID: 35264359 PMCID: PMC8915270 DOI: 10.1136/bmjopen-2021-055527] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Approximately 30% of individuals with stroke report unmet lower extremity recovery needs after formal hospital-based rehabilitation programmes have ended. Telerehabilitation can mitigate issues surrounding accessibility of rehabilitation services by providing ongoing support to promote recovery, however, no review exists that is specific to telerehabilitation for lower extremity recovery. This paper describes the protocol of a systematic review and meta-analysis that aims to describe and evaluate the effectiveness of lower extremity-focused telerehabilitation interventions on clinical outcomes poststroke. METHODS AND ANALYSIS A systematic review of relevant electronic databases (MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, Google Scholar, PEDro, PubMed and Cochrane Library) between inception and February 2022 will be undertaken to identify eligible interventional studies published in English that compared telerehabilitation focusing on lower extremity recovery to another intervention or usual care for individuals living in the community with stroke. Clinical outcomes examined will include those related to physical function and impairment, activities and participation that are typically assessed in clinical practice and research. Two reviewers will independently screen results, identify studies to be included for review, extract data and assess risk of bias. Meta-analyses will be performed if sufficient data exist. Sensitivity analyses will be performed by removing studies with low methodological quality, and subgroup analyses will be performed if data allow by stratifying papers based on salient demographic or stroke factors and comparing results. The reporting of the review will follow the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The quality of evidence regarding various outcomes for telerehabilitation for lower extremity recovery poststroke will be assessed according to the Grading of Recommendation, Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION No ethical approval or informed consent is needed for this systematic review. The findings of this review will be disseminated via peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER CRD42021246886.
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Affiliation(s)
- Sarah Park
- Faculty of Medicine, Graduate Program in Rehabilitation Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
- Faculty of Medicine, Centre for Chronic Disease Prevention and Management, The University of British Columbia, Kelowna, British Columbia, Canada
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Courtney Pollock
- Faculty of Medicine, Graduate Program in Rehabilitation Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
- Faculty of Medicine, Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
- GF Strong Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Brodie M Sakakibara
- Faculty of Medicine, Graduate Program in Rehabilitation Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
- Faculty of Medicine, Centre for Chronic Disease Prevention and Management, The University of British Columbia, Kelowna, British Columbia, Canada
- GF Strong Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Faculty of Medicine, Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
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132
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Sieczkowska SM, Astley C, Marques IG, Iraha AY, Franco TC, Ihara BP, Martins Lavorato SS, Lindoso L, Demitrol Setoue DN, Tanigava NY, Campos LMA, Pereira RMR, Aikawa NE, Roschel H, Queiroz LB, Polanczyk GV, Silva CA, Gualano B. A home-based exercise program during COVID-19 pandemic: Perceptions and acceptability of juvenile systemic lupus erythematosus and juvenile idiopathic arthritis adolescents. Lupus 2022; 31:443-456. [PMID: 35264025 PMCID: PMC8914298 DOI: 10.1177/09612033221083273] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To investigate the perceptions and acceptability of a home-based exercise intervention in systemic lupus erythematosus (JSLE) and juvenile idiopathic arthritis (JIA) adolescent patients during the COVID-19 pandemic, and to explore the effects of the intervention on health-related quality of life (HRQoL), sleep quality, and mental health conditions parameters. METHODS This was a randomized controlled trial of a 12-week, home-based exercise training program conducted between October and December 2020. During this period, social distancing measures were in place in Brazil to contain the spread of COVID-19. Adolescent patients diagnosed with JSLE and JIA participated in the study. Health-related qualitative and quantitative data were collected before and after the follow-up. RESULTS 21 JSLE patients and 30 JIA patients were analyzed. Six themes emerged from patients' feedback: 1) Suitability of the home-based format; 2) Appropriate trainer supervision, 3) Motivators and facilitators for the program; 4) Barriers to the program; 5) Health benefits; 6) Patients' suggestions to improve the program. Overall, data indicated that the intervention showed good acceptability and elicited improvements in the perceived HRQoL and fatigue in JIA and JSLE patients during the pandemic. However, further quantitative analyses with validated HRQoL, sleep quality, and mental health conditions instruments did not capture these benefits (p>0.05). CONCLUSION Our main findings based on in-depth qualitative assessments suggest that a home-based exercise training program was suitable and well-accepted by adolescents with JSLE and JIA during the COVID-19 pandemic. Nonetheless, adherence was not high, particularly among JIA patients, suggesting that facilitators and barriers identified in the current study should be explored to improve the quality of new home-based exercise programs implementation, particularly in a future emerging crisis.
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Affiliation(s)
- Sofia Mendes Sieczkowska
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, 2028133Universidade de Sao Paulo, Sao Paulo, Brazil.,Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Camilla Astley
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, 2028133Universidade de Sao Paulo, Sao Paulo, Brazil.,Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Isabela Gouveia Marques
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, 2028133Universidade de Sao Paulo, Sao Paulo, Brazil.,Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Amanda Yuri Iraha
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, 2028133Universidade de Sao Paulo, Sao Paulo, Brazil.,Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Tathiane Christine Franco
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, 2028133Universidade de Sao Paulo, Sao Paulo, Brazil.,Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Bianca Pires Ihara
- Instituto da Criança e do Adolescente (ICr), Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Sofia Simão Martins Lavorato
- Instituto da Criança e do Adolescente (ICr), Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Livia Lindoso
- Instituto da Criança e do Adolescente (ICr), Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Debora Narumi Demitrol Setoue
- Instituto da Criança e do Adolescente (ICr), Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Nicolas Yamada Tanigava
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Lucia Maria Arruda Campos
- Instituto da Criança e do Adolescente (ICr), Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Rosa Maria Rodrigues Pereira
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Nadia Emi Aikawa
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.,Instituto da Criança e do Adolescente (ICr), Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, 2028133Universidade de Sao Paulo, Sao Paulo, Brazil.,Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Ligia Bruni Queiroz
- Instituto da Criança e do Adolescente (ICr), Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Guilherme V Polanczyk
- Instituto da Criança e do Adolescente (ICr), Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Clovis Artur Silva
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.,Instituto da Criança e do Adolescente (ICr), Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, 2028133Universidade de Sao Paulo, Sao Paulo, Brazil.,Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, 2037884Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.,Food Research Center, 2028133University of Sao Paulo, Sao Paulo, Brazil
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Gava V, Ribeiro LP, Barreto RPG, Camargo PR. Effectiveness of physical therapy given by telerehabilitation on pain and disability of individuals with shoulder pain: A systematic review. Clin Rehabil 2022; 36:715-725. [PMID: 35230167 DOI: 10.1177/02692155221083496] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To systematically review the effects of physical therapy given by telerehabilitation on pain and disability in individuals with shoulder pain. DATA SOURCES PubMed, Embase, CINAHL, LILACS, Cochrane, Web of Science, SCOPUS, SciELO and Ibecs were searched in January/2022. METHODS This systematic review followed PRISMA guidelines. Randomized controlled trials investigating the effects of physical therapy given by telerehabilitation on pain and disability in patients with shoulder pain were included. The quality and level of the evidence were assessed with the Cochrane Risk of Bias tool and GRADE, respectively. The effect sizes of the main outcomes were also calculated. RESULTS Six randomized controlled trials were included with a total sample of 368 patients with shoulder pain. Four and two randomized controlled trials were assessed as low and high risk of bias, respectively. Three randomized controlled trials assessed shoulder post-operative care, two assessed chronic shoulder pain, and one assessed frozen shoulder. Very low to low evidence suggests that there is no difference between telerehabilitation and in-person physical therapy or home-based exercises programs to improve pain and disability in patients with shoulder pain. Low evidence suggests that telerehabilitation is superior to advice only to improve shoulder pain (effect size: 2.42; 95% Confidence Interval: 1.72, 3.06) and disability (effect size: 1.61; 95% Confidence Interval: 1.01, 2.18). CONCLUSIONS Although telerehabilitation may be a promising tool to treat patients with shoulder pain and disability, the very low to low quality of evidence does not support a definite recommendation of its use in this population.
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Affiliation(s)
- Vander Gava
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, 67828Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Larissa Pechincha Ribeiro
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, 67828Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | | | - Paula Rezende Camargo
- Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, 67828Universidade Federal de São Carlos, São Carlos, SP, Brazil
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Dupuis F, Déry J, Lucas de Oliveira FC, Pecora AT, Gagnon R, Harding K, Camden C, Roy JS, Lettre J, Hudon A, Beauséjour M, Pinard AM, Bath B, Deslauriers S, Lamontagne MÈ, Feldman D, Routhier F, Desmeules F, Hébert LJ, Miller J, Ruiz A, Perreault K. Strategies to reduce waiting times in outpatient rehabilitation services for adults with physical disabilities: A systematic literature review. J Health Serv Res Policy 2022; 27:157-167. [DOI: 10.1177/13558196211065707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective Identifying effective strategies to reduce waiting times is a crucial issue in many areas of health services. Long waiting times for rehabilitation services have been associated with numerous adverse effects in people with disabilities. The main objective of this study was to conduct a systematic literature review to assess the effectiveness of service redesign strategies to reduce waiting times in outpatient rehabilitation services for adults with physical disabilities. Methods We conducted a systematic review, searching three databases (MEDLINE, CINAHL and EMBASE) from their inception until May 2021. We identified studies with comparative data evaluating the effect of rehabilitation services redesign strategies on reducing waiting times. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the studies. A narrative synthesis was conducted. Results Nineteen articles including various settings and populations met the selection criteria. They covered physiotherapy ( n = 11), occupational therapy ( n = 2), prosthetics ( n = 1), exercise physiology ( n = 1) and multidisciplinary ( n = 4) services. The methodological quality varied ( n = 10 high quality, n = 6 medium, n = 3 low); common flaws being missing information on the pre-redesign setting and characteristics of the populations. Seven articles assessed access processes or referral management strategies (e.g. self-referral), four focused on extending/modifying the roles of service providers (e.g. to triage) and eight changed the model of care delivery (e.g. mode of intervention). The different redesign strategies had positive effects on waiting times in outpatient rehabilitation services. Conclusions This review highlights the positive effects of many service redesign strategies. These findings suggest that there are several effective strategies to choose from to reduce waiting times and help better respond to the needs of persons experiencing physical disabilities.
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Affiliation(s)
- Frédérique Dupuis
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Québec, Canada
| | - Julien Déry
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Québec, Canada
| | - Fabio Carlos Lucas de Oliveira
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Québec, Canada
| | - Ana Tereza Pecora
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Québec, Canada
| | - Rose Gagnon
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Québec, Canada
| | - Katherine Harding
- Allied Health Clinical Research Office, Eastern Health, Victoria, Australia
| | - Chantal Camden
- École de réadaptation, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-Sébastien Roy
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Québec, Canada
| | - Josiane Lettre
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Québec, Canada
| | - Anne Hudon
- École de Réadaptation, Université de Montréal, Montreal, QC, Canada
| | - Marie Beauséjour
- Département des Sciences de la santé communautaire, Université de Sherbrooke, Longueuil, QC, Canada
| | - Anne-Marie Pinard
- Département D’anesthésiologie et de Soins Intensifs, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Brenna Bath
- School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Simon Deslauriers
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Québec, Canada
| | - Marie-Ève Lamontagne
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Québec, Canada
| | - Debbie Feldman
- École de Réadaptation, Université de Montréal, Montreal, QC, Canada
| | - François Routhier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Québec, Canada
| | | | - Luc J. Hébert
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Québec, Canada
| | - Jordan Miller
- School of Rehabilitation Therapy, Physical Therapy Program, Queen’s University, Kingston, ON, Canada
| | - Angel Ruiz
- Département d’opérations et systèmes de décision, Faculté des sciences de l’administration, Université Laval, Québec, QC, Canada
| | - Kadija Perreault
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Québec, Canada
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Barak Ventura R, Stewart Hughes K, Nov O, Raghavan P, Ruiz Marín M, Porfiri M. Data-Driven Classification of Human Movements in Virtual Reality-Based Serious Games: Preclinical Rehabilitation Study in Citizen Science. JMIR Serious Games 2022; 10:e27597. [PMID: 35142629 PMCID: PMC8874800 DOI: 10.2196/27597] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/14/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background Sustained engagement is essential for the success of telerehabilitation programs. However, patients’ lack of motivation and adherence could undermine these goals. To overcome this challenge, physical exercises have often been gamified. Building on the advantages of serious games, we propose a citizen science–based approach in which patients perform scientific tasks by using interactive interfaces and help advance scientific causes of their choice. This approach capitalizes on human intellect and benevolence while promoting learning. To further enhance engagement, we propose performing citizen science activities in immersive media, such as virtual reality (VR). Objective This study aims to present a novel methodology to facilitate the remote identification and classification of human movements for the automatic assessment of motor performance in telerehabilitation. The data-driven approach is presented in the context of a citizen science software dedicated to bimanual training in VR. Specifically, users interact with the interface and make contributions to an environmental citizen science project while moving both arms in concert. Methods In all, 9 healthy individuals interacted with the citizen science software by using a commercial VR gaming device. The software included a calibration phase to evaluate the users’ range of motion along the 3 anatomical planes of motion and to adapt the sensitivity of the software’s response to their movements. During calibration, the time series of the users’ movements were recorded by the sensors embedded in the device. We performed principal component analysis to identify salient features of movements and then applied a bagged trees ensemble classifier to classify the movements. Results The classification achieved high performance, reaching 99.9% accuracy. Among the movements, elbow flexion was the most accurately classified movement (99.2%), and horizontal shoulder abduction to the right side of the body was the most misclassified movement (98.8%). Conclusions Coordinated bimanual movements in VR can be classified with high accuracy. Our findings lay the foundation for the development of motion analysis algorithms in VR-mediated telerehabilitation.
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Affiliation(s)
- Roni Barak Ventura
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States
| | - Kora Stewart Hughes
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States
| | - Oded Nov
- Department of Technology Management and Innovation, New York University Tandon School of Engineering, Brooklyn, NY, United States
| | - Preeti Raghavan
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Manuel Ruiz Marín
- Department of Quantitative Methods, Law and Modern Languages, Technical University of Cartagena, Cartagena, Spain.,Murcia Bio-Health Institute (IMIB-Arrixaca), Health Science Campus, Cartagena, Spain
| | - Maurizio Porfiri
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States.,Center for Urban Science and Progress, New York University, Brooklyn, NY, United States.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States
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136
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Beltran-Alacreu H, Navarro-Fernández G, Godia-Lledó D, Graell-Pasarón L, Ramos-González Á, Raya R, Martin-Pintado Zugasti A, Fernandez-Carnero J. A Serious Game for Performing Task-Oriented Cervical Exercises Among Older Adult Patients With Chronic Neck Pain: Development, Suitability, and Crossover Pilot Study. JMIR Serious Games 2022; 10:e31404. [PMID: 35103608 PMCID: PMC8848226 DOI: 10.2196/31404] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/15/2021] [Accepted: 11/13/2021] [Indexed: 12/22/2022] Open
Abstract
Background There is sparse research on the effectiveness of therapeutic exercise for the treatment of neck pain in older adult populations. Moreover, there is a lack of research on the use of serious games or virtual reality for the treatment of neck pain in this population. Objective The primary aim of this study was to develop and assess the suitability of a serious game for performing task-oriented cervical exercises in patients with neck pain. Methods A serious game was designed based on the key features identified by previous studies that designed serious video games for physical and cognitive rehabilitation or exercise. The game in this study was designed to provide an interactive scenario, with the main functionality of the software solution to control a virtual airplane to reach targets using head motions. At the end of the exercise, the application stores the targets reached and missed and the airplane’s trajectory. A crossover pilot study was carried out for preliminary evaluation of the suitability of the technology in the older adult population. Men and women over 65 years of age with chronic neck pain were included. Subjects were randomly assigned to two study arms; each arm consisted of a sequence of two 4-week treatments with an intermediate washout period of 4 weeks. The total study duration was 16 weeks due to a final follow-up measure 4 weeks after the end of all treatments. Treatment A consisted of the use of the serious game developed in this study, and treatment B consisted of conventional exercises. Subjects allocated to the A-B study arm received treatment A first, followed by treatment B, and vice versa in the B-A arm. The following variables were assessed: Suitability Evaluation Questionnaire (SEQ) scores, Visual Analog Scale scores, and the number of targets reached in the serious game. Results A total of 18 subjects were assessed for eligibility. A total of 13 subjects, aged between 71 and 92 years (mean 81.85, SD 6.82), were finally included and completed the study protocol. The global mean SEQ score was 50.38 (SD 5.35) out of 65 points, showing good suitability of the serious game. Most patients considered the experience very enjoyable and “real” in terms of the virtual environment and found the information provided to be clear. Also, they believed that the game could be very helpful for their rehabilitation. None of the patients felt any neck pain or discomfort when playing the game, and only 2 patients out of 13 (15%) reported some degree of dizziness, eye discomfort, or disorientation, which did not limit their capacity to finish the session. Conclusions The serious game developed in this study showed good suitability for use in adults over 70 years of age with chronic neck pain. The game was a safe method for performing task-oriented cervical exercises, and patients reported very high levels of satisfaction and acceptance after the use of this technology.
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Affiliation(s)
- Hector Beltran-Alacreu
- Toledo Physiotherapy Research Group, Faculty of Physical Therapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain.,CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Madrid, Spain
| | - Gonzalo Navarro-Fernández
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Madrid, Spain.,Innovation and Research Unit, Galeneo, Madrid, Spain
| | - Daniela Godia-Lledó
- Physiotherapy Department, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Lucas Graell-Pasarón
- Physiotherapy Department, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Álvaro Ramos-González
- Physiotherapy Department, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Rafael Raya
- Departamento de Ingeniería de Sistemas de Información, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain.,Werium Solutions, Madrid, Spain
| | | | - Josue Fernandez-Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain.,Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora Universidad Rey Juan Carlos-Banco de Santander, Madrid, Spain
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137
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Mohseni Afshar Z, Hosseinzadeh R, Barary M, Ebrahimpour S, Alijanpour A, Sayad B, Hosseinzadeh D, Miri SR, Sio TT, Sullman MJM, Carson‐Chahhoud K, Babazadeh A. Challenges posed by COVID-19 in cancer patients: A narrative review. Cancer Med 2022; 11:1119-1135. [PMID: 34951152 PMCID: PMC8855916 DOI: 10.1002/cam4.4519] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/08/2021] [Accepted: 12/08/2021] [Indexed: 01/09/2023] Open
Abstract
A novel coronavirus, or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified as the causative agent of coronavirus disease 2019 (COVID-19). In early 2020, the World Health Organization declared COVID-19 the sixth public health emergency of international concern. The COVID-19 pandemic has substantially affected many groups within the general population, but particularly those with extant clinical conditions, such as having or being treated for cancer. Cancer patients are at a higher risk of developing severe COVID-19 since the malignancy and chemotherapy may negatively affect the immune system, and their immunocompromised condition also increases the risk of infection. Substantial international efforts are currently underway to develop specific methods for diagnosing and treating COVID-19. However, cancer patients' risk profiles, management, and outcomes are not well understood. Thus, the main objective of this review is to discuss the relevant evidence to understand the prognosis of COVID-19 infections in cancer patients more clearly, as well as helping to improve the clinical management of these patients.
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Affiliation(s)
- Zeinab Mohseni Afshar
- Clinical Research Development CenterImam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | | | - Mohammad Barary
- Student Research CommitteeBabol University of Medical SciencesBabolIran
- Students’ Scientific Research Center (SSRC)Tehran University of Medical SciencesTehranIran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research CenterHealth Research InstituteBabol University of Medical SciencesBabolIran
| | | | - Babak Sayad
- Clinical Research Development CenterImam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | | | - Seyed Rouhollah Miri
- Cancer Research CenterCancer Institute of IranTehran University of Medical ScienceTehranIran
| | - Terence T. Sio
- Department of Radiation OncologyMayo ClinicPhoenixArizonaUSA
| | - Mark J. M. Sullman
- Department of Social SciencesUniversity of NicosiaNicosiaCyprus
- Department of Life and Health SciencesUniversity of NicosiaNicosiaCyprus
| | | | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research CenterHealth Research InstituteBabol University of Medical SciencesBabolIran
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138
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Telerehabilitation in response to constrained physical distance: an opportunity to rethink neurorehabilitative routines. J Neurol 2022. [PMID: 33449202 DOI: 10.1007/s00415-021-10397-w/tables/2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Ensuring proper dosage of treatment and repetition over time is a major challenge in neurorehabilitation. However, a requirement of physical distancing to date compromises their achievement. While mostly associated to COVID-19, physical distancing is not only required in a pandemic scenario, but also advised for several clinical conditions (e.g. immunocompromised individuals) or forced for specific social contexts (e.g. people living in remote areas worldwide). All these contexts advocate for the implementation of alternative healthcare models. The objective of this perspective is to highlight the benefits of remote administration of rehabilitative treatment, namely telerehabilitation, in counteracting physical distancing barriers in neurorehabilitation. Sustaining boosters of treatment outcome, such as compliance, sustainability, as well as motivation, telerehabilitation may adapt to multiple neurological conditions, with the further advantage of a high potential for individualization to patient's or pathology's specificities. The effectiveness of telerehabilitation can be potentiated by several technologies available to date: virtual reality can recreate realistic environments in which patients may bodily operate, wearable sensors allow to quantitatively monitor the patient's performance, and signal processing may contribute to the prediction of long-term dynamics of patient recovery. Telerehabilitation might spark its advantages far beyond the mere limitation of physical distancing effects, mitigating criticalities of daily neurorehabilitative practice, and thus paving the way to the envision of mixed models of care, where hospital-based procedures are complementarily integrated with telerehabilitative ones.
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139
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Ora J, Prendi E, Attinà ML, Cazzola M, Calzetta L, Rogliani P. Efficacy of respiratory tele-rehabilitation in COPD patients: Systematic review and meta-analysis. Monaldi Arch Chest Dis 2022; 92. [PMID: 35086329 DOI: 10.4081/monaldi.2022.2105] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/27/2021] [Indexed: 11/22/2022] Open
Abstract
Pulmonary rehabilitation (PR) is a proven and effective intervention for chronic obstructive pulmonary disease (COPD). The recent pandemic has raised interest on new services, such as telerehabilitation (Tele-R). The aim of this study was to systematically review the effects of Tele-R in COPD on: 1) exercise capacity evaluated by the 6-minute walk test (6MWT); 2) dyspnea (modified Medical Research Council - mMRC); 3) COPD control (the COPD assessment test - CAT). The analysis compared Tele-R versus no rehabilitation and Tele-R versus center-based rehabilitation. This meta-analysis was undertaken according to PRISMA recommendations. This pair-wise meta-analysis included data obtained from studies that enrolled 758 COPD patients. The tele-R compared to no rehabilitation improved the 6MWT distance of 48 m (CI: 24, 72; p<0.001) and the mMRC of -1.02U (CI: -1.49, -0.59; p<0.001), and the CAT of -5.74U (CI: -7.42, -0.407; p<0.001). The tele-R compared to center-based rehabilitation showed no difference on 6MWT distance (p=0.563), mMRC (p=0.911), and CAT (p=0.85). In COPD patients, Tele-R is effective in improving exercise tolerance and patient-reported outcomes and it seems to be a valid alternative to center-based rehabilitation, but more studies are needed to better understand how to select the right patients and which kind of Tele-R is more appropriate.
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Affiliation(s)
- Josuel Ora
- Division of Respiratory Medicine, University Hospital Policlinico Tor Vergata, Rome.
| | - Emanuela Prendi
- Department of Biomedical Sciences, Catholic University "Nostra Signora del Buon Consiglio", Tirana.
| | - Maria Laura Attinà
- Department of Biomedical Sciences, Catholic University "Nostra Signora del Buon Consiglio", Tirana.
| | - Mario Cazzola
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome.
| | - Luigino Calzetta
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma.
| | - Paola Rogliani
- Division of Respiratory Medicine, University Hospital Policlinico Tor Vergata; Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome.
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140
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Robotic Device for Out-of-Clinic Post-Stroke Hand Rehabilitation. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Due to the ageing population and an increasing number of stroke patients, we see the potential future of rehabilitation in telerehabilitation, which might alleviate the workload of physiotherapists and occupational therapists. In order to enable the use of telerehabilitation, devices aimed for home and independent use need to be developed. This paper describes the design of a robotic device for post-stroke wrist and finger rehabilitation and evaluates the movement it can perform. Six healthy subjects were tested in three experimental conditions: performing a coupled movement of wrist and fingers from flexion to extension without the device, with a passive device, and with an active device. The kinematics of the hand were captured using three Optotrak Certus motion capture systems and tracking 11 infrared active light-emitting diode (LED) markers. The results are presented in the form of base-line trajectories for all middle finger (MF) joints. In addition, the deviations of trajectories between conditions across all subjects were computed for the metacarpophalangeal (MCP) joint and fingertip of the MF and pinkie (PF) finger. Deviations from the base-line trajectory between measurement protocols and the root-mean-square deviation (RMSD) values indicate that the motion of the hand, imposed by the developed device, is comparable to the unconstrained motion of the healthy subjects, especially when moving into the extension, opening the hand.
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141
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Single Camera-Based Remote Physical Therapy: Verification on a Large Video Dataset. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12020799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In recent years, several systems have been developed to capture human motion in real-time using common RGB cameras. This approach has great potential to become widespread among the general public as it allows the remote evaluation of exercise at no additional cost. The concept of using these systems in rehabilitation in the home environment has been discussed, but no work has addressed the practical problem of detecting basic body parts under different sensing conditions on a large scale. In this study, we evaluate the ability of the OpenPose pose estimation algorithm to perform keypoint detection of anatomical landmarks under different conditions. We infer the quality of detection based on the keypoint confidence values reported by the OpenPose. We used more than two thousand unique exercises for the evaluation. We focus on the influence of the camera view and the influence of the position of the trainees, which are essential in terms of the use for home exercise. Our results show that the position of the trainee has the greatest effect, in the following increasing order of suitability across all camera views: lying position, position on the knees, sitting position, and standing position. On the other hand, the effect of the camera view was only marginal, showing that the side view is having slightly worse results. The results might also indicate that the quality of detection of lower body joints is lower across all conditions than the quality of detection of upper body joints. In this practical overview, we present the possibilities and limitations of current camera-based systems in telerehabilitation.
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142
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Hellsten T, Karlsson J, Shamsuzzaman M, Pulkkis G. The Potential of Computer Vision-Based Marker-Less Human Motion Analysis for Rehabilitation. Rehabil Process Outcome 2022; 10:11795727211022330. [PMID: 34987303 PMCID: PMC8492027 DOI: 10.1177/11795727211022330] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 05/08/2021] [Indexed: 11/16/2022] Open
Abstract
Background Several factors, including the aging population and the recent corona pandemic, have increased the need for cost effective, easy-to-use and reliable telerehabilitation services. Computer vision-based marker-less human pose estimation is a promising variant of telerehabilitation and is currently an intensive research topic. It has attracted significant interest for detailed motion analysis, as it does not need arrangement of external fiducials while capturing motion data from images. This is promising for rehabilitation applications, as they enable analysis and supervision of clients' exercises and reduce clients' need for visiting physiotherapists in person. However, development of a marker-less motion analysis system with precise accuracy for joint identification, joint angle measurements and advanced motion analysis is an open challenge. Objectives The main objective of this paper is to provide a critical overview of recent computer vision-based marker-less human pose estimation systems and their applicability for rehabilitation application. An overview of some existing marker-less rehabilitation applications is also provided. Methods This paper presents a critical review of recent computer vision-based marker-less human pose estimation systems with focus on their provided joint localization accuracy in comparison to physiotherapy requirements and ease of use. The accuracy, in terms of the capability to measure the knee angle, is analysed using simulation. Results Current pose estimation systems use 2D, 3D, multiple and single view-based techniques. The most promising techniques from a physiotherapy point of view are 3D marker-less pose estimation based on a single view as these can perform advanced motion analysis of the human body while only requiring a single camera and a computing device. Preliminary simulations reveal that some proposed systems already provide a sufficient accuracy for 2D joint angle estimations. Conclusions Even though test results of different applications for some proposed techniques are promising, more rigour testing is required for validating their accuracy before they can be widely adopted in advanced rehabilitation applications.
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Affiliation(s)
- Thomas Hellsten
- Department of Health and Wellbeing, Arcada University of Applied Sciences, Helsinki, Finland
| | - Jonny Karlsson
- Department of Business Administration and Analytics, Arcada University of Applied Sciences, Helsinki, Finland
| | - Muhammed Shamsuzzaman
- Department of Business Administration and Analytics, Arcada University of Applied Sciences, Helsinki, Finland
| | - Göran Pulkkis
- Department of Business Administration and Analytics, Arcada University of Applied Sciences, Helsinki, Finland
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Comparing Advanced with Basic Telerehabilitation Technologies for Patients with Rett Syndrome-A Pilot Study on Behavioral Parameters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010507. [PMID: 35010767 PMCID: PMC8744542 DOI: 10.3390/ijerph19010507] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 02/04/2023]
Abstract
The aim of this study is to compare the performances of patients with Rett syndrome that were undergoing advanced telerehabilitation (ATR) and patients that were undergoing basic telerehabilitation (BTR). It was hypothesized that patients that were undergoing ATR training would have better improvement in nearly all the motor and cognitive scale scoring activities that were administered, thus showing reduced disability. A total of 20 young girls and women with a diagnosis of RTT, ranging from age 4 to 31 years old (Median: 12.50; IQR: 9.50–17.25) underwent a pre-test, treatment post-test 1, treatment, and post-test 2 procedure. The treatment consisted of either ATR or BTR, lasting 10 weeks with three sessions a week of about an hour. The results showed that the group with advanced telerehabilitation improved their performance better than the control group only in some neuropsychological measurements. The results are discussed in the light of critical factors of telerehabilitation.
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Implementation of telerehabilitation in Austrian outpatient physiotherapy – A qualitative study / Implementierung von Telerehabilitation in der ambulanten Physiotherapie in Österreich – Eine qualitative Studie. INTERNATIONAL JOURNAL OF HEALTH PROFESSIONS 2022. [DOI: 10.2478/ijhp-2022-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Abstract
Background
New technologies, for example, telerehabilitation (TR) tools, can support physiotherapists’ work. Even though studies have demonstrated their potential, TR is not yet fully implemented in Austrian outpatient physiotherapy. As a result of the Coronavirus pandemic and the associated lockdowns, physiotherapists in Austria were confronted with the challenge of offering therapies without physical contact. This study aims to investigate opinions and experiences of physiotherapists in Austria regarding TR and its implementation in different clinical fields.
Methods
A qualitative research design with expert interviews and a focus group discussion were conducted. Data were analysed using content analysis. The categories were formed following a deductive-inductive approach.
Results
The interview partners considered opportunities for using synchronous TR in internal medicine as well as orthopaedics and traumatology, especially in later, exercise-dominated stages. In addition, using TR can be supportive for patient education. In the field of neurology, synchronous TR is viewed with some criticism, especially when used for people with severe neuropsychological disorders. Asynchronous TR is considered useful across all disciplines and could support physical therapy from the first therapy session and throughout the treatment. Important questions regarding liability, billing, or data protection still need to be clarified. Interdisciplinary approaches in TR should also be pursued to improve care.
Conclusion
The use of asynchronous TR in addition to regular physiotherapy is seen as promising in all clinical fields. In general, when implementing TR, the needs and requirements of different fields should be considered. Moreover, various framework conditions still need to be clarified for further implementation of TR.
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Cerdan de las Heras J, Balbino F, Catalán-Matamoros D, Løkke A, Hilberg O, Bendstrup E. Effect of a Telerehabilitation program in sarcoidosis. SARCOIDOSIS, VASCULITIS, AND DIFFUSE LUNG DISEASES : OFFICIAL JOURNAL OF WASOG 2022; 39:e2022003. [PMID: 35494172 PMCID: PMC9007024 DOI: 10.36141/svdld.v39i1.12526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/17/2021] [Indexed: 11/02/2022]
Abstract
Background Sarcoidosis can lead to variable periods of sickness and unemployment. Rehabilitation is recommended in sarcoidosis to improve exercise capacity. Therefore, focus on creating different and flexible rehabilitation options adapted to the needs of working patients is warranted to keep patients with sarcoidosis employed and to reduce the socioeconomic burden. Telerehabilitation (TR) might be an alternative. We investigated the usefulness and effectiveness of TR on exercise capacity in patients with sarcoidosis. Method Single-center, prospective, randomized study including stable patients with sarcoidosis who were enrolled in either a control group where they received the usual standard of care (not including rehabilitation) or in the 3 months TR group composed of video and chat-consultations with a physiotherapist and workout sessions with a virtual autonomous physiotherapist agent (VAPA) (1). 6-minute-walk-test (6MWT), forced vital capacity (FVC), diffusion capacity of the lung for carbon monoxide (DLCO), isometric voluntary contraction (MVC), 7 days pedometry, Saint George Respiratory Questionnaire for interstitial lung disease (SGRQ-I), The King's Brief Interstitial Lung Disease Questionnaire (KBILD) and General Anxiety Disorder-7 Questionnaire (GAD7) were tested before and after 3 months of TR, and after 3- and 6 months follow-up. Patient satisfaction was measured with a 5-point scale (5 very satisfied) and adherence was calculated as percent of tasks and time spent training. Adverse events were documented. Results Thirty patients aged 53.9±13.5 years, male 63.3%, FVC% 88.9±18.8, DLCO% 65.2±16.0, 6MWT 513.1±141.3 were included. Fifteen patients were randomized to TR with VAPA and 15 patients to the control group. Differences in meters walked (6MWTD) between groups was at baseline (-28.9 m (p=0.58)), after 3 (+25.8 m (p=0.57)), 6 (+48.4 m (p=0.39)) and 9 months (+77.3 m (p=0.18)) follow-up in favor of telerehabilitation. No differences were observed in MVC, 7 days pedometry, SGRQ-I, KBILD or GAD7. Exercise adherence in the intervention group was 64% and average exercise time was 28 minutes per exercise session during the first 3 months. Patient satisfaction scored 3.8 ± 0.7. No adverse events were reported. Conclusion VAPA TR did not result in any change in exercise capacity or patient-reported outcomes in this pilot study in patients with sarcoidosis. However, a statistically non-significant trend for improved 6MWTD was observed during follow-up. VAPA TR was safe, had high patient satisfaction and acceptable adherence. Further randomized studies including larger numbers of participants are needed.
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Affiliation(s)
- Jose Cerdan de las Heras
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark, Department of Clinical Research, Nordsjaellands Hospital, Hilleroed, Denmark, Department of Research and Development, Physio R&D ApS, Frederiksberg, Denmark
| | - Fernanda Balbino
- Department of Research and Development, Physio R&D ApS, Frederiksberg, Denmark
| | - Daniel Catalán-Matamoros
- Department of Communication Studies, University Carlos III of Madrid, Madrid, Spain, Health Research Institute, University of Almeria, Almeria, Spain
| | - Anders Løkke
- Department of Respiratory Medicine, Vejle Hospital, Vejle, Denmark
| | - Ole Hilberg
- Department of Respiratory Medicine, Vejle Hospital, Vejle, Denmark
| | - Elisabeth Bendstrup
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Madhavan S, Sivaramakrishnan A, Bowden MG, Chumbler NR, Field-Fote EC, Kesar T. Commentary: Remote assessments of gait and balance - Implications for research during and beyond Covid-19. Top Stroke Rehabil 2022; 29:74-81. [PMID: 33596774 PMCID: PMC8371083 DOI: 10.1080/10749357.2021.1886641] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The COVID-19 pandemic has disrupted non-essential in-person research activities that require contact with human subjects. While guidelines are being developed for ramping up human subjects research, one component of research that can be performed remotely is participant screening for lower limb function and gait impairments. In this commentary, we summarize evidence-supported clinical assessments that have potential to be conducted remotely in a safe manner, to make an initial determination of the functional mobility status of persons with neurological disorders. We present assessments that do not require complex or costly equipment, specialized software, or trained personnel to administer. We provide recommendations to implement remote functional assessments for participant recruitment and continuation of lower limb neurorehabilitation research as a rapid response to the COVID-19 pandemic and for utilization beyond the current pandemic. We also highlight critical research gaps related to feasibility and measurement characteristics of remote lower limb assessments, providing opportunities for future research to advance tele-assessment and tele-rehabilitation.
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Affiliation(s)
- Sangeetha Madhavan
- Department of Physical Therapy, The University of Illinois at Chicago, Chicago, IL 60612
| | - Anjali Sivaramakrishnan
- Graduate Program in Rehabilitation Science, The University of Illinois at Chicago, Chicago, IL 60612
| | - Mark G. Bowden
- Division of Physical Therapy and Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC 29425
| | - Neale R. Chumbler
- Department of Rehabilitation and Health Services, University of North Texas, College of Health and Public Service, 1155 Union Circle #311340, Denton, TX 76203
| | - Edelle C. Field-Fote
- Crawford Research Institute, Shepherd Center, Atlanta, GA 30309, Division of Physical Therapy, Emory University School of Medicine, 30322
| | - Trisha Kesar
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA 30322
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147
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Hollywood RA, Poyade M, Paul L, Webster A. Proof of Concept for the Use of Immersive Virtual Reality in Upper Limb Rehabilitation of Multiple Sclerosis Patients. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1356:73-93. [PMID: 35146618 DOI: 10.1007/978-3-030-87779-8_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Multiple sclerosis (MS) is a debilitating disease which gradually reduces motor function and mobility. Virtual reality (VR) has been successfully utilised in support of existing therapeutic approaches for many different conditions, and new innovative and experimental features could be the future of VR rehabilitation. The Quest is a new headset by Oculus, with its built-in tracking, relatively low cost, portability and lack of reliance on expensive processing heavy PCs to power it, and could be an ideal system to facilitate at-home or clinic-based upper limb rehabilitation. A hand-tracking-based rehabilitation game aimed at people with MS was developed for Oculus Quest using Unity. Two distinct games were made to replicate different types of hand exercises, piano playing for isolated finger flexion and maze tracking for coordination and arm flexion. This pilot study assesses the value of such approach along with evaluating intrinsic and extrinsic methods of providing feedback, namely, positive scoring, negative scoring and audio response. One physiotherapist and two individuals with MS were surveyed. Participant response was positive although small sample size impacts the user testing validity of the results. Future research is recommended to build off the data gathered as a pilot study and increase sample size to collect richer feedback.
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Affiliation(s)
| | | | - Lorna Paul
- Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Amy Webster
- Glasgow Caledonian University, Glasgow, Scotland, UK
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Current Approaches in Telehealth and Telerehabilitation for Spinal Cord Injury (TeleSCI). CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022; 10:77-88. [PMID: 35493027 PMCID: PMC9039273 DOI: 10.1007/s40141-022-00348-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 12/04/2022]
Abstract
Purpose of Review Telehealth and telerehabilitation in spinal cord injury (teleSCI) is a growing field that can improve access to care and improve health outcomes in the spinal cord injury population. This review provides an overview of the recent literature on the topic of teleSCI and provides insights on current evidence, future directions, and considerations when using teleSCI for clinical care. Recent Findings TeleSCI is used most often for preventive health; management of chronic pain, anxiety, and depression; and rehabilitation-related interventions. As video telehealth becomes mainstream, growth in wearable monitors, bio and neurofeedback mechanisms, and app-based care is expected. Summary TeleSCI is growing in prevalence, demonstrates positive impact on health outcomes, and requires ongoing study to identify, refine, and implement best practices.
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Kim SY, Daley K, Pruski AD, AlFarra T, Azola A, Gonzalez Fernandez M, Keszler MS, Friedel S, Haaf H, Segall H, Lien P, Cypher J, Mazariegos J, Raghavan P. Implementation of a Framework for Telerehabilitation in Clinical Care Across the Continuum During COVID-19 and Beyond. Am J Phys Med Rehabil 2022; 101:53-60. [PMID: 34915545 PMCID: PMC8667677 DOI: 10.1097/phm.0000000000001904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The COVID-19 pandemic has propelled an unprecedented global implementation of telemedicine and telerehabilitation as well as its integration into the healthcare system. Here, we describe the clinical implementation of the A3E framework for the deployment of telerehabilitation in the inpatient and outpatient rehabilitation continuum by addressing accessibility, adaptability, accountability, and engagement during the COVID-19 pandemic. By using an organized, coordinated, and stratified approach, we increased our telerehabilitation practice from 0 to more than 39,000 visits since the pandemic began. Learning from both the successes and challenges can help address the need to increase access to rehabilitation services even beyond the COVID-19 pandemic.
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Arzani P, Khalkhali Zavieh M, Khademi-Kalantari K, Akbarzadeh Baghban A. Opportunities and barriers for telerehabilitation during Coronavirus outbreak. Med J Islam Repub Iran 2021; 35:100. [PMID: 34956946 PMCID: PMC8683792 DOI: 10.47176/mjiri.35.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Parisa Arzani
- Department of Physiotherapy, School of Rehabilitation, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Minoo Khalkhali Zavieh
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Khosro Khademi-Kalantari
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, Department of Basic Science, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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