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Palumbo A, Vizza P, Calabrese B, Ielpo N. Biopotential Signal Monitoring Systems in Rehabilitation: A Review. SENSORS 2021; 21:s21217172. [PMID: 34770477 PMCID: PMC8587479 DOI: 10.3390/s21217172] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 12/14/2022]
Abstract
Monitoring physical activity in medical and clinical rehabilitation, in sports environments or as a wellness indicator is helpful to measure, analyze and evaluate physiological parameters involving the correct subject’s movements. Thanks to integrated circuit (IC) technologies, wearable sensors and portable devices have expanded rapidly in monitoring physical activities in sports and tele-rehabilitation. Therefore, sensors and signal acquisition devices became essential in the tele-rehabilitation path to obtain accurate and reliable information by analyzing the acquired physiological signals. In this context, this paper provides a state-of-the-art review of the recent advances in electroencephalogram (EEG), electrocardiogram (ECG) and electromyogram (EMG) signal monitoring systems and sensors that are relevant to the field of tele-rehabilitation and health monitoring. Mostly, we focused our contribution in EMG signals to highlight its importance in rehabilitation context applications. This review focuses on analyzing the implementation of sensors and biomedical applications both in literature than in commerce. Moreover, a final review discussion about the analyzed solutions is also reported at the end of this paper to highlight the advantages of physiological monitoring systems in rehabilitation and individuate future advancements in this direction. The main contributions of this paper are (i) the presentation of interesting works in the biomedical area, mainly focusing on sensors and systems for physical rehabilitation and health monitoring between 2016 and up-to-date, and (ii) the indication of the main types of commercial sensors currently being used for biomedical applications.
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Affiliation(s)
- Arrigo Palumbo
- Department of Medical and Surgical Sciences, Magna Græcia University, 88100 Catanzaro, Italy; (A.P.); (B.C.); (N.I.)
| | - Patrizia Vizza
- Mater Domini University Hospital, 88100 Catanzaro, Italy
- Interdepartmental Center of Services (CIS), Magna Græcia University, 88100 Catanzaro, Italy
- Correspondence:
| | - Barbara Calabrese
- Department of Medical and Surgical Sciences, Magna Græcia University, 88100 Catanzaro, Italy; (A.P.); (B.C.); (N.I.)
| | - Nicola Ielpo
- Department of Medical and Surgical Sciences, Magna Græcia University, 88100 Catanzaro, Italy; (A.P.); (B.C.); (N.I.)
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152
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Srivastava A, Swaminathan A, Chockalingam M, Srinivasan MK, Surya N, Ray P, Hegde PS, Akkunje PS, Kamble S, Chitnis S, Kamalakannan S, Ganvir S, Shah U. Tele-Neurorehabilitation During the COVID-19 Pandemic: Implications for Practice in Low- and Middle-Income Countries. Front Neurol 2021; 12:667925. [PMID: 34690907 PMCID: PMC8529345 DOI: 10.3389/fneur.2021.667925] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
The importance of neurorehabilitation services for people with disabilities is getting well-recognized in low- and middle-income countries (LMICs) recently. However, accessibility to the same has remained the most significant challenge, in these contexts. This is especially because of the non-availability of trained specialists and the availability of neurorehabilitation centers only in urban cities owned predominantly by private healthcare organizations. In the current COVID-19 pandemic, the members of the Task Force for research at the Indian Federation of Neurorehabilitation (IFNR) reviewed the context for tele-neurorehabilitation (TNR) and have provided the contemporary implications for practicing TNR during COVID-19 for people with neurological disabilities (PWNDs) in LMICs. Neurorehabilitation is a science that is driven by rigorous research-based evidence. The current pandemic implies the need for systematically developed TNR interventions that is evaluated for its feasibility and acceptability and that is informed by available evidence from LMICs. Given the lack of organized systems in place for the provision of neurorehabilitation services in general, there needs to be sufficient budgetary allocations and a sector-wide approach to developing policies and systems for the provision of TNR services for PWNDs. The pandemic situation provides an opportunity to optimize the technological innovations in health and scale up these innovations to meet the growing burden of neurological disability in LMICs. Thus, this immense opportunity must be tapped to build capacity for safe and effective TNR services provision for PWNDs in these settings.
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Affiliation(s)
- Abhishek Srivastava
- Centre for Physical Medicine and Rehabilitation, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India
| | | | | | - Murali K Srinivasan
- Faculty of Occupational Therapy, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Nirmal Surya
- Chairman Surya Neuro Centre Mumbai, President Indian Federation of Neurorehabilitation (IFNR), Mumbai, India
| | - Partha Ray
- National Health Services England, The Walton Centre Liverpool & National Professor of Neurology, Liverpool, United Kingdom
| | - Prasanna S Hegde
- Deglutology and Speech-Language Pathology, HCG Hospital, Bangalore, India
| | - Preetie Shetty Akkunje
- Department of Speech Pathology and Audiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Sanjivani Kamble
- Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Sonal Chitnis
- Bharati Vidyapeeth (Deemed to be) University, School of Audiology Speech Language Pathology, Pune, India
| | - Sureshkumar Kamalakannan
- South Asia Centre for Disability Inclusive Development and Research (SACDIR), Public Health Foundation of India, The Indian Institute of Public Health Hyderabad, Hyderabad, India
| | - Suvarna Ganvir
- Department of Neuro Physiotherapy, Dr. Vitalrao Vikhe Patil Foundation's College of Physiotherapy, Ahmednagar, India
| | - Urvashi Shah
- Department of Neurology, King Edward Memorial and Global Hospitals Mumbai, Mumbai, India
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153
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Everard G, Luc A, Doumas I, Ajana K, Stoquart G, Edwards MG, Lejeune T. Self-Rehabilitation for Post-Stroke Motor Function and Activity-A Systematic Review and Meta-Analysis. Neurorehabil Neural Repair 2021; 35:1043-1058. [PMID: 34696645 DOI: 10.1177/15459683211048773] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Due to an increasing stroke incidence, a lack of resources to implement effective rehabilitation and a significant proportion of patients with remaining impairments after treatment, there is a rise in demand for effective and prolonged rehabilitation. Development of self-rehabilitation programs provides an opportunity to meet these increasing demands.Objective. The primary aim of this meta-analysis was to determine the effect of self-rehabilitation on motor outcomes, in comparison to conventional rehabilitation, among patients with stroke. The secondary aim was to assess the influence of trial location (continent), technology, time since stroke (acute/subacute vs chronic), dose (total training duration > vs ≤ 15 hours), and intervention design (self-rehabilitation in addition/substitution to conventional therapy) on effect of self-rehabilitation.Methods. Studies were selected if participants were adults with stroke; the intervention consisted of a self-rehabilitation program defined as a tailored program where for most of the time, the patient performed rehabilitation exercises independently; the control group received conventional therapy; outcomes included motor function and activity; and the study was a randomized controlled trial with a PEDro score ≥5.Results. Thirty-five trials were selected (2225 participants) and included in quantitative synthesis regarding motor outcomes. Trials had a median PEDro Score of 7 [6-8]. Self-rehabilitation programs were shown to be as effective as conventional therapy. Trial location, use of technology, stroke stage, and intervention design did not appear to have a significant influence on outcomes.Conclusion. This meta-analysis showed low to moderate evidence that self-rehabilitation and conventional therapy efficacy was equally valuable for post-stroke motor function and activity.
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Affiliation(s)
- Gauthier Everard
- Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique, Secteur des Sciences de la Santé, 193391Université catholique de Louvain, Brussels, Belgium.,Louvain Bionics, 83415Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Alexandre Luc
- Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique, Secteur des Sciences de la Santé, 193391Université catholique de Louvain, Brussels, Belgium
| | - Ioannis Doumas
- Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique, Secteur des Sciences de la Santé, 193391Université catholique de Louvain, Brussels, Belgium.,Louvain Bionics, 83415Université catholique de Louvain, Louvain-la-Neuve, Belgium.,Service de médecine physique et réadaptation, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Khawla Ajana
- Psychological Sciences Research Institute (IPSY), 83415Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Gaëtan Stoquart
- Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique, Secteur des Sciences de la Santé, 193391Université catholique de Louvain, Brussels, Belgium.,Louvain Bionics, 83415Université catholique de Louvain, Louvain-la-Neuve, Belgium.,Service de médecine physique et réadaptation, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Martin Gareth Edwards
- Louvain Bionics, 83415Université catholique de Louvain, Louvain-la-Neuve, Belgium.,Psychological Sciences Research Institute (IPSY), 83415Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Thierry Lejeune
- Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique, Secteur des Sciences de la Santé, 193391Université catholique de Louvain, Brussels, Belgium.,Louvain Bionics, 83415Université catholique de Louvain, Louvain-la-Neuve, Belgium.,Service de médecine physique et réadaptation, Cliniques universitaires Saint-Luc, Brussels, Belgium
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154
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Menici V, Barzacchi V, Filogna S, Beani E, Tinelli F, Cioni G, Sgandurra G. Tele-Rehabilitation for Postural Control by Means of Virtual Reality Rehabilitation System in an Adolescent With Motor Disorder: A Case Study. Front Psychol 2021; 12:720677. [PMID: 34721174 PMCID: PMC8551356 DOI: 10.3389/fpsyg.2021.720677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/30/2021] [Indexed: 11/13/2022] Open
Abstract
The coming of an unforeseen and hostile event such as the COVID-19 pandemic has brought about various changes in everyone's daily life. During the lockdown period, a huge number of restrictions were imposed, hence interrupting a wide range of activities previously proven to be necessary for some people. Due to the circumstances, rehabilitation treatments for children with neurodevelopmental disorders have been suspended, resulting in consequent distress for the children themselves and their parents. To overcome this problem, a tele-rehabilitation approach has proven to be an excellent solution to give continuity to children's rehabilitation. The tele-rehabilitation approach allows access to rehabilitation services directly from home. During lockdown due to the COVID-19 pandemic, the Virtual Reality Rehabilitation System (VRRS) HomeKit, developed by Khymeia, was employed as a rehabilitation system for the treatment of posture and balance of an adolescent with disabilities for the first time ever. Specifically, a 17-year-old female patient was enrolled and evaluated by the clinical staff before and after the home-training sessions. The system was delivered to the patient's home so that she could perform the tasks in a familiar environment, while under the supervision of the clinical staff. Through a specific platform, using different modules of the system, therapists could remotely check that the proposed exercises were properly performed and provide feedback and/or increase the difficulty according to the patient's needs and progress. Therefore, the treatment performed was carried out at home in a personalized, intensive, and playful way; characteristics do not present in a traditional treatment. Our results are promising and demonstrate both the efficacy of rehabilitation exercises carried out at home and the feasibility of home-based rehabilitation, when using the VRRS HomeKit even with adolescents. The VRRS HomeKit presents some limitations, such as the need to have the line connection and free space at home, the presence of technical issues, and the education of parents and patients to understand the instructions. Despite the limitations, this study provides the basis for continuing the experience of tele-rehabilitation on patients with a motor disorder also by customizing the exercises to their characteristics.
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Affiliation(s)
- Valentina Menici
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
| | - Veronica Barzacchi
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
| | - Silvia Filogna
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
| | - Elena Beani
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
| | - Francesca Tinelli
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
| | - Giovanni Cioni
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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155
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Batalik L, Dosbaba F, Hartman M, Konecny V, Batalikova K, Spinar J. Long-term exercise effects after cardiac telerehabilitation in patients with coronary artery disease: 1-year follow-up results of the randomized study. Eur J Phys Rehabil Med 2021; 57:807-814. [PMID: 33619944 DOI: 10.23736/s1973-9087.21.06653-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Home-based cardiac telerehabilitation (HBCT) is a feasible and effective alternative to traditional center-based cardiac rehabilitation (CBCR). Currently, there are only limited studies focusing on a long-term effect of HBCT, which means it is essential to do more research in this study field. AIM This study aimed at investigating a 1-year effect of a randomized controlled study using Cardiac Rehabilitation through the Global Position System (CR-GPS) compared to outpatient cardiac rehabilitation. Study focused on cardiorespiratory fitness (CRF) and health-related quality of life (HRQL) in patients with coronary heart disease (CAD). DESIGN A long-term follow-up of a randomized study. SETTING Patients were enrolled, and the intervention was performed in an outpatient or home-based model. The results were obtained and evaluated in a hospital. POPULATION Patients who participated in the CR-GPS study were diagnosed with CAD with low to moderate cardiovascular risk. METHODS Patients enrolled in the study were eligible participants who had previously completed a 12-week HBCT program using a wrist heart rate (HR) monitor or attended a traditional CBCR. Primary outcome was the change in CRF expressed in peak oxygen uptake (pVO<inf>2</inf>), and the secondary outcomes were self-reported HRQL, objectively measured anthropometric characteristics, and mortality and hospitalization rates. RESULTS Forty-four patients (76%) completed the long-term follow-up. The average peak of pVO<inf>2</inf> was higher after 1-year follow-up in the telerehabilitation group (HBCT 25.5 mL/kg/min compared to the active control group CBCR 23.6 mL/kg/min P=0.047). No statistically significant difference between the two groups was found after long-term follow-up for the parameter HRQL. For both groups, there was a significant improvement in the range of perceptions of general health. There was no death case and no difference in hospitalization rate between the groups. CONCLUSIONS This study supports the HBCT model. It has been demonstrated that it induces satisfactory long-term effects in pVO<inf>2</inf>, exercise performance, and perceived general health in CAD patients with low to moderate cardiovascular risk. CLINICAL REHABILITATION IMPACT Cardiovascular telerehabilitation using wrist HR monitors is a feasible and effective rehabilitation method that can help patients eliminate barriers that prevent them from using CBCR programs. Especially in the current global situation with the COVID-19 pandemic, this topic is becoming increasingly important.
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Affiliation(s)
- Ladislav Batalik
- Department of Rehabilitation, University Hospital of Brno, Brno, Czech Republic -
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic -
| | - Filip Dosbaba
- Department of Rehabilitation, University Hospital of Brno, Brno, Czech Republic
| | - Martin Hartman
- Department of Rehabilitation, University Hospital of Brno, Brno, Czech Republic
| | - Vladimir Konecny
- Department of Rehabilitation, University Hospital of Brno, Brno, Czech Republic
| | - Katerina Batalikova
- Department of Rehabilitation, University Hospital of Brno, Brno, Czech Republic
| | - Jindrich Spinar
- First Department of Internal Medicine and Cardioangiology, Institutions shared with St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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156
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Vellata C, Belli S, Balsamo F, Giordano A, Colombo R, Maggioni G. Effectiveness of Telerehabilitation on Motor Impairments, Non-motor Symptoms and Compliance in Patients With Parkinson's Disease: A Systematic Review. Front Neurol 2021; 12:627999. [PMID: 34512495 PMCID: PMC8427282 DOI: 10.3389/fneur.2021.627999] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 07/19/2021] [Indexed: 12/17/2022] Open
Abstract
Introduction: Parkinson's disease (PD) is a chronic neurodegenerative disease involving a progressive alteration of the motor and non-motor function. PD influences the patient's daily living and reduces participation and quality of life in all phases of the disease. Early physical exercise can mitigate the effects of symptoms but access to specialist care is difficult. With current technological progress, telemedicine, and telerehabilitation is now a viable option for managing patients, although few studies have investigated the use of telerehabilitation in PD. In this systematic review, was investigated whether telerehabilitation leads to improvements in global or specific motor tasks (gait and balance, hand function) and non-motor dysfunction (motor speech disorder, dysphagia). The impact of TR on quality of life and patient satisfaction, were also assessed. The usage of telerehabilitation technologies in the management of cognitive impairment was not addressed. Method: An electronic database search was performed using the following databases: PubMed/MEDLINE, COCHRANE Library, PEDro, and SCOPUS for data published between January 2005 and December 2019 on the effects of telerehabilitation systems in managing motor and non-motor symptoms. This systematic review was conducted in accordance with the PRISMA guideline and was registered in the PROSPERO database (CRD42020141300). Results: A total of 15 articles involving 421 patients affected by PD were analyzed. The articles were divided into two categories based on their topic of interest or outcome. The first category consisted of the effects of telerehabilitation on gait and balance (3), dexterity of the upper limbs (3), and bradykinesia (0); the second category regarded non-motor symptoms such as speech disorders (8) and dysphagia (0). Quality of life (7) and patient satisfaction (8) following telerehabilitation programs were also analyzed, as well as feasibility and costs. Conclusion: Telerehabilitation is feasible in people affected by PD. Our analysis of the available data highlighted that telerehabilitation systems are effective in maintaining and/or improving some clinical and non-clinical aspects of PD (balance and gait, speech and voice, quality of life, patient satisfaction). Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier: CRD42020141300.
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Affiliation(s)
- Chiara Vellata
- Istituti Clinici Scientifici Maugeri Spa - Società Benefit, Neurologic Rehabilitation Unit of Veruno Institute, Veruno, Italy
| | - Stefano Belli
- Istituti Clinici Scientifici Maugeri Spa - Società Benefit, Neurologic Rehabilitation Unit of Veruno Institute, Veruno, Italy
| | - Francesca Balsamo
- Istituti Clinici Scientifici Maugeri Spa - Società Benefit, Neurologic Rehabilitation Unit of Veruno Institute, Veruno, Italy
| | - Andrea Giordano
- Istituti Clinici Scientifici Maugeri Spa - Società Benefit, Bioengineering Service, Veruno, Italy
| | - Roberto Colombo
- Istituti Clinici Scientifici Maugeri Spa - Società Benefit, Bioengineering Service, Veruno, Italy
| | - Giorgio Maggioni
- Istituti Clinici Scientifici Maugeri Spa - Società Benefit, Neurologic Rehabilitation Unit of Veruno Institute, Veruno, Italy
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157
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Tokgöz P, Dockweiler C. [Telemedicine in Rehabilitation Aftercare for Women with Breast Cancer - A Systematic Literature Review]. REHABILITATION 2021; 61:17-24. [PMID: 34399436 DOI: 10.1055/a-1480-3712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Breast cancer continues to be the most common maligned tumor disease in women. Diagnosis and treatment-related side effects affect functioning of women in the long run. The provision of rehabilitation aftercare services for breast cancer survivors is often limited by resources and access. Telemedicine seems to be a potential way of the remote delivery of rehabilitation aftercare. The aim of this systematic review is to examine the efficacy of telemedicine-based aftercare interventions for breast cancer survivors regarding specific outcomes of functioning. METHODS A systematic search was conducted in April to May 2020 in the databases Pubmed and The Cochrane Library and has been updated in August 2020. Only randomized controlled trials were considered, that examined the efficacy of telemedicine-based interventions for the aftercare of women with breast cancer. RESULTS In total, 11 publications of 10 intervention studies were identified and included in this review. No study was found from Germany. In general, studies were classified as psychosocial interventions and interventions for lifestyle changes. Regarding the between-study heterogeneity the results indicate positive effects in certain parameters of functioning (therapy-induced menopausal symptoms, fatigue, sleep functions, adherence). However, for certain of the outcomes (mental functions like emotional and cognitive functions, health-related quality of life) there is no sufficient evidence for the efficacy of telemedicine-based interventions in the aftercare for women with breast cancer. CONCLUSION The results indicate the need of an evidence-based practice in telemedicine-based interventions in the aftercare for women with breast cancer. In future, well-designed randomized controlled trials are needed in Germany to systematically explore the efficacy of telemedicine-based aftercare interventions.
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Affiliation(s)
- Pinar Tokgöz
- Fakultät für Gesundheitswissenschaften, Centre for ePublic Health Research, Universität Bielefeld, Deutschland
| | - Christoph Dockweiler
- Fakultät für Gesundheitswissenschaften, Centre for ePublic Health Research, Universität Bielefeld, Deutschland
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158
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Anil K, Freeman JA, Buckingham S, Demain S, Gunn H, Jones RB, Logan A, Marsden J, Playford D, Sein K, Kent B. Scope, context and quality of telerehabilitation guidelines for physical disabilities: a scoping review. BMJ Open 2021; 11:e049603. [PMID: 34385253 PMCID: PMC8361705 DOI: 10.1136/bmjopen-2021-049603] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To identify the available guidance and training to implement telerehabilitation movement assessments for people (adults and children) with a physical disability, including those recovering from COVID-19. DESIGN Rapid scoping review. INCLUDED SOURCES AND ARTICLES PubMed, CINAHL, PsychInfo, Cochrane, Embase, Web of Science, PEDro, UK Health Forum, WHO, National Archives and NHS England were searched using the participant-concept-context framework from 2015 to August 2020. Primary studies that recruited individuals with physical disabilities and guidance documents aimed at providers to implement movement-related telerehabilitation were included. RESULTS 23 articles (11 primary research studies, 3 systematic reviews and 9 guidance documents) were included out of 7857 that were identified from the literature search. Two main issues were found: (1) telerehabilitation guidance (from both research studies and guidance documents) was not specific to movement-related assessment and (2) most primary research studies provided neither guidance nor training of movement-specific assessment to practitioners. Of the COVID-19 related guidance, two articles reported COVID-19 management that only referred to identifying COVID-19 status without references to specific movement-related guidance. CONCLUSIONS Telerehabilitation guidance and training have existed pre-COVID-19, yet the lack of specific movement-related information and provider support is surprising. This gap must be addressed to optimise effective implementation of remote assessments for those with physical disabilities. REVIEW REGISTRATION Open Science Framework: osf.io/vm6sp.
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Affiliation(s)
- Krithika Anil
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Jennifer A Freeman
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Sarah Buckingham
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Sara Demain
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Hilary Gunn
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Ray B Jones
- School of Nursing and Midwifery, Plymouth University, Plymouth, UK
| | - Angela Logan
- Stroke Rehabilitation, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Jonathan Marsden
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Diane Playford
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Kim Sein
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Bridie Kent
- School of Nursing and Midwifery, Plymouth University, Plymouth, UK
- Innovations in Health and Social Care: A JBI Centre of Excellence, Plymouth University, Plymouth, UK
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159
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Maldonado-Díaz M, Vargas P, Vasquez R, Gonzalez-Seguel F, Rivero B, Hidalgo-Cabalín V, Gutierrez-Panchana T. Teleneurorehabilitation program (virtual reality) for patients with balance disorders: descriptive study. BMC Sports Sci Med Rehabil 2021; 13:83. [PMID: 34340687 PMCID: PMC8330090 DOI: 10.1186/s13102-021-00314-z] [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: 03/01/2021] [Accepted: 07/09/2021] [Indexed: 11/24/2022]
Abstract
Background Balance disorders are common in patients with neurological or vestibular diseases. Telerehabilitation program is a treatment to be as safe as conventional treatment. One of the most used methods to perform telerehabilitation is the incorporation of Virtual Reality. In general, rehabilitation programs train predictive postural control, so the patient does not always acquire the necessary autonomy to react to situations of instability. On the other hand, the objective and systematic supervision and measurement of these programs is limited, making it necessary to create clinical protocols with precise and measurable rehabilitation objectives. This study present the training selection methodology and clinical protocol for patients with balance disorders inserted in a Telerehabilitation Program based on Virtual Reality. Methods Descriptive study where physiotherapists were trained to use RehaMetrics®. To evaluate their level of agreement in the selection of the exercise clusters developed, the Interobserver Reliability was measured through the kappa statistic. Subsequently, the exercises were applied to a group of patients recruited with sedentary trunk control (Berg Balance Scale = 3 points in item 3), mild or normal cognitive level (Montreal Cognitive Assessment> 21 points), and prescribed for tele-rehabilitation by a doctor. Results The agreement among the expert physiotherapists irrespective of the cluster exceeds 80%, which indicates a very good strength of agreement, while the novices reached a level of agreement of 45%, which suggests a moderate strength of agreement. All clinical outcomes showed statistically significant differences between the median times, as did the Maximum Width Left Side (MWLS) (cm). The average number of minutes of training was 485.81 (SD 246.49 min), and the number of sessions performed during the 4 weeks of intervention was 17 (SD 7.15 sessions). Conclusions This analysis what had excellent interobserver reliability with trained physiotherapists. Regarding the second phase of the study, the results show a statistically significant difference between the initial and final evaluation of the clinical tests, which could result in better performance in aspects such as: balance, gait functionality, meter walked and cognition. Telerehabilitation Program based on Virtual Reality is an excellent alternative to provide continuity of treatment to patients with balance disorders. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-021-00314-z.
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Affiliation(s)
- Marcos Maldonado-Díaz
- Clinica Alemana Universidad del Desarrollo, Vitacura 5951. Región Metropolitana, Santiago, Chile.
| | - Patricia Vargas
- Clinica Alemana Universidad del Desarrollo, Vitacura 5951. Región Metropolitana, Santiago, Chile
| | - Ricardo Vasquez
- Clinica Alemana Universidad del Desarrollo, Vitacura 5951. Región Metropolitana, Santiago, Chile
| | - Felipe Gonzalez-Seguel
- Clinica Alemana Universidad del Desarrollo, Vitacura 5951. Región Metropolitana, Santiago, Chile
| | - Betel Rivero
- Clinica Alemana Universidad del Desarrollo, Vitacura 5951. Región Metropolitana, Santiago, Chile
| | - Viviane Hidalgo-Cabalín
- Clinica Alemana Universidad del Desarrollo, Vitacura 5951. Región Metropolitana, Santiago, Chile
| | - Tania Gutierrez-Panchana
- Clinica Alemana Universidad del Desarrollo, Vitacura 5951. Región Metropolitana, Santiago, Chile
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Lam SKY, Chau JPC, Lo SHS, Siow EKC, Lee VWY, Shum EWC, Lau AYL. User engagement in the development of a home-based virtual multidisciplinary stroke care clinic for stroke survivors and caregivers: a qualitative descriptive study. Disabil Rehabil 2021; 44:5983-5989. [PMID: 34297647 DOI: 10.1080/09638288.2021.1955305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To understand the user expectations and the facilitators and barriers of using a virtual multidisciplinary stroke care clinic ("virtual clinic"). METHODS A qualitative descriptive study involving two rounds of face-to-face semi-structured interviews per participant was conducted. We purposively recruited ten participants in Hong Kong who were receiving traditional stroke rehabilitation. The first interview was conducted to explore participants' expectations. The second interview was conducted after a 4-week trial of the virtual clinic. Both interviews were analysed using thematic analysis. The findings were translated from Cantonese into English. RESULTS Before using the virtual clinic, the participants perceived a need for (i) information communication technology guidance and support, (ii) familiar hardware and applications, and (iii) services to meet psychosocial needs. Facilitators identified by the participants included (i) feeling safe and supported, (ii) willingness to learn, adapt to, and use the new service, and (iii) ease of use with a flexible schedule. Issues relating to (i) internet connectivity, (ii) hardware, and (iii) interface and design were perceived barriers to the use of the clinic. CONCLUSION This study provides findings of users' expectations of using telehealth services. Their perspectives on facilitators and barriers may increase the adoption of the newly developed telehealth service.Implications for rehabilitationTo implement telehealth as part of post-stroke care, it is important to ensure that stroke survivors and caregivers have the necessary information and communication technology support and infrastructure to engage in two-way interactions.Stroke survivors and caregivers may be inclined to use telehealth services due to ease of use, having flexibility in scheduling consultation sessions, do not need to travel to the clinic, useful online content, and remote blood pressure monitoring.Addressing the barriers of using telehealth services (e.g., hardware issues, internet connectivity issues, and user interface to facilitate the reading of information on the website) can improve the usability and acceptance to ensure the successful adoption of telehealth as part of post-stroke recovery.
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Affiliation(s)
- Simon Kwun Yu Lam
- Faculty of Medicine, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Janita Pak Chun Chau
- Faculty of Medicine, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Suzanne Hoi Shan Lo
- Faculty of Medicine, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Elaine Kee Chen Siow
- Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
| | - Vivian Wing Yan Lee
- Centre for Learning Enhancement and Research, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Alexander Yuk Lun Lau
- Department of Medicine and Therapeutics, Faculty of Medicine, Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Borges PRT, Resende RA, Dias JF, Mancini MC, Sampaio RF. Telerehabilitation program for older adults on a waiting list for physical therapy after hospital discharge: study protocol for a pragmatic randomized trial protocol. Trials 2021; 22:445. [PMID: 34256830 PMCID: PMC8275917 DOI: 10.1186/s13063-021-05387-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/21/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Delays in starting physical therapy after hospital discharge worsen deconditioning in older adults. Intervening quickly can minimize the negative effects of deconditioning. Telerehabilitation is a strategy that increases access to rehabilitation, improves clinical outcomes, and reduces costs. This paper presents the protocol for a pragmatic clinical trial that aims to determine the effectiveness and cost-effectiveness of a multi-component intervention offered by telerehabilitation for discharged older adults awaiting physical therapy for any specific medical condition. METHODS This is a pragmatic randomized controlled clinical trial with two groups: telerehabilitation and control. Participants (n=230) will be recruited among individuals discharged from hospitals who are in the public healthcare system physical therapy waiting lists. The telerehabilitation group will receive a smartphone app with a personalized program (based on individual's functional ability) of resistance, balance, and daily activity training exercises. The intervention will be implemented at the individuals' homes. This group will be monitored weekly by phone and monthly through a face-to-face meeting until they start physical therapy. The control group will adhere to the public healthcare system's usual flow and will be monitored weekly by telephone until they start physical therapy. The primary outcome will be a physical function (Timed Up and Go and 30-s Chair Stand Test). The measurements will take place in baseline, start, and discharge of outpatient physical therapy. The economic evaluations will be performed from the perspective of society and the Brazilian public healthcare system. DISCUSSION The study will produce evidence on the effectiveness and cost-effectiveness of multi-component telerehabilitation intervention for discharged older adult patients awaiting physical therapy, providing input that can aid the implementation of similar proposals in other patient groups. TRIAL REGISTRATION Brazilian Registry of Clinical Trials (ReBEC), RBR-9243v7 . Registered on 24 August 2020.
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Affiliation(s)
- Pollyana Ruggio Tristão Borges
- Rehabilitation Sciences Graduate Program, Department of Physical Therapy, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627 - Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Renan Alves Resende
- Rehabilitation Sciences Graduate Program, Department of Physical Therapy, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627 - Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
| | - Jane Fonseca Dias
- Rehabilitation Sciences Graduate Program, Department of Physical Therapy, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627 - Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Marisa Cotta Mancini
- Rehabilitation Sciences Graduate Program, Department of Physical Therapy, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627 - Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Rosana Ferreira Sampaio
- Rehabilitation Sciences Graduate Program, Department of Physical Therapy, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627 - Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
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Alaimo C, Campana E, Stoppelli MR, Gobbi E, Baglio F, Rossetto F, Binetti G, Zanetti O, Manenti R, Cotelli M. Cognitive Tele-Enhancement in Healthy Older Adults and Subjects With Subjective Memory Complaints: A Review. Front Neurol 2021; 12:650553. [PMID: 34290660 PMCID: PMC8287022 DOI: 10.3389/fneur.2021.650553] [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: 01/07/2021] [Accepted: 06/03/2021] [Indexed: 11/13/2022] Open
Abstract
Background: In recent years, emphasis has been placed on cognitive enhancement to stimulate cognitive abilities and prevent functional decline. Considering that traditional face-to-face interventions can be very expensive and are not accessible to all individuals, the need to transfer care from the clinic to the patient's home is evident. In this regard, cognitive tele-enhancement interventions have received increased attention. Aim: The aim of this review was to provide an overview of protocols that apply remotely controlled cognitive training with individualized feedback on performance by the therapist in healthy older adults or participants with subjective memory complaints. Methods: Out of 35 articles assessed for eligibility, eight studies were identified. Of the selected studies, five included cognitively healthy older adults, while three included participants with subjective memory complaints. Results: Most of the reviewed studies showed beneficial effects of cognitive tele-enhancement interventions, reporting improvements in memory, sustained attention, working memory, executive functions, and language abilities. Moreover, reductions in anxiety and depression symptomatology levels, as well as in subjective memory difficulties, were described in some of the studies. Conclusions: Cognitive tele-enhancement treatment could be a good alternative to face-to-face intervention. This literature review highlights the importance of applying preventive cognitive interventions to subjects with initial subjective memory complaints. Remote modalities seem to facilitate the application of such interventions.
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Affiliation(s)
- Cristina Alaimo
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Campana
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Maria Rachele Stoppelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | | | - Giuliano Binetti
- Macroattività Ambulatoriale Complessa (MAC) Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Orazio Zanetti
- Alzheimer's Research Unit, Macroattività Ambulatoriale Complessa (MAC) Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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163
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Hameed NT, Satheesan SC, Santhamma JP. Parental experiences of telerehabilitation for children with special needs: An exploratory survey. Ind Psychiatry J 2021; 30:272-277. [PMID: 35017811 PMCID: PMC8709514 DOI: 10.4103/ipj.ipj_235_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 04/25/2021] [Accepted: 07/05/2021] [Indexed: 11/15/2022] Open
Abstract
CONTEXT The COVID-19 pandemic's emergence necessitated that clinic/hospital-based rehabilitation is replaced or substituted by other modes. Using telecommunication devices was found a convenient alternative. AIMS Present study explored the telerehabilitation experiences of the parents of children with developmental disabilities (CDD). SETTINGS AND DESIGN The study was conducted among the service users of a not-for-profit NGO located in Kerala. Parents of children with one or more developmental disabilities formed the population of the present study. The present study was a cross-sectional exploratory survey. SUBJECTS AND METHODS A total of 205 parents took part in the study using a brief open-ended survey. The majority of the participants were females (65%). STATISTICAL ANALYSIS USED The sociodemographic data were analyzed using frequency and percentage. The qualitative data were analyzed using thematic analysis. RESULTS Overall, the study found that parents experienced more challenges in telerehabilitation compared to face-to-face interventions. Perceived challenges included externalizing problems, reduced effectiveness, logistical issues, multiple disabilities, and the child's lack of interest in gadgets. Perceived advantages included the child's liking for the device and increased availability of time. CONCLUSION In short, the study throws light on the various challenges experienced by parents in implementing telerehabilitation for their CDD. The findings strongly recommend fine-tuning telerehabilitation programs to meet these challenges to provide optimal care to our children with special needs.
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Ebrahim H, Pillay-Jayaraman P, Leibovitz Y, Naidoo N, Bulmer T, Bull B, Lord S, Keller MM. Experiences and effects of telerehabilitation services for physiotherapy outpatients in a resource-constrained public health set-up in the backdrop of the COVID-19 pandemic: A proposal. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2021; 77:1528. [PMID: 34230898 PMCID: PMC8252170 DOI: 10.4102/sajp.v77i1.1528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/08/2021] [Indexed: 11/01/2022] Open
Abstract
Background The announcement of a national lockdown in South Africa had country-wide impact on the delivery of health services. Strategies included prioritisation of patients and protecting patients who were considered at risk, resulting in the need for cancellation and temporary termination of many outpatient therapy services. This necessitated the urgent need to come up with a way of delivering physiotherapy rehabilitation services to patients in a more non-traditional format. Telerehabilitation allows for the provision of services by using electronic communication, thus ensuring that patients are still able to access necessary rehabilitation services. Methods/design This is a prospective, mixed method study with participants recruited from the outpatient physiotherapy department of Chris Hani Baragwanath Academic Hospital (CHBAH). Telerehabilitation services will be provided via the patients' preferred method of communication. On discharge, participants and therapists will be asked about their experiences of telerehabilitation. Discussion Because of the current coronavirus disease 2019 (COVID-19) pandemic, patients are unable to receive traditional face-to-face physiotherapy services. Telerehabilitation offers a suitable alternative to treatment, but the feasibility, outcome and experiences of offering these services in the public health system have not been studied. Conclusion This study will determine whether telerehabilitation is a feasible service that can be offered in the COVID-19 pandemic, as well as post-pandemic, to enable physiotherapists to access those patients who are often unable to attend physiotherapy because of transport costs and various other reasons for non-attendance. Clinical implications The results of this study may indicate a way of managing patients in situations where face to face therapy cannot be undertaken. Protocol identification Pan African Clinical Trial Registry, PACTR202103637993156.
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Affiliation(s)
- Humairaa Ebrahim
- Department of Physiotherapy, Faculty of Health, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Prithi Pillay-Jayaraman
- Department of Physiotherapy, Faculty of Health, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.,Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Yehudit Leibovitz
- Department of Physiotherapy, Faculty of Health, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Nirvashi Naidoo
- Department of Physiotherapy, Faculty of Health, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Tracey Bulmer
- Department of Physiotherapy, Faculty of Health, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Bulelwa Bull
- Department of Physiotherapy, Faculty of Health, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Sandy Lord
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Monique M Keller
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Dovigo L, Caprì T, Iannizzotto G, Nucita A, Semino M, Giannatiempo S, Zocca L, Fabio RA. Social and Cognitive Interactions Through an Interactive School Service for RTT Patients at the COVID-19 Time. Front Psychol 2021; 12:676238. [PMID: 34248774 PMCID: PMC8265204 DOI: 10.3389/fpsyg.2021.676238] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/27/2021] [Indexed: 11/30/2022] Open
Abstract
Background: The closure of all educational institutions and most rehabilitation centres represents a precautionary measure to face the COVID-19 pandemic, but the isolation and social distancing may be particularly challenging for children with special needs and disabilities (SEND), such as Rett Syndrome (RTT). The main aim of this study was to promote cognitive and social interactions among children with RTT through an interactive school program. Methods: The Interactive School palimpsest was composed of moments in which a teacher spoke directly to children with RTT and expected a response through eye gaze, and moments in which storeys-cartoon were presented while tracking the eye gaze of children. We investigated behavioural, social and cognitive parameters. Results: Children participated in both social and cognitive tasks with the spontaneous reduction of stereotypies and with increase in attention. They recalled more significant indexes when music or a song was presented together with a cartoon or a cognitive task. Conclusions: This study provides initial insights in promoting cognitive and social interactions and in the support needs of families with a child with RTT during the COVID-19 pandemic.
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Affiliation(s)
- Lucia Dovigo
- Airett Innovation and Research Center, Verona, Italy
| | - Tindara Caprì
- Airett Innovation and Research Center, Verona, Italy
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giancarlo Iannizzotto
- Airett Innovation and Research Center, Verona, Italy
- Department of Cognitive Sciences, Psychological, Educational and Cultural Studies, University of Messina, Messina, Italy
| | - Andrea Nucita
- Airett Innovation and Research Center, Verona, Italy
- Department of Cognitive Sciences, Psychological, Educational and Cultural Studies, University of Messina, Messina, Italy
| | - Martina Semino
- Airett Innovation and Research Center, Verona, Italy
- Tice Learning Center, Piacenza, Italy
| | - Samantha Giannatiempo
- Airett Innovation and Research Center, Verona, Italy
- Tice Learning Center, Piacenza, Italy
| | - Lia Zocca
- Airett Innovation and Research Center, Verona, Italy
| | - Rosa Angela Fabio
- Airett Innovation and Research Center, Verona, Italy
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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166
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Dovigo L, Caprì T, Iannizzotto G, Nucita A, Semino M, Giannatiempo S, Zocca L, Fabio RA. Social and Cognitive Interactions Through an Interactive School Service for RTT Patients at the COVID-19 Time. Front Psychol 2021; 12:676238. [PMID: 34248774 PMCID: PMC8265204 DOI: 10.3389/fpsyg.2021.676238 10.3389/fpsyg.2021.676238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: The closure of all educational institutions and most rehabilitation centres represents a precautionary measure to face the COVID-19 pandemic, but the isolation and social distancing may be particularly challenging for children with special needs and disabilities (SEND), such as Rett Syndrome (RTT). The main aim of this study was to promote cognitive and social interactions among children with RTT through an interactive school program. Methods: The Interactive School palimpsest was composed of moments in which a teacher spoke directly to children with RTT and expected a response through eye gaze, and moments in which storeys-cartoon were presented while tracking the eye gaze of children. We investigated behavioural, social and cognitive parameters. Results: Children participated in both social and cognitive tasks with the spontaneous reduction of stereotypies and with increase in attention. They recalled more significant indexes when music or a song was presented together with a cartoon or a cognitive task. Conclusions: This study provides initial insights in promoting cognitive and social interactions and in the support needs of families with a child with RTT during the COVID-19 pandemic.
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Affiliation(s)
- Lucia Dovigo
- Airett Innovation and Research Center, Verona, Italy
| | - Tindara Caprì
- Airett Innovation and Research Center, Verona, Italy,Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy,*Correspondence: Tindara Caprì
| | - Giancarlo Iannizzotto
- Airett Innovation and Research Center, Verona, Italy,Department of Cognitive Sciences, Psychological, Educational and Cultural Studies, University of Messina, Messina, Italy
| | - Andrea Nucita
- Airett Innovation and Research Center, Verona, Italy,Department of Cognitive Sciences, Psychological, Educational and Cultural Studies, University of Messina, Messina, Italy
| | - Martina Semino
- Airett Innovation and Research Center, Verona, Italy,Tice Learning Center, Piacenza, Italy
| | - Samantha Giannatiempo
- Airett Innovation and Research Center, Verona, Italy,Tice Learning Center, Piacenza, Italy
| | - Lia Zocca
- Airett Innovation and Research Center, Verona, Italy
| | - Rosa Angela Fabio
- Airett Innovation and Research Center, Verona, Italy,Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Wickerson L, Helm D, Gottesman C, Rozenberg D, Singer LG, Keshavjee S, Sidhu A. Telerehabilitation for Lung Transplant Candidates and Recipients During the COVID-19 Pandemic: Program Evaluation. JMIR Mhealth Uhealth 2021; 9:e28708. [PMID: 34048354 PMCID: PMC8213059 DOI: 10.2196/28708] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/30/2021] [Accepted: 05/27/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic resulted in a rapid shift from center-based rehabilitation to telerehabilitation for chronic respiratory disease and lung transplantation due to infection control precautions. Clinical experience with this delivery model on a large scale has not been described. OBJECTIVE The aim of this study is to describe usage and satisfaction of providers and lung transplant (LTx) candidates and recipients and functional outcomes following the broad implementation of telerehabilitation with remote patient monitoring during the first wave of the COVID-19 pandemic. METHODS This study was a program evaluation of providers, LTx candidates, and early LTx recipients who used a web-based, remote monitoring app for at least four weeks between March 16 and September 1, 2020, to participate in telerehabilitation. Within-subjects analysis was performed for physical activity, Self-efficacy For Exercise (SEE) scale score, aerobic and resistance exercise volumes, 6-minute walk test results, and Short Physical Performance Battery (SPPB) results. RESULTS In total, 78 LTx candidates and 33 recipients were included (57 [51%] males, mean age 58 [SD 12] years, 58 [52%] with interstitial lung disease, 34 [31%] with chronic obstructive pulmonary disease). A total of 50 (64%) LTx candidates and 17 (51%) LTx recipients entered ≥10 prescribed exercise sessions into the app during the study time frame. In addition, 35/42 (83%) candidates agreed the app helped prepare them for surgery and 18/21 (85%) recipients found the app helpful in their self-recovery. The strongest barrier perceived by physiotherapists delivering the telerehabilitation was patient access to home exercise and monitoring equipment. Between the time of app registration and ≥4 weeks on the waiting list, 26 LTx candidates used a treadmill, with sessions increasing in mean duration (from 16 to 22 minutes, P=.002) but not speed (from 1.7 to 1.75 mph, P=.31). Quadriceps weight (pounds) for leg extension did not change (median 3.5, IQR 2.4-5 versus median 4.3, IQR 3-5; P=.08; n=37). On the Rapid Assessment of Physical Activity questionnaire (RAPA), 57% of LTx candidates scored as active, which improved to 87% (P=.02; n=23). There was a decrease in pretransplant 6-minute walk distance (6MWD) from 346 (SD 84) meters to 307 (SD 85) meters (P=.002; n=45) and no change in the SPPB result (12 [IQR 9.5-12] versus 12 [IQR 10-12]; P=.90; n=42). A total of 9 LTx recipients used a treadmill that increased in speed (from 1.9 to 2.7 mph; P=.003) between hospital discharge and three months posttransplant. Quadriceps weight increased (3 [IQR 0-3] pounds versus 5 [IQR 3.8-6.5] pounds; P<.001; n=15). At three months posttransplant, 76% of LTx recipients scored as active (n=17), with a high total SEE score of 74 (SD 11; n=12). In addition, three months posttransplant, 6MWD was 62% (SD 18%) predicted (n=8). CONCLUSIONS We were able to provide telerehabilitation despite challenges around exercise equipment. This early experience will inform the development of a robust and equitable telerehabilitation model beyond the COVID-19 pandemic.
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Affiliation(s)
- Lisa Wickerson
- Toronto Lung Transplant Program, University Health Network, Toronto, ON, Canada.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Denise Helm
- Toronto Lung Transplant Program, University Health Network, Toronto, ON, Canada.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Chaya Gottesman
- Toronto Lung Transplant Program, University Health Network, Toronto, ON, Canada.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Dmitry Rozenberg
- Toronto Lung Transplant Program, University Health Network, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lianne G Singer
- Toronto Lung Transplant Program, University Health Network, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Shaf Keshavjee
- Toronto Lung Transplant Program, University Health Network, Toronto, ON, Canada.,Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Aman Sidhu
- Toronto Lung Transplant Program, University Health Network, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
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Klamroth-Marganska V, Gemperle M, Ballmer T, Grylka-Baeschlin S, Pehlke-Milde J, Gantschnig BE. Does therapy always need touch? A cross-sectional study among Switzerland-based occupational therapists and midwives regarding their experience with health care at a distance during the COVID-19 pandemic in spring 2020. BMC Health Serv Res 2021; 21:578. [PMID: 34130691 PMCID: PMC8205206 DOI: 10.1186/s12913-021-06527-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 05/13/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic impedes therapy and care activities. Tele-health, i.e., the provision of health care at a distance (HCD), is a promising way to fill the supply gap. However, facilitators and barriers influence the use and experience of HCD for occupational therapists (OTs) and midwives. We identified use of services and appraisal of experiences of Switzerland-based OTs and midwives regarding the provision of HCD during the lockdown as it pertains to the COVID-19 pandemic in spring 2020. 1. HYPOTHESIS Profession, age in years, and area of work have a significant and meaningful influence over whether HCD is provided. 2. HYPOTHESIS Profession, age in years, area of work, possibility of reimbursement by health insurance, and application used have a significant and meaningful influence on the experience of HCD. METHODS In a cross-sectional survey, 5755 OTs and midwives were contacted to fill out an online questionnaire with 13 questions regarding demographic information, use of HCD, and experiences while providing the service. Eleven potential facilitators and barriers and areas where there was desire for support were identified. RESULTS The questionnaire was completed by 1269 health professionals (response rate 22.5%). 73.4% of responding OTs (n = 431) and midwives (n = 501) provided HCD during the COVID-19 pandemic lockdown. Profession and area of work had a significant influence on whether HCD was provided. Age only had a significant influence on the use of videotelephony, SMS, and chat services. OTs experienced HCD significantly more positively than midwives (log odds = 1.3; p ≤ .01). Video-telephony (log odds = 1.1; p ≤ .01) and use of phone (log odds = 0.8; p = .01) were positive predictors for positive experience, while use of SMS (log odds = - 0.33; p = .02) was a negative predictor. Among OTs, 67.5% experienced HCD as positive or mostly positive, while 27.0% experienced it as negative or mostly negative. Among midwives, 39.5% experienced it as positive or mostly positive, while 57.5% experienced it as negative or mostly negative. Most respondents desired support concerning reimbursement by health insurance (70.8%), followed by law and data protection (60.4%). CONCLUSIONS HCD during the early COVID-19 pandemic was generally perceived as positive by OTs and midwives. There is need for training opportunities in connection with HCD during the COVID-19 pandemic.
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Affiliation(s)
- Verena Klamroth-Marganska
- Institute of Occupational Therapy, School of Health Professions, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland.
| | - Michael Gemperle
- Institute of Midwifery, School of Health Professions, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Thomas Ballmer
- Institute of Occupational Therapy, School of Health Professions, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Susanne Grylka-Baeschlin
- Institute of Midwifery, School of Health Professions, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Jessica Pehlke-Milde
- Institute of Midwifery, School of Health Professions, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Brigitte E Gantschnig
- Institute of Occupational Therapy, School of Health Professions, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
- Department of Rheumatology, Immunology, and Allergology, University Hospital (Inselspital) and University Bern, Bern, Switzerland
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Effects of Preoperative Telerehabilitation on Muscle Strength, Range of Motion, and Functional Outcomes in Candidates for Total Knee Arthroplasty: A Single-Blind Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116071. [PMID: 34199913 PMCID: PMC8200128 DOI: 10.3390/ijerph18116071] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/26/2021] [Accepted: 06/01/2021] [Indexed: 11/28/2022]
Abstract
This study aims to investigate the effect of a preoperative telerehabilitation (PT) program on muscle strength, knee range of motion (ROM), and functional outcomes in candidates for total knee arthroplasty (TKA). Sixty patients (all women, mean age 70.53 ± 2.7 years) scheduled for bilateral TKA participated in this study. The PT and preoperative patient education (PE) groups participated in a 3-week intensive exercise program (30 min/session, 2 times/day, 5 days/week), whereas the control group received the usual care before TKA. Quadriceps muscle strength, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), ROM of knee flexion, pain, and time up-and-go (TUG) test time were evaluated at 4 weeks preoperatively, post-interventionally, and 6 weeks after TKA. Significant differences were found in the time-by-group interaction for 60°/s extension peak torque [F(4, 100) = 2.499, p = 0.047, η2p = 0.91], 180°/s extension peak torque [F(4, 100) = 3.583, p = 0.009, η2p = 0.125], ROM [F(4, 100) = 4.689, p = 0.002, η2p = 0.158], TUG time [F(4, 100) = 7.252, p < 0.001, η2p = 0.225], WOMAC pain [F(4, 100) = 9.113, p < 0.001, η2p = 0.267], WOMAC functional outcome [F(4, 100) = 6.579, p < 0.001, η2p = 0.208], and WOMAC total score [F(4, 100) = 10.410, p < 0.001, η2p = 0.294]. The results of this study demonstrate the early benefits of a PT program in elderly female patients with end-stage osteoarthritis. The PT program improved muscle strength, ROM, and functional outcomes before TKA, which contributed to better functional recovery after TKA.
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Mahmoud IAM. Usability of Telemedicine in Physical Therapy Rehabilitation: Systematic review. JMIR Rehabil Assist Technol 2021. [PMID: 34287208 DOI: 10.2196/25250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The term 'Telemedicine' was coined in the 1970s to imply 'healing at a distance. Physical therapy rehabilitation (PTR) focuses on the re-institution of function in bodily strength and movement. Covid-19 has created a challenge in one-on-one PTR sessions due to social distancing, which requires the minimization of all non-essential physical contact. Most outpatient services in PTR have had to be staggered and minimized to increase adherence to social distancing requirements and flatten the pandemic's curve. Telemedicine is applicable in PTR in several ways, including guided therapy sessions, and remote monitoring of patient progress through videoconferencing. Telemedicine allows patients to access PTR from the comfort of their homes, which minimizes travel costs and general strain on the body. Although it has been encumbered by various challenges, telemedicine could revolutionize the delivery of PTR while also increasing access to essential healthcare services. OBJECTIVE Purpose: Covering the main aspects of telemedicine usability in physical therapy rehabilitation, that encourage using of the telemedicine in physical therapy in the world regions not covered by, especially the Middle East. METHODS Method: A systematic search in libgen.is, jmir.org, wiley.com, sagepub.com, and scholar.google.com. was performed using the search terms: Telemedicine; asynchronous telemedicine; synchronous telemedicine; Covid-19; rehabilitation medicine; physical therapy rehabilitation; videoconferencing; Medicaid programs; telehealth; and HIPAA. Papers published up to Oct. 22nd, 2020, in English, were included. RESULTS Telemedicine is cost-effective for physical therapy Rehabilitation particularly in pandemic like COVID19, also it's time and human resources saving especially with hands-off skills rehabilitation. CONCLUSIONS Telemedicine is a revolutionary aspect of medicine that has seen an unexpected uptake following the Covid-19 pandemic. While people formerly preferred live sessions for PTR, the convenience of telemedicine is increasingly emerging. The various advantages, including reduced cost implications, reduced waiting time, and reduction of non-essential travel to obtain therapy have increased the preference for telemedicine. [9] The WHO recognizes the importance of Telemedicine, and conducted a regional and global survey to analyze its viability. At the onset of global lockdown due to Covid-19, the APTA expressed the need for physiotherapists to utilize telemedicine as an alternative for efficient PTR delivery within the bounds of social recommendations for curve-flattening. Telemedicine in PTR has various advantages including cost reduction, the convenience of access, reduction of long waiting lists among others for the patient. [10] PTR can also be availed to areas that are too remote to have a full-fledged PTR center. Through the utilization of nurse aides and other social support systems, therapists can effectively conduct therapy sessions through videoconferencing. Laws governing the adoption and use of telemedicine for PTR include the HIPAA and other DPL, which regulate the extent to which therapists can collect, use, and store data collected during online therapy sessions. Therapists need to obtain verifiable consent from the patient before commencement. CLINICALTRIAL
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Seron P, Oliveros MJ, Gutierrez-Arias R, Fuentes-Aspe R, Torres-Castro RC, Merino-Osorio C, Nahuelhual P, Inostroza J, Jalil Y, Solano R, Marzuca-Nassr GN, Aguilera-Eguía R, Lavados-Romo P, Soto-Rodríguez FJ, Sabelle C, Villarroel-Silva G, Gomolán P, Huaiquilaf S, Sanchez P. Effectiveness of Telerehabilitation in Physical Therapy: A Rapid Overview. Phys Ther 2021; 101:pzab053. [PMID: 33561280 PMCID: PMC7928601 DOI: 10.1093/ptj/pzab053] [Citation(s) in RCA: 175] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/20/2020] [Accepted: 01/11/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The purpose of this article was to summarize the available evidence from systematic reviews on telerehabilitation in physical therapy. METHODS We searched Medline/PubMed, EMBASE, and Cochrane Library databases. In addition, the records in PROSPERO and Epistemonikos and PEDro were consulted. Systematic reviews of different conditions, populations, and contexts-where the intervention to be evaluated is telerehabilitation by physical therapy-were included. The outcomes were clinical effectiveness depending on specific condition, functionality, quality of life, satisfaction, adherence, and safety. Data extraction and risk of bias assessment were carried out by a reviewer with non-independent verification by a second reviewer. The findings are reported qualitatively in the tables and figures. RESULTS Fifty-three systematic reviews were included, of which 17 were assessed as having low risk of bias. Fifteen reviews were on cardiorespiratory rehabilitation, 14 on musculoskeletal conditions, and 13 on neurorehabilitation. The other 11 reviews addressed other types of conditions and rehabilitation. Thirteen reviews evaluated with low risk of bias showed results in favor of telerehabilitation versus in-person rehabilitation or no rehabilitation, while 17 reported no differences between the groups. Thirty-five reviews with unclear or high risk of bias showed mixed results. CONCLUSIONS Despite the contradictory results, telerehabilitation in physical therapy could be comparable with in-person rehabilitation or better than no rehabilitation for conditions such as osteoarthritis, low-back pain, hip and knee replacement, and multiple sclerosis and also in the context of cardiac and pulmonary rehabilitation. It is imperative to conduct better quality clinical trials and systematic reviews. IMPACT Providing the best available evidence on the effectiveness of telerehabilitation to professionals, mainly physical therapists, will impact the decision-making process and therefore yield better clinical outcomes for patients, both in these times of the COVID-19 pandemic and in the future. The identification of research gaps will also contribute to the generation of relevant and novel research questions.
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Affiliation(s)
- Pamela Seron
- Internal Medicine Department and CIGES, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - María-Jose Oliveros
- Internal Medicine Department and CIGES, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Ruvistay Gutierrez-Arias
- Instituto Nacional del Tórax and Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación, Universidad Andres Bello, Santiago, Chile
| | - Rocío Fuentes-Aspe
- Internal Medicine Department and CIGES, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | | | - Catalina Merino-Osorio
- Carrera de Kinesiología, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
| | - Paula Nahuelhual
- Departamento de Evaluación de Tecnologías Sanitarias y Salud Basada en Evidencia, Ministerios de Salud, Santiago, Chile
- Facultad de Medicina, Clínica Alemana de Santiago – Universidad del Desarrollo, Santiago, Chile
| | - Jacqueline Inostroza
- Internal Medicine Department, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Yorschua Jalil
- Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación, Universidad Andres Bello
- Programa de Doctorado Ciencias Medicas, Pontificia Universidad Católica de Chile, Escuela de Medicina, Santiago, Chile
| | - Ricardo Solano
- Medical Specialties Medicine Department, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Gabriel N Marzuca-Nassr
- Internal Medicine Department, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Raul Aguilera-Eguía
- Departamento de Salud Pública and Carrera de Kinesiología, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Pamela Lavados-Romo
- Departamento Ciencias Preclínicas, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Francisco J Soto-Rodríguez
- Internal Medicine Department, Faculty of Medicine, Universidad de La Frontera
- Facultad de Ciencias de la Salud, Carrera de Kinesiología, Universidad Autónoma de Chile, Temuco, Chile
| | - Cecilia Sabelle
- Universidad Santo Tomás, Temuco, Chile
- Servicio de Salud Araucanía Sur, Temuco, Chile
| | - Gregory Villarroel-Silva
- Departamento Ciencias de la Salud, Carrera de Kinesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Hospital Josefina Martínez, Santiago, Chile
| | | | - Sayen Huaiquilaf
- Pediatrics and Child surgery Department, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
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Leochico CFD, Mojica JAP, Rey-Matias RR, Supnet IE, Ignacio SD. Role of Telerehabilitation in the Rehabilitation Medicine Training Program of a COVID-19 Referral Center in a Developing Country. Am J Phys Med Rehabil 2021; 100:526-532. [PMID: 33998606 DOI: 10.1097/phm.0000000000001755] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT This article describes the impact of the pandemic on physical medicine and rehabilitation in a COVID-19 referral center of a developing country. It describes how telerehabilitation can be leveraged to fill in the gaps in service, training, and research arms of the physical medicine and rehabilitation specialty. The ITAWAG ("to call") telerehabilitation program is the response of the Department of Rehabilitation Medicine at Philippine General Hospital, which is the country's national university hospital, to the ongoing COVID-19 crisis that continues to limit face-to-face access to physical medicine and rehabilitation services throughout the country. With the significant decline in the number of patients served since the start of the pandemic, the ITAWAG program aimed to bridge the physical distance between patients and clinicians after a set of eligibility criteria for teleconsultation or teletherapy and a step-by-step process used before, during, and after each virtual encounter. However, because many physical medicine and rehabilitation consultants, residents, and therapists were not trained for the virtual approach to patient care, a telerehabilitation curriculum was developed to help in providing quality and competent services. Finally, despite the growing awareness of telerehabilitation throughout the country, several research gaps about this emerging technology are identified to determine its acceptance, applicability, and cost-effectiveness among others.
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Affiliation(s)
- Carl Froilan D Leochico
- From the Department of Rehabilitation Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines (CFDL, JAPM, RRR-M, IES, SDI); and Department of Physical Medicine and Rehabilitation, St Luke's Medical Center, Global City/Quezon City, Philippines (CFDL, RRR-M, SDI)
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Manjunatha H, Pareek S, Jujjavarapu SS, Ghobadi M, Kesavadas T, Esfahani ET. Upper Limb Home-Based Robotic Rehabilitation During COVID-19 Outbreak. Front Robot AI 2021; 8:612834. [PMID: 34109220 PMCID: PMC8181124 DOI: 10.3389/frobt.2021.612834] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 03/03/2021] [Indexed: 12/23/2022] Open
Abstract
The coronavirus disease (COVID-19) outbreak requires rapid reshaping of rehabilitation services to include patients recovering from severe COVID-19 with post-intensive care syndromes, which results in physical deconditioning and cognitive impairments, patients with comorbid conditions, and other patients requiring physical therapy during the outbreak with no or limited access to hospital and rehabilitation centers. Considering the access barriers to quality rehabilitation settings and services imposed by social distancing and stay-at-home orders, these patients can be benefited from providing access to affordable and good quality care through home-based rehabilitation. The success of such treatment will depend highly on the intensity of the therapy and effort invested by the patient. Monitoring patients' compliance and designing a home-based rehabilitation that can mentally engage them are the critical elements in home-based therapy's success. Hence, we study the state-of-the-art telerehabilitation frameworks and robotic devices, and comment about a hybrid model that can use existing telerehabilitation framework and home-based robotic devices for treatment and simultaneously assess patient's progress remotely. Second, we comment on the patients' social support and engagement, which is critical for the success of telerehabilitation service. As the therapists are not physically present to guide the patients, we also discuss the adaptability requirement of home-based telerehabilitation. Finally, we suggest that the reformed rehabilitation services should consider both home-based solutions for enhancing the activities of daily living and an on-demand ambulatory rehabilitation unit for extensive training where we can monitor both cognitive and motor performance of the patients remotely.
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Affiliation(s)
- Hemanth Manjunatha
- Human in the Loop Systems Laboratory, Department of Mechanical and Aerospace Engineering, University at Buffalo, Buffalo, NY, United States
| | - Shrey Pareek
- Health Care Engineering Systems Center, University of Illinois Urbana-Champaign, Champaign, IL, United States
| | - Sri Sadhan Jujjavarapu
- Human in the Loop Systems Laboratory, Department of Mechanical and Aerospace Engineering, University at Buffalo, Buffalo, NY, United States
| | - Mostafa Ghobadi
- Human in the Loop Systems Laboratory, Department of Mechanical and Aerospace Engineering, University at Buffalo, Buffalo, NY, United States
| | - Thenkurussi Kesavadas
- Health Care Engineering Systems Center, University of Illinois Urbana-Champaign, Champaign, IL, United States
| | - Ehsan T Esfahani
- Human in the Loop Systems Laboratory, Department of Mechanical and Aerospace Engineering, University at Buffalo, Buffalo, NY, United States
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Rabanifar N, Abdi K. Letter to Editor: Telerehabilitation: A Useful and appropriate approach for people with disability in Covid-19 pandemic. Med J Islam Repub Iran 2021; 35:18. [PMID: 33996669 PMCID: PMC8111618 DOI: 10.47176/mjiri.35.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Niloufar Rabanifar
- Department of Rehabilitation Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Kianoush Abdi
- Department of Rehabilitation Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Effects of Self RehAbilitation Video Exercises (SAVE) on Functional Restorations in Patients with Subacute Stroke. Healthcare (Basel) 2021; 9:healthcare9050565. [PMID: 34064979 PMCID: PMC8150768 DOI: 10.3390/healthcare9050565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Additional exercise therapy has been shown to positively affect acute stroke rehabilitation, which requires an effective method to deliver increased exercise. In this study, we designed a 4-week caregiver-supervised self-exercise program with videos, named “Self rehAbilitation Video Exercises (SAVE)”, to improve the functional outcomes and facilitate early recovery by increasing the continuity of rehabilitation therapy after acute stroke. Methods: This study is a non-randomized trial. Eighty-eight patients were included in an intervention group (SAVE group), who received conventional rehabilitation therapies and an additional self-rehabilitation session by watching bedside exercise videos and continued their own exercises in their rooms for 60 min every day for 4 weeks. Ninety-six patients were included in a control group, who received only conventional rehabilitation therapies. After 4 weeks of hospitalization, both groups assessed several outcome measurements, including the Berg Balance Scale (BBS), Modified Barthel Index (MBI), physical component summary (PCS) and the mental component summary of the Short-Form Survey 36 (SF-36), Mini-Mental State Examination, and Beck Depression Inventory. Results: Differences in BBS, MBI, and PCS components in SF-36 were more statistically significant in the SAVE group than that in the control group (p < 0.05). Patients in the SAVE group showed more significant improvement in BBS, MBI, and PCS components in SF-36 as compared to that in the control group. Conclusions: This evidence-based SAVE intervention can optimize patient recovery after a subacute stroke while keeping the available resources in mind.
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Nutarelli S, Delahunt E, Cuzzolin M, Delcogliano M, Candrian C, Filardo G. Home-Based vs Supervised Inpatient and/or Outpatient Rehabilitation Following Knee Meniscectomy: A Systematic Review and Meta-analysis. JAMA Netw Open 2021; 4:e2111582. [PMID: 34037730 PMCID: PMC8155825 DOI: 10.1001/jamanetworkopen.2021.11582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IMPORTANCE Arthroscopic meniscectomy is one of the most common orthopedic procedures. The optimal postoperative approach remains debated. OBJECTIVE To compare outcomes associated with home-based rehabilitation programs (HBP) vs standard inpatient and/or outpatient supervised physical therapy (IOP) following arthroscopic isolated meniscectomy (AM). DATA SOURCES A systematic literature search was conducted on PubMed, Web of Science, Cochrane Library, and Scopus databases on March 15, 2021. The included studies were published from 1982 to 2019. STUDY SELECTION Randomized clinical trials of patients treated with HBP vs IOP after AM were included. DATA EXTRACTION AND SYNTHESIS Data were independently screened and extracted by 2 authors according to the Preferred Reporting Items for Systematic Reviews (PRISMA) reporting guideline. The meta-analysis was performed using a random-effect model; when an I2 < 25% was observed, the fixed-effect model was used. The Hartung-Knapp correction was applied. MAIN OUTCOMES AND MEASURES The primary outcome was the Lysholm score (scale of 0-100 with higher scores indicating better knee function) and secondary outcomes were subjective International Knee Documentation Committee (IKDC) score, knee extension and flexion, thigh girth, horizontal and vertical hop test, and days to return to work, as indicated in the PROSPERO registration. Outcomes were measured in the short-term (ranging from 28 to 50 days) and the midterm (6 months). RESULTS In this meta-analysis of 8 RCTs including 434 patients, IOP was associated with a greater short-term improvement in Lysholm score compared with HBP, with a mean difference of -8.64 points (95% CI, -15.14 to -2.13 points; P = .02) between the 2 approached, but the sensitivity analysis showed no difference. Similarly, no statistically significant difference was detected at midterm for Lysholm score, with a mean difference between groups of -4.78 points (95% CI, -9.98 to 0.42 points; P = .07). HBP was associated with a greater short-term improvement in thigh girth, with a mean difference between groups of 1.38 cm (95% CI, 0.27 to 2.48 cm; P = .01), whereas IOP was associated with a better short-term vertical hop score, with a mean difference between groups of -3.25 cm (95% CI, -6.20 to -0.29 cm; P = .03). No differences were found for all the other secondary outcomes. CONCLUSIONS AND RELEVANCE No intervention was found to be superior in terms of physical and functional outcomes as well as work-related and patient-reported outcomes, both at short-term and midterm follow-up. Overall, these results suggest that HBP may be an effective management approach after AM in the general population.
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Affiliation(s)
- Sebastiano Nutarelli
- Orthopaedic and Traumatology Unit, Ospedale Regionale di Lugano, EOC, Lugano, Switzerland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
- Institute for Sport and Health, University College Dublin, Dublin, Ireland
| | - Marco Cuzzolin
- Orthopaedic and Traumatology Unit, Ospedale Regionale di Lugano, EOC, Lugano, Switzerland
| | - Marco Delcogliano
- Orthopaedic and Traumatology Unit, Ospedale Regionale di Lugano, EOC, Lugano, Switzerland
- USI-Università della Svizzera Italiana, Faculty of Biomedical Sciences, Lugano, Switzerland
| | - Christian Candrian
- Orthopaedic and Traumatology Unit, Ospedale Regionale di Lugano, EOC, Lugano, Switzerland
- USI-Università della Svizzera Italiana, Faculty of Biomedical Sciences, Lugano, Switzerland
| | - Giuseppe Filardo
- Orthopaedic and Traumatology Unit, Ospedale Regionale di Lugano, EOC, Lugano, Switzerland
- USI-Università della Svizzera Italiana, Faculty of Biomedical Sciences, Lugano, Switzerland
- Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Cornejo Thumm P, Giladi N, Hausdorff JM, Mirelman A. Tele-Rehabilitation with Virtual Reality: A Case Report on the Simultaneous, Remote Training of Two Patients with Parkinson Disease. Am J Phys Med Rehabil 2021; 100:435-438. [PMID: 33819924 DOI: 10.1097/phm.0000000000001745] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Physical training in Parkinson disease improves motor performance, alleviates nonmotor symptoms, and enhances cognition and quality of life. Nonetheless, adherence to exercise is low and travel costs and time may limit participation and compliance. Training at home can help avoid these burdens and, as needed during the recent global pandemic (COVID-19), reinforce social distancing and reduce the risk of infection. However, training at home requires motivation and self-control and telerehabilitation is time-consuming for both patient and therapist. In recent years, there is growing use of virtual reality and exergaming to increase motivation and adherence for exercising with evidence of improvements in mobility and balance after using virtual reality in the clinic. Here, a novel telerehabilitation training program using a treadmill-virtual reality system for simultaneous training of two patients with Parkinson disease in their homes is described. Remote monitoring software enabled visual and auditory communication with the two patients, allowing the trainer to adapt the settings remotely and provide feedback. Participants received weekly training sessions over 1 yr. The findings show high adherence to training, increased walking duration throughout the sessions, and increased patient confidence, gait speed, and mobility. Training multiple participants simultaneously was feasible, enabling an individualized treatment approach while conserving therapist time.
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Affiliation(s)
- Pablo Cornejo Thumm
- From the Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel (PCT, NG, JMH, AM); Sackler School of Medicine, Sackler Faculty of Medicine (NG, JMH, AM), Sagol School of Neuroscience (NG, JMH, AM), and Department of Physical Therapy, Sackler Faculty of Medicine (JMH), Tel Aviv University, Tel Aviv, Israel; and Rush Alzheimer's Disease Center and Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois (JMH)
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Lao A, Wilesmith S, Forbes R. Exploring the workplace mentorship needs of new-graduate physiotherapists: a qualitative study. Physiother Theory Pract 2021; 38:2160-2169. [PMID: 33882799 DOI: 10.1080/09593985.2021.1917023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Mentorship plays an important role in an individuals' transition into the workforce, yet little is known of new-graduates experiences of workplace mentorship. The aim of this study was to explore new-graduate physiotherapists' experiences of mentorship during their transition into professional practice in Australia.Method: A qualitative study with an interpretive phenomenological analytical approach was used. Semi-structured interviews of fifteen employed new-graduate physical therapists were undertaken within their first three to six months of clinical practice.Results: Four key themes emerged from the data: 1) Advantages of individualized mentorship; 2) Supporting the needs of professional development through mentorship; 3) Mentorship is valued by new-graduate employees; and 4) Mentorship moderates perceptions of stress and anxiety.Conclusions: New-graduate physiotherapists perceive workplace mentorship as a critical factor during the transition from student to clinician, which extends to the broader workplace. New-graduates place a strong value on individualized mentorship to support their professional development, which can influence self-perceived stress and anxiety and their perception of the workplace.
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Affiliation(s)
- Andrew Lao
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sarah Wilesmith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Roma Forbes
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Scheenstra B, Mohansingh C, Bongers BC, Dahmen S, Wouters YIMS, Lenssen TF, Geerlings P, Knols HFM, van Kuijk SMJ, Kimman ML, Nieman M, Maessen JG, van’t Hof AWJ, Peyman SN. Personalized teleprehabilitation in elective cardiac surgery: a study protocol of the Digital Cardiac Counselling randomized controlled trial. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2021; 2:477-486. [PMID: 36713609 PMCID: PMC9708005 DOI: 10.1093/ehjdh/ztab041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/27/2021] [Accepted: 04/15/2021] [Indexed: 02/01/2023]
Abstract
Aims Previous research has shown the possibility to use the pre-operative period to improve a patient's tolerance for surgery. However, there is limited experience with prehabilitation in cardiac surgery. The aim of this study is to evaluate the effect of a comprehensive personalized teleprehabilitation programme on major adverse cardiac events (MACE) in patients scheduled for elective cardiac surgery. Secondary outcomes are post-operative complications, cardiovascular risk factors, quality of life, and cost-effectiveness. Methods and results In this single-centre randomized controlled trial, patients are eligible for inclusion when they are ≥18 years of age and cardiac surgery is scheduled at least 8 weeks from informed consent. Participants will be randomized to the teleprehabilitation group or the control group. After a digital baseline screening for perioperative risk factors, patients in the intervention arm can pre-operatively be referred to one or more of the prehabilitation modules (functional exercise training, inspiratory muscle training, psychological support, nutritional support, and/or smoking cessation). The programme is targeted at a duration of at least 6 weeks. It is executed by a multidisciplinary team using (video)calls and supported by a custom-made digital platform. During the pre-operative period, the platform is also used to inform patients about their upcoming surgery and for telemonitoring. Conclusion Reducing perioperative risk factors might result in a reduction of MACE, post-operative complications, length of stay, and cardiovascular risk factors, as well as improved quality of life. Cost-effectiveness will be evaluated.
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Affiliation(s)
- Bart Scheenstra
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands,Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Chanu Mohansingh
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Bart C Bongers
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands,Department of Nutrition and Human Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Sandra Dahmen
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Yvonne I M S Wouters
- Department of Physiotherapy, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ton F Lenssen
- Department of Physiotherapy, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Phil Geerlings
- Department of Dietetics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Henriette F M Knols
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Sander M J van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Merel L Kimman
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands,Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Maxime Nieman
- Department of Pulmonology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jos G Maessen
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands,Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Arnoud W J van’t Hof
- Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands,Department of Cardiology, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands,Department of Cardiology, Zuyderland Medical Centre, Heerlen, The Netherlands
| | - Sardari Nia Peyman
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands,Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands,Corresponding author. Tel: +31 043 387 6543,
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180
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Tonga E, Williamson E, Srikesavan C, Özen T, Sarıtaş F, Lamb SE. A hand exercise mobile app for people with rheumatoid arthritis in Turkey: design, development and usability study. Rheumatol Int 2021; 41:1151-1160. [PMID: 33870452 DOI: 10.1007/s00296-021-04860-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
To design and develop a smartphone application for a structured hand exercise programme for patients with rheumatoid arthritis (RA) in Turkey and to test its usability. We followed a two-stage process: (1) Design and Development and (2) Usability testing. In stage 1, we used a qualitative user-centered design approach. We conducted a focus group (8 therapists and people with RA) to discuss the content, features and design to produce a prototype of the application. In a second focus group session, the participants tested the prototype, provided feedback and further revisions were made. In stage 2, 17 participants with RA used the app for 4 to 6 weeks. The System Usability Scale and the adapted Usability, Satisfaction and Ease to Use Questionnaires were used to measure usability, ease of use. Semi-structured interviews were conducted to explore user experiences with the application with 17 participants. In stage 1, the following themes were identified from the focus groups (a) login techniques (b) self-monitoring (c) exercises, (d) exercise diary, (e) information, (f) behavioral change and encouragement (g) exercise adherence. In stage 2, 3 themes were determined from interviews: (a) learning and accuracy, (b) ease of use, (c) motivation and adherence. USE and SUS scores indicated that users reported a high level of usability, satisfaction and ease of use. A mobile app for hand exercise for people with RA was developed using a mixed-method and iterative design. Participants perceived the mobile app as easy to use with high levels of satisfaction.
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Affiliation(s)
- Eda Tonga
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Marmara University, Başıbüyük Campus, Başıbüyük St. 3484, Maltepe, Istanbul, Turkey.
| | - Esther Williamson
- Centre for Rehabilitation Research, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Cynthia Srikesavan
- Centre for Rehabilitation Research, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Tuğçe Özen
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Marmara University, Başıbüyük Campus, Başıbüyük St. 3484, Maltepe, Istanbul, Turkey
| | - Fatih Sarıtaş
- Haydarpasa Numune Research and Education Hospital, Rheumatology Clinic, Istanbul, Turkey
| | - Sarah E Lamb
- Centre for Rehabilitation Research, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK.,Collage of Medicine and Health, University of Exeter, Exeter, UK
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181
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Sieczkowska SM, Smaira FI, Mazzolani BC, Gualano B, Roschel H, Peçanha T. Efficacy of home-based physical activity interventions in patients with autoimmune rheumatic diseases: A systematic review and meta-analysis. Semin Arthritis Rheum 2021; 51:576-587. [PMID: 33945907 DOI: 10.1016/j.semarthrit.2021.04.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Physical activity (PA) has been receiving increasing interest in recent years as an adjuvant therapy for autoimmune rheumatic disease (ARDs), but there is scarce information about the efficacy of home-based PA for patients with ARDs. OBJECTIVE To perform a systematic review and meta-analysis on the efficacy of home-based physical activity (PA) interventions in improving health-related quality of life, functional capacity, pain, and disease activity in patients with ARDs. METHODS Searches were performed in PubMed, Web of Science, Scopus, Cochrane, CINAHL database and Sport Discus. Trials were considered eligible if they included a home-based physical activity intervention. The population included adults with autoimmune rheumatic diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus, idiopathic inflammatory myopathies, systemic sclerosis and ankylosing spondylitis), comparisons included non-physical activity control or centre-based interventions (i.e., interventions performed on a specialized exercise centre) and the outcomes were quality of life, pain, functional capacity, disease activity and inflammation. RESULTS Home-based physical activity improved quality of life (p<0.01; g = 0.69; IC95%, 0.61 to 1.07) and functional capacity (p = 0.04; g = - 0.51; IC95%, -0.86; -0.16), and reduced disease activity (p = 0.03; g = - 0.60; IC95%, -1.16; -0.04) and pain (p = 0.01; g = -1.62; IC95%, -2.94 to -0.31) compared to the non-physical activity control condition. Additionally, home-based physical activity interventions were as effective as centre-based interventions for all investigated outcomes. CONCLUSION Home-based PA is an efficacious strategy to improve disease control and aleviate symptoms in ARD.
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Affiliation(s)
- Sofia Mendes Sieczkowska
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, SP, Brazil. Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de Sao Paulo, Sao Paulo, SP, Brazil Av. Dr. Arnaldo, 455, ZIP code: 01246-903, Sao Paulo-SP, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Fabiana Infante Smaira
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, SP, Brazil. Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de Sao Paulo, Sao Paulo, SP, Brazil Av. Dr. Arnaldo, 455, ZIP code: 01246-903, Sao Paulo-SP, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Bruna Caruso Mazzolani
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, SP, Brazil. Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de Sao Paulo, Sao Paulo, SP, Brazil Av. Dr. Arnaldo, 455, ZIP code: 01246-903, Sao Paulo-SP, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, SP, Brazil. Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de Sao Paulo, Sao Paulo, SP, Brazil Av. Dr. Arnaldo, 455, ZIP code: 01246-903, Sao Paulo-SP, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, SP, Brazil. Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de Sao Paulo, Sao Paulo, SP, Brazil Av. Dr. Arnaldo, 455, ZIP code: 01246-903, Sao Paulo-SP, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Tiago Peçanha
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, SP, Brazil. Laboratory of Assessment and Conditioning in Rhematology, Faculdade de Medicina FMUSP, Disciplina de Reumatologia, Universidade de Sao Paulo, Sao Paulo, SP, Brazil Av. Dr. Arnaldo, 455, ZIP code: 01246-903, Sao Paulo-SP, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
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182
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Batalik L, Winnige P, Dosbaba F, Vlazna D, Janikova A. Home-Based Aerobic and Resistance Exercise Interventions in Cancer Patients and Survivors: A Systematic Review. Cancers (Basel) 2021; 13:cancers13081915. [PMID: 33921141 PMCID: PMC8071485 DOI: 10.3390/cancers13081915] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023] Open
Abstract
Cancer is a chronic disease requiring long-term treatment. Exercise interventions are increasingly being recognized as an important part of treatment and supportive cancer care for patients and survivors. Previous reviews have evaluated the benefits of exercise interventions in populations of patients under supervision at a center, but none have explored the possibilities of a home-based (HB) approach in exercise during cancer rehabilitation and the period immediately following the end of cancer treatment. The aim of this descriptive systematic review was to identify the literature focusing on the health effects of HB exercise interventions in cancer survivors and to evaluate the methodological quality of the examined studies. Relevant studies were identified by a systematic search of PubMed and the Web of Science until January 2021. Nine randomized controlled trials were included. Most studies were on aerobic and resistance exercises, and the frequency, duration, intensity, and modality varied across the different interventions. Improvements in cardiorespiratory fitness (CRF), physical activity (PA) levels, fatigue, health-related quality of life (HRQOL), and body composition have been reported. However, all the studies were limited in methodology and the reporting of results. Nevertheless, the evidence in this new area, despite the methodological limitations of the studies, suggests that HB exercise interventions are feasible, and may provide physiological and psychological benefits for cancer survivors during the rehabilitation period. A methodologically rigorous design for future research is essential for making progress in this field of study.
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Affiliation(s)
- Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic; (P.W.); (F.D.); (D.V.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
- Correspondence:
| | - Petr Winnige
- Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic; (P.W.); (F.D.); (D.V.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
| | - Filip Dosbaba
- Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic; (P.W.); (F.D.); (D.V.)
| | - Daniela Vlazna
- Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic; (P.W.); (F.D.); (D.V.)
- Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic;
- Department of Neurology, University Hospital Brno, 62500 Brno, Czech Republic
| | - Andrea Janikova
- Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic;
- Department of Internal Medicine–Hematology and Oncology, University Hospital Brno, 62500 Brno, Czech Republic
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183
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C.E M, T.A. B, C.T. S, B. AA, Fatoye C, Maikudi L, Fatoye F. Awareness, Attitude and Expectations of Physiotherapy Students on Telerehabilitation. MEDICAL SCIENCE EDUCATOR 2021; 31:627-636. [PMID: 33619445 PMCID: PMC7889412 DOI: 10.1007/s40670-021-01234-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND OBJECTIVE Explosion in information technology knowledge and utilization among young people, referred to as digital natives, seems less explored in the health sector and training. This study was aimed to assess awareness, attitude and expectations of physiotherapy students on telerehabilitation. METHODS This cross-sectional survey employed systematic probability sampling technique to recruit 200 physiotherapy students. A self-developed questionnaire which was tested for its face and content validity was used to obtain data. Data was analysed using descriptive and inferential statistics. Alpha level was set at p < 0.05. RESULTS The mean age of the respondents was 21.2 ± 2.04 years. There was higher prevalence of moderate awareness (43%) and positive attitude towards telerehabilitation (39%). Majority of the respondents (62%) had high expectation towards future telerehabilitation products and services. There was significant association between level of awareness of telerehabilitation and age (X 2 = 7.119; p = 0.001). DISCUSSION The responding students in this study are by age in the class of digital natives, who should be conversant with technology. This could account for the higher moderate level of awareness of telerehabilitation. However, the higher rates of negative attitude towards telerehabilitation could be attributed to prevailing barriers to its utilization in Nigeria. Nonetheless, a large percentage of the students had high expectations for the future of telerehabilitation. CONCLUSION Nigerian physiotherapy students have moderate awareness and high expectation for future telerehabilitation applications. However, a larger number of them hold negative attitude towards it use.
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Affiliation(s)
- Mbada C.E
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Baderinwa T.A.
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Sanuade C.T.
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Ademoyegun Adekola B.
- Department of Physiotherapy, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria
| | - Clara Fatoye
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Laminde Maikudi
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Francis Fatoye
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
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184
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Matamala-Gomez M, Bottiroli S, Realdon O, Riva G, Galvagni L, Platz T, Sandrini G, De Icco R, Tassorelli C. Telemedicine and Virtual Reality at Time of COVID-19 Pandemic: An Overview for Future Perspectives in Neurorehabilitation. Front Neurol 2021; 12:646902. [PMID: 33841313 PMCID: PMC8027250 DOI: 10.3389/fneur.2021.646902] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/03/2021] [Indexed: 12/13/2022] Open
Abstract
In catastrophic situations such as pandemics, patients' healthcare including admissions to hospitals and emergency services are challenged by the risk of infection and by limitations of healthcare resources. In such a setting, the use of telemedicine interventions has become extremely important. New technologies have proved helpful in pandemics as a solution to improve the quality of life in vulnerable patients such as persons with neurological diseases. Moreover, telemedicine interventions provide at-home solutions allowing clinicians to telemonitor and assess patients remotely, thus minimizing risk of infection. After a review of different studies using telemedicine in neurological patients, we propose a telemedicine process flow for healthcare of subjects with chronic neurological disease to respond to the new challenges for delivering quality healthcare during the transformation of public and private healthcare organizations around the world forced by COVID-19 pandemic contingency. This telemedicine process flow represents a replacement for in-person treatment and thereby the provision equitable access to the care of vulnerable people. It is conceptualized as comprehensive service including (1) teleassistance with patient counseling and medical treatment, (2) telemonitoring of patients' health conditions and any changes over time, as well as (3) telerehabilitation, i.e., interventions to assess and promote body functions, activities, and consecutively participation. The hereby proposed telemedicine process flow could be adopted on a large scale to improve the public health response during healthcare crises like the COVID-19 pandemic but could equally promote equitable health care independent of people's mobility or location with respect to the specialized health care center.
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Affiliation(s)
- Marta Matamala-Gomez
- Department of Human Sciences for Education "Riccardo Massa," Center for Studies in Communication Sciences "Luigi Anolli" (CESCOM), University of Milano-Bicocca, Milan, Italy
| | - Sara Bottiroli
- Faculty of Law, Giustino Fortunato University, Benevento, Italy.,Headache Science and Neurorehabilitation Center, Istituto di Ricovero e Cura a Carattere Scientifico Mondino Foundation, Pavia, Italy
| | - Olivia Realdon
- Department of Human Sciences for Education "Riccardo Massa," Center for Studies in Communication Sciences "Luigi Anolli" (CESCOM), University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Riva
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Lucia Galvagni
- Center for Religious Studies, Bruno Kessler, Foundation, Trento, Italy
| | - Thomas Platz
- BDH-Klinik Greifswald, Institute for Neurorehabilitation and Evidence-Based Practice, "An-Institut,#x0201D; University of Greifswald, Greifswald, Germany.,Neurorehabilitation Research Group, University Medical Centre Greifswald (UMG), Greifswald, Germany
| | - Giorgio Sandrini
- Headache Science and Neurorehabilitation Center, Istituto di Ricovero e Cura a Carattere Scientifico Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Roberto De Icco
- Headache Science and Neurorehabilitation Center, Istituto di Ricovero e Cura a Carattere Scientifico Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Cristina Tassorelli
- Headache Science and Neurorehabilitation Center, Istituto di Ricovero e Cura a Carattere Scientifico Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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185
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Bottiroli S, Bernini S, Cavallini E, Sinforiani E, Zucchella C, Pazzi S, Cristiani P, Vecchi T, Tost D, Sandrini G, Tassorelli C. The Smart Aging Platform for Assessing Early Phases of Cognitive Impairment in Patients With Neurodegenerative Diseases. Front Psychol 2021; 12:635410. [PMID: 33790839 PMCID: PMC8005545 DOI: 10.3389/fpsyg.2021.635410] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/05/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Smart Aging is a serious game (SG) platform that generates a 3D virtual reality environment in which users perform a set of screening tasks designed to allow evaluation of global cognition. Each task replicates activities of daily living performed in a familiar environment. The main goal of the present study was to ascertain whether Smart Aging could differentiate between different types and levels of cognitive impairment in patients with neurodegenerative disease. Methods: Ninety-one subjects (mean age = 70.29 ± 7.70 years)—healthy older adults (HCs, n = 23), patients with single-domain amnesic mild cognitive impairment (aMCI, n = 23), patients with single-domain executive Parkinson's disease MCI (PD-MCI, n = 20), and patients with mild Alzheimer's disease (mild AD, n = 25)—were enrolled in the study. All participants underwent cognitive evaluations performed using both traditional neuropsychological assessment tools, including the Mini-Mental State Examination (MMSE), Montreal Overall Cognitive Assessment (MoCA), and the Smart Aging platform. We analyzed global scores on Smart Aging indices (i.e., accuracy, time, distance) as well as the Smart Aging total score, looking for differences between the four groups. Results: The findings revealed significant between-group differences in all the Smart Aging indices: accuracy (p < 0.001), time (p < 0.001), distance (p < 0.001), and total Smart Aging score (p < 0.001). The HCs outperformed the mild AD, aMCI, and PD-MCI patients in terms of accuracy, time, distance, and Smart Aging total score. In addition, the mild AD group was outperformed both by the HCs and by the aMCI and PD-MCI patients on accuracy and distance. No significant differences were found between aMCI and PD-MCI patients. Finally, the Smart Aging scores significantly correlated with the results of the neuropsychological assessments used. Conclusion: These findings, although preliminary due to the small sample size, suggest the validity of Smart Aging as a screening tool for the detection of cognitive impairment in patients with neurodegenerative diseases.
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Affiliation(s)
- Sara Bottiroli
- Faculty of Law, Giustino Fortunato University, Benevento, Italy.,National Neurological Institute C. Mondino Foundation, Pavia, Italy
| | - Sara Bernini
- National Neurological Institute C. Mondino Foundation, Pavia, Italy
| | - Elena Cavallini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Elena Sinforiani
- National Neurological Institute C. Mondino Foundation, Pavia, Italy
| | - Chiara Zucchella
- Neurology Unit, Department of Neurosciences, Verona University Hospital, Verona, Italy
| | - Stefania Pazzi
- Consorzio di Bioingegneria Medica e Informatica CBIM, Pavia, Italy
| | - Paolo Cristiani
- Consorzio di Bioingegneria Medica e Informatica CBIM, Pavia, Italy
| | - Tomaso Vecchi
- National Neurological Institute C. Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Daniela Tost
- Computer Graphics Division Research Centre for Biomedical Engineering (CREB), Universitat Politecnica de Catalunya, Barcelona, Spain
| | - Giorgio Sandrini
- National Neurological Institute C. Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Cristina Tassorelli
- National Neurological Institute C. Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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186
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Senjam SS, Manna S, Vashist P, Gupta V, Varughese S, Tandon R. Tele-rehabilitation for visually challenged students during COVID-19 pandemic: Lesson learned. Indian J Ophthalmol 2021; 69:722-728. [PMID: 33595510 PMCID: PMC7942065 DOI: 10.4103/ijo.ijo_2527_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/27/2020] [Accepted: 01/21/2021] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The COVID-19 outbreak poses a global crisis in health care delivery system, including habilitation and rehabilitation services. In this study, we shared our experiences on telerehabilitation services established primarily for students with visual disabilities (SwVD) amidst COVID-19 pandemic and its outputs. METHODS Following the lockdown declared on March 23, 2020, the rehabilitative team of a tertiary eye center in north India received information that many visually challenged students (VCS) were stranded in schools for the blind in Delhi, and feeling with anxiety and panic in absence of teachers. Shortly, the room for vision rehabilitation clinic was set-up for telefacilities. The intended services were explained while disseminating the mobile numbers. A semi-structured questionnaire consisting of closed and open-ended was developed to record COVID-19 knowledge and concerns. Inductive content analysis was used to report the qualitative information. RESULTS As of June 30, 2020, a total of 492 clients contacted the team, with maximum from Delhi (41.5%), and predominantly males (78.8%). Around 80.3% of callers were VCS with age range of 11 to 30 years. The two most frequently encountered health needs were itching in eyes (36.1%) and headache (29%). Television news was the most used medium among callers to get COVID-19 information. Cough is a less frequently known mode of transmission (28%), similarly handwashing as a less known for prevention (17.2%). Eight concerns were recorded based on qualitative data analysis. CONCLUSION Telerehabilitation provides valuable insights and has the potential to address various concerns, uncertainty, anxiety, and fear among VCS during the pandemic.
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Affiliation(s)
- Suraj Singh Senjam
- Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences New Delhi, India
| | - Souvik Manna
- Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences New Delhi, India
| | - Praveen Vashist
- Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences New Delhi, India
| | - Vivek Gupta
- Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences New Delhi, India
| | - Sara Varughese
- Country Director & Managing Trustee: CBM, Charmarajpet, Bengaluru, Karnataka, India
| | - Radhika Tandon
- Cornea, Cataract & Refractive Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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187
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Batalik L, Konecny V, Dosbaba F, Vlazna D, Brat K. Cardiac Rehabilitation Based on the Walking Test and Telerehabilitation Improved Cardiorespiratory Fitness in People Diagnosed with Coronary Heart Disease during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052241. [PMID: 33668304 PMCID: PMC7956401 DOI: 10.3390/ijerph18052241] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/08/2021] [Accepted: 02/19/2021] [Indexed: 02/07/2023]
Abstract
This study investigated an alternative home-based cardiac telerehabilitation model in consideration of the recommendations for the COVID-19 quarantine of people diagnosed with coronary heart disease (CHD). We hypothesized that using a 200 m fast walking test (200 mFWT) and telerehabilitation would create an effective alternative cardiac rehabilitation (CR) intervention that could improve cardiorespiratory fitness. Participants (n = 19, mean age 60.4 ± 9.6) of the 8-week intervention performed regular physical exercise at the target heart rate zone determined by calculations based on the 200 mFWT results. In our study, the participants were supervised using telerehabilitation. A total of 84% of participants completed the 8-week intervention. No adverse events were reported during telerehabilitation. The study participants noted a significant improvement (p < 0.001) in cardiorespiratory fitness expressed by an 8% reduction in the walking test time (Δ 8.8 ± 5.9 s). Home-based telerehabilitation based on 200 mFWT effectively increased the cardiorespiratory fitness in people with CHD with a low to moderate cardiovascular risk. This was a novel approach in CR during the COVID-19 pandemic. As research in this area is justified, this paper may serve as an alternative method of providing healthcare during the COVID-19 pandemic and as a basis for further upcoming randomized controlled trials.
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Affiliation(s)
- Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic; (F.D.); (D.V.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
- Correspondence:
| | - Vladimir Konecny
- Non-Government Health Facility, Cardiovascular Rehabilitation, 62500 Brno, Czech Republic;
| | - Filip Dosbaba
- Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic; (F.D.); (D.V.)
| | - Daniela Vlazna
- Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic; (F.D.); (D.V.)
- Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic;
| | - Kristian Brat
- Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic;
- Department of Respiratory Diseases, University Hospital Brno, 62500 Brno, Czech Republic
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188
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Guillén-Climent S, Garzo A, Muñoz-Alcaraz MN, Casado-Adam P, Arcas-Ruiz-Ruano J, Mejías-Ruiz M, Mayordomo-Riera FJ. A usability study in patients with stroke using MERLIN, a robotic system based on serious games for upper limb rehabilitation in the home setting. J Neuroeng Rehabil 2021; 18:41. [PMID: 33622344 PMCID: PMC7901008 DOI: 10.1186/s12984-021-00837-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/10/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Neuroscience and neurotechnology are transforming stroke rehabilitation. Robotic devices, in addition to telerehabilitation, are increasingly being used to train the upper limbs after stroke, and their use at home allows us to extend institutional rehabilitation by increasing and prolonging therapy. The aim of this study is to assess the usability of the MERLIN robotic system based on serious games for upper limb rehabilitation in people with stroke in the home environment. METHODS 9 participants with a stroke in three different stages of recovery (subacute, short-term chronic and long-term chronic) with impaired arm/hand function, were recruited to use the MERLIN system for 3 weeks: 1 week training at the Maimonides Biomedical Research Institute of Cordoba (IMIBIC), and 2 weeks at the patients' homes. To evaluate usability, the System Usability Scale (SUS), Adapted Intrinsic Motivation Inventory (IMI), Quebec User Evaluation of Satisfaction with assistive Technology (QUEST), and the ArmAssist Usability Assessment Questionnaire were used in the post-intervention. Clinical outcomes for upper limb motor function were assessed pre- and post-intervention. RESULTS 9 patients participated in and completed the study. The usability assessment reported a high level of satisfaction: mean SUS score 71.94 % (SD = 16.38), mean QUEST scale 3.81 (SD = 0.38), and mean Adapted IMI score 6.12 (SD = 1.36). The results of the ArmAssist Questionnaire showed an average of 6 out of 7, which indicates that MERLIN is extremely intuitive, easy to learn and easy to use. Regarding clinical assessment, the Fugl-Meyer scores showed moderate improvements from pre- to post-intervention in the total score of motor function (p = 0.002). There were no significant changes in the Modified Ashworth scale outcomes (p = 0.169). CONCLUSIONS This usability study indicates that home-based rehabilitation for upper limbs with the MERLIN system is safe, useful, feasible and motivating. Telerehabilitation constitutes a major step forward in the use of intensive rehabilitation at home. Trial registration ClinicalTrials.gov, NCT04405609. Registered 06 January 2020-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04405609.
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Affiliation(s)
- Silvia Guillén-Climent
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain.
| | - Ainara Garzo
- Neurorehabilitation area, Health Division of TECNALIA, Basque Research and Technology Alliance (BRTA), San Sebastián, Spain
| | - María Nieves Muñoz-Alcaraz
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain
- Interlevel Clinical Management Unit of Physical Medicine and Rehabilitation, Reina Sofía University Hospital of Córdoba, Córdoba, Spain
- Córdoba and Guadalquivir Health District, Andalusia Health Service, Córdoba, Spain
| | - Pablo Casado-Adam
- Interlevel Clinical Management Unit of Physical Medicine and Rehabilitation, Reina Sofía University Hospital of Córdoba, Córdoba, Spain
| | - Javier Arcas-Ruiz-Ruano
- Neurorehabilitation area, Health Division of TECNALIA, Basque Research and Technology Alliance (BRTA), San Sebastián, Spain
| | - Manuela Mejías-Ruiz
- Interlevel Clinical Management Unit of Physical Medicine and Rehabilitation, Reina Sofía University Hospital of Córdoba, Córdoba, Spain
| | - Fernando Jesús Mayordomo-Riera
- Interlevel Clinical Management Unit of Physical Medicine and Rehabilitation, Reina Sofía University Hospital of Córdoba, Córdoba, Spain
- Department of Applied Physics, Radiology and Physical Medicine, University of Córdoba, Córdoba, Spain
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189
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Suso-Martí L, La Touche R, Herranz-Gómez A, Angulo-Díaz-Parreño S, Paris-Alemany A, Cuenca-Martínez F. Effectiveness of Telerehabilitation in Physical Therapist Practice: An Umbrella and Mapping Review With Meta-Meta-Analysis. Phys Ther 2021; 101:6145901. [PMID: 33611598 PMCID: PMC7928612 DOI: 10.1093/ptj/pzab075] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 10/23/2020] [Accepted: 12/31/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Telerehabilitation is an option that should be adapted as soon as possible to face the crisis caused by coronavirus disease 2019. An umbrella and mapping review with meta-meta-analysis (MMA) of the available scientific evidence was performed to determine whether telerehabilitation could be an effective alternative to conventional rehabilitation in physical therapist practice. METHODS A systematic review of reviews and a synthesis of the findings of all systematic evidence published to date with a visual map and a meta-meta-analysis (MMA) were performed. A systematic search was realized in Cochrane Database of Systematic Reviews, MEDLINE (PubMed), and Google Scholar. Two independent reviewers performed a data analysis and assessed the quality of the included reviews, assessing the risk of bias using ROBIS. RESULTS Twenty-nine articles that met the inclusion criteria were selected and divided according to the type of patient targeted for rehabilitation (patients with cardiorespiratory, musculoskeletal, and neurological conditions). The MMA regarding physical function between telerehabilitation and usual care rehabilitation did not reveal a statistically significant difference for patients with cardiorespiratory and musculoskeletal conditions. For patients with neurological conditions, the MMA revealed a statistically significant but negligible effect size in 6 reviews in favor of telerehabilitation (standardized mean difference = 0.18; 95% CI = 0.03-0.34). CONCLUSION The results of the present review showed that telerehabilitation offers positive clinical results, even comparable to conventional face-to-face rehabilitation approaches. IMPACT The advantages of lower cost and less interference by the rehabilitation processes in patients' daily life could justify implementing telerehabilitation in clinical settings in the coronavirus disease 2019 era.
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Affiliation(s)
- Luis Suso-Martí
- Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain,Department of Physiotherapy, University CEU Cardenal Herrera, CEU Universities, Valencia, Spain
| | - Roy La Touche
- Address all correspondence tLa Touche, Address: Centro Superior de Estudios Universitarios La Salle, Calle La Salle, n° 10, 28023 Madrid, Spain. E-mail:
| | - Aida Herranz-Gómez
- Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain,Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain
| | | | - Alba Paris-Alemany
- Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain,Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain,Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, Spain
| | - Ferran Cuenca-Martínez
- Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain,Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain
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190
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Immediate Effects of a Telerehabilitation Program Based on Aerobic Exercise in Women with Fibromyalgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042075. [PMID: 33672691 PMCID: PMC7924356 DOI: 10.3390/ijerph18042075] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/11/2021] [Accepted: 02/15/2021] [Indexed: 12/17/2022]
Abstract
Background: We analyzed the immediate effects of a Telerehabilitation Program (TP) based on aerobic exercise in women with fibromyalgia (FM) syndrome during the lockdown declared in Spain due to the COVID-19 pandemic. Methods: A single-blind randomized controlled trial was designed. Thirty-four women with FM were randomized into two groups: TP group and Control group. The intervention lasted 15 weeks, with 2 sessions per week. The TP based on aerobic exercise was guided by video and the intensity of each session was monitored using the Borg scale. Pain intensity (Visual Analogue Scale), mechanical pain sensitivity (algometer), number of tender points, FM impact (Revised Fibromyalgia Impact Questionnaire), pain catastrophizing (Pain Catastrophizing Scale), physiological distress (Hospital Anxiety and Depression Scale), upper (Arm Curl Test) and lower-limb physical function (6-min Walk Test) were measured at baseline and after the intervention. Results: The TP group improved pain intensity (p = 0.022), mechanical pain sensitivity (p < 0.05), and psychological distress (p = 0.005), compared to the Control group. The Control group showed no statistically significant changes in any variable (p > 0.05). Conclusions: A TP based on aerobic exercise achieved improvements on pain intensity, mechanical pain sensitivity, and psychological distress compared to a Control group during the lockdown declared in Spain due to COVID-19 pandemic.
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191
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Tsutsui M, Gerayeli F, Sin DD. Pulmonary Rehabilitation in a Post-COVID-19 World: Telerehabilitation as a New Standard in Patients with COPD. Int J Chron Obstruct Pulmon Dis 2021; 16:379-391. [PMID: 33642858 PMCID: PMC7903963 DOI: 10.2147/copd.s263031] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 02/07/2021] [Indexed: 12/15/2022] Open
Abstract
Pulmonary rehabilitation (PR) is effective in reducing symptoms and improving health status, and exercise tolerance of patients with chronic obstructive pulmonary disease (COPD). The coronavirus disease 19 (COVID-19) pandemic has greatly impacted PR programs and their delivery to patients. Owing to fears of viral transmission and resultant outbreaks of COVID-19, institution-based PR programs have been forced to significantly reduce enrolment or in some cases completely shut down during the pandemic. As a majority of COPD patients are elderly and have multiple co-morbidities including cardiovascular disease and diabetes, they are notably susceptible to severe complications of COVID-19. As such, patients have been advised to stay at home and avoid social contact to the maximum extent possible. This has increased patients’ vulnerability to physical deconditioning, depression, and social isolation. To address this major gap in care, some traditional hospital or clinic-centered PR programs have converted some or all of their learning contents to home-based telerehabilitation during the pandemic. There are, however, some significant barriers to this approach that have impeded its implementation in the community. These include variable access and use of technology (by patients), a lack of standardization of methods and tools for evaluation of the program, and inadequate training and resources for health professionals in optimally delivering telerehabilitation to patients. There is a pressing need for high-quality studies on these modalities of PR to enable the successful implementation of PR at home and via teleconferencing technologies. Here, we highlight the importance of telerehabilitation of patients with COPD in the post-COVID world and discuss various strategies for clinical implementation.
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Affiliation(s)
- Mai Tsutsui
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Firoozeh Gerayeli
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Don D Sin
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.,Division of Respiratory Medicine, University of British Columbia, Vancouver, BC, Canada
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192
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Phuphanich ME, Sinha KR, Truong M, Pham QG. Telemedicine for Musculoskeletal Rehabilitation and Orthopedic Postoperative Rehabilitation. Phys Med Rehabil Clin N Am 2021; 32:319-353. [PMID: 33814061 DOI: 10.1016/j.pmr.2020.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Telehealth visits result in high-quality care, with high patient and provider satisfaction. Strong evidence suggests that virtual physical therapy is noninferior to conventional face-to-face physical therapy for a variety of musculoskeletal disorders. Postoperative telerehabilitation has a strong positive effect on clinical outcomes, and the increased intensity telerehabilitation programs offer is a promising option for patients. Studies demonstrate effective virtual postoperative management. The novel coronavirus disease 2019 pandemic has led to improved reimbursement for telehealth visits and accelerated widespread implementation of telemedicine. This article establishes experience and evidence-based practice guidelines for conducting telemedicine visits, with emphasis on the virtual physical examination.
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Affiliation(s)
- Melissa E Phuphanich
- Department of Physical Medicine and Rehabilitation, Greater Los Angeles VA Healthcare System, (117), 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA
| | - Kunal R Sinha
- Department of Physical Medicine and Rehabilitation, Greater Los Angeles VA Healthcare System, (117), 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA
| | - Michael Truong
- University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Quynh Giao Pham
- Pain Medicine Fellowship Training Program, Department of Medicine, Division of Physical Medicine and Rehabilitation, Greater Los Angeles VA Healthcare System, David Geffen School of Medicine at UCLA, (117), 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA.
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193
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Rapid Prototyping of Virtual Reality Cognitive Exercises in a Tele-Rehabilitation Context. ELECTRONICS 2021. [DOI: 10.3390/electronics10040457] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In recent years, the need to contain healthcare costs due to the growing public debt of many countries, combined with the need to reduce costly travel by patients unable to move autonomously, have captured the attention of public administrators towards tele-rehabilitation. This trend has been consolidated overwhelmingly following the Covid-19 pandemic, which has made it precarious, difficult and even dangerous for patients to access hospital facilities. We present an approach based on the rapid prototyping of virtual reality, cognitive tele-rehabilitation exercises, which reinforce the group of exercises available in the Nu!reha platform. Patients who experienced injury or pathology need to practice continuous training in order to recover functional abilities, and the therapist needs to monitor the outcomes of such practices. The group of new exercises based on the rapid prototyping approach, become crucial especially in this pandemic period. The Virtual Reality exercises are designed on Unity 3D to empower the therapist to set up personalized exercises in an easy way, enabling the patient to receive personalized stimuli, which are essential for a positive outcome in the practice. Furthermore, the reaction speed of the system is of fundamental importance, as the temporal evolution of the scene must proceed parallel to the patient’s movements, to ensure an effective and efficient therapeutic response. So, we optimized the virtual reality application in order to make the loading phase and the startup phase as fast as possible and we have tested the results obtained with many devices: in particular computers and smartphones with different operating systems and hardware. The implemented method powers up the Nu!Reha system®, a collection of tele-rehabilitation services that helps patients to recover cognitive and functional capabilities.
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194
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Surya N, Srivastava A, Nagda T, Palande D, Someshwar H. Education, Training, and Practices of Neurorehabilitation in India During the COVID-19 Pandemic. Front Neurol 2021; 12:626399. [PMID: 33643202 PMCID: PMC7902936 DOI: 10.3389/fneur.2021.626399] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/04/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Corona virus disease (COVID-19) was declared a pandemic by the World Health Organization in March 2020. This has affected service delivery among all medical disciplines in India including neurorehabilitation services. Aims and Objectives: The aims and objectives of the study were to assess the effect of COVID-19 pandemic on neurorehabilitation services across India. Methodology: A prospective nationwide survey study was undertaken by the Indian Federation of Neurorehabilitation during the pandemic. A questionnaire was prepared using Google forms software consisting of four sections: demography, neurorehabilitation practice before COVID-19 pandemic, neurorehabilitation practice during COVID-19 pandemic, and continuing medical education during COVID-19 pandemic. Results: Responses (872) were received from neurorehabilitation professionals across the country out of which 2.2% professionals did not give consent for participating in the survey. Participants (36.6%) were practicing traditional or independent referral basis rehabilitation, while 63.4% participants were practicing multidisciplinary rehabilitation. On an average, respective units were conducting 500–750 therapy sessions per month. Majority of the rehabilitation units in India lacked a physiatrist, rehabilitation nurse, music therapist, cognitive therapist, and urologist. Approximately 80% of the rehabilitation units have the basic rehabilitation modalities and advance technology was present in only 20% of the rehabilitation units. During COVID-19 pandemic, 19.5% centers were providing elective services, 50.3% emergency services, 15.6% new outpatient services, and 22.7% were providing follow-up outpatient services. Centers (51.5%) were providing telerehabilitation services for neurological conditions during the times of COVID-19 pandemic. Professionals (61.1%) providing telerehabilitation were working from home. Among the patients who needed neurorehabilitation, 28% were doing their exercises independently, 31% were supervised by caregivers, 17% were supervised by therapists, and 24% were not receiving any therapy. Participants (95.5%) wanted to receive more training in the field of neurorehabilitation. The participants utilized webinars (71%), online courses (22%), case discussion forums (19%), panel discussions (13%), and literature search (8%) during COVID-19 pandemic to continue education. Conclusion: The study reflects the situation of neurorehabilitation service delivery in India during the pandemic as the respondents were from all parts of the country and included most components of the neurorehabilitation team. Neurorehabilitation services were severely affected across India during the COVID-19 pandemic. Tele-neurorehabilitation has emerged as a new service delivery model during the pandemic. Online means of education has emerged as the primary source of continuing medical education during the pandemic.
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Affiliation(s)
- Nirmal Surya
- Epilepsy Foundation India, Mumbai, India.,Bombay Hospital, Mumbai, India
| | | | - Taral Nagda
- Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India
| | - Deepak Palande
- Society for Rehabilitation and Care of Children Hospital, Mumbai, India
| | - Hitav Someshwar
- Grant Medical College and Sir Jamshedjee Jeejeebhoy Group of Hospitals, Mumbai, India
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195
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A group-based real-time videoconferencing telerehabilitation programme in recently discharged geriatric patients: a feasibility study. Eur Geriatr Med 2021; 12:801-808. [PMID: 33544388 PMCID: PMC7863611 DOI: 10.1007/s41999-020-00444-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 12/17/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Exercise at home and improvement in the ability to undertake daily tasks are highly valued by older people after hospitalisation. New telerehabilitation (TR) technologies make it possible to supervise and communicate with exercising participants through videoconferencing equipment. This technology has been shown to be both feasible and effective in Danish chronic obstructive pulmonary disease patients in terms of basic mobility, safety, social interactions and patient perception. This study sought to examine whether it was feasible to carry out TR through home exercises in groups. METHODS Both medical and hip-fracture home-dwelling patients aged 65 years and older admitted to the Emergency Department (ED) and Department of Geriatrics for acute reasons were asked to participate in the study just before their discharge. The inclusion criteria were normal cognitive function, being dependent on a walking aid and computer users before hospitalisation. RESULTS At discharge, 333 patients were consecutively screened for participation. Of those, 300 patients were excluded. Thirty-three patients met the inclusion criteria. They had a mean age of 82.3 years (± 7.8) and 76% were women. Nine patients agreed to participate, but seven withdrew. The most frequent explanation was exhaustion in the continuation of hospitalisation. CONCLUSION It was not possible to conduct a videoconference TR study in a geriatric population, as many were excluded and those who were eligible withdrew after inclusion. During the COVID-19 pandemic, TR may be an important tool for isolated older persons to hinder functional decline. Aspects such as recruitment procedures and IT solutions designed for older people must be considered.
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196
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Elgert L, Steiner B, Saalfeld B, Marschollek M, Wolf KH. Health-Enabling Technologies to Assist Patients With Musculoskeletal Shoulder Disorders When Exercising at Home: Scoping Review. JMIR Rehabil Assist Technol 2021; 8:e21107. [PMID: 33538701 PMCID: PMC8294637 DOI: 10.2196/21107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/04/2020] [Accepted: 12/16/2020] [Indexed: 12/11/2022] Open
Abstract
Background Health-enabling technologies (HETs) are information and communication technologies that promote individual health and well-being. An important application of HETs is telerehabilitation for patients with musculoskeletal shoulder disorders. Currently, there is no overview of HETs that assist patients with musculoskeletal shoulder disorders when exercising at home. Objective This scoping review provides a broad overview of HETs that assist patients with musculoskeletal shoulder disorders when exercising at home. It focuses on concepts and components of HETs, exercise program strategies, development phases, and reported outcomes. Methods The search strategy used Medical Subject Headings and text words related to the terms upper extremity, exercises, and information and communication technologies. The MEDLINE, Embase, IEEE Xplore, CINAHL, PEDro, and Scopus databases were searched. Two reviewers independently screened titles and abstracts and then full texts against predefined inclusion and exclusion criteria. A systematic narrative synthesis was performed. Overall, 8988 records published between 1997 and 2019 were screened. Finally, 70 articles introducing 56 HETs were included. Results Identified HETs range from simple videoconferencing systems to mobile apps with video instructions to complex sensor-based technologies. Various software, sensor hardware, and hardware for output are in use. The most common hardware for output are PC displays (in 34 HETs). Microsoft Kinect cameras in connection with related software are frequently used as sensor hardware (in 27 HETs). The identified HETs provide direct or indirect instruction, monitoring, correction, assessment, information, or a reminder to exercise. Common parameters for exercise instructions are a patient’s range of motion (in 43 HETs), starting and final position (in 32 HETs), and exercise intensity (in 20 HETs). In total, 48 HETs provide visual instructions for the exercises; 29 HETs report on telerehabilitation aspects; 34 HETs only report on prototypes; and 15 HETs are evaluated for technical feasibility, acceptance, or usability, using different assessment instruments. Efficacy or effectiveness is demonstrated for only 8 HETs. In total, 18 articles report on patients’ evaluations. An interdisciplinary contribution to the development of technologies is found in 17 HETs. Conclusions There are various HETs, ranging from simple videoconferencing systems to complex sensor-based technologies for telerehabilitation, that assist patients with musculoskeletal shoulder disorders when exercising at home. Most HETs are not ready for practical use. Comparability is complicated by varying prototype status, different measurement instruments, missing telerehabilitation aspects, and few efficacy studies. Consequently, choosing an HET for daily use is difficult for health care professionals and decision makers. Prototype testing, usability, and acceptance tests with the later target group under real-life conditions as well as efficacy or effectiveness studies with patient-relevant core outcomes for every promising HET are required. Furthermore, health care professionals and patients should be more involved in the product design cycle to consider relevant practical aspects.
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Affiliation(s)
- Lena Elgert
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany
| | - Bianca Steiner
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Braunschweig, Germany
| | - Birgit Saalfeld
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany
| | - Michael Marschollek
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany
| | - Klaus-Hendrik Wolf
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany
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197
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Nuara A, Fabbri-Destro M, Scalona E, Lenzi SE, Rizzolatti G, Avanzini P. Telerehabilitation in response to constrained physical distance: an opportunity to rethink neurorehabilitative routines. J Neurol 2021; 269:627-638. [PMID: 33449202 PMCID: PMC7809551 DOI: 10.1007/s00415-021-10397-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/02/2021] [Accepted: 01/04/2021] [Indexed: 02/07/2023]
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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Affiliation(s)
- Arturo Nuara
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, via Volturno 39/E, 43125, Parma, Italy. .,Department of Biomedical, Metabolic, and Neuronal Sciences, University of Modena and Reggio Emilia, Modena, Italy. .,Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Maddalena Fabbri-Destro
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, via Volturno 39/E, 43125, Parma, Italy
| | - Emilia Scalona
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, via Volturno 39/E, 43125, Parma, Italy
| | - Stefano Elio Lenzi
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, via Volturno 39/E, 43125, Parma, Italy
| | - Giacomo Rizzolatti
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, via Volturno 39/E, 43125, Parma, Italy.,Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Pietro Avanzini
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, via Volturno 39/E, 43125, Parma, Italy.,Istituto Clinico Humanitas, Rozzano, Italy
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198
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Bernini S, Stasolla F, Panzarasa S, Quaglini S, Sinforiani E, Sandrini G, Vecchi T, Tassorelli C, Bottiroli S. Cognitive Telerehabilitation for Older Adults With Neurodegenerative Diseases in the COVID-19 Era: A Perspective Study. Front Neurol 2021; 11:623933. [PMID: 33519704 PMCID: PMC7840692 DOI: 10.3389/fneur.2020.623933] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/03/2020] [Indexed: 12/20/2022] Open
Abstract
The COVID-19 pandemic is a global health problem that is radically transforming public and private healthcare organizations around the world, negatively affecting the rehabilitative treatments of non-COVID pathologies as well. In this situation, it becomes crucial to be able to guarantee the continuity of care also to all those patients with neurodegenerative diseases unable to reach healthcare services. Remote communication technologies are gaining momentum as potentially effective options to support health care interventions-including cognitive rehabilitation-while patients can stay safely at home. In this context, we are implementing HomeCoRe (i.e., Home Cognitive Rehabilitation software) in order to offer an innovative approach and a valid support for home-based cognitive rehabilitation in neurodegenerative diseases, such as mild cognitive impairment and early dementia. HomeCoRe has been developed within a research project between engineers and clinicians in order to obtain a usable and safe cognitive rehabilitation tool. This software has multiple advantages for patients and therapists over traditional approaches, as shown in its use in hospital settings. HomeCoRe could then represent an opportunity for accessing cognitive rehabilitation in all those situations where patients and therapists are not in the same location due to particular restrictions, such as COVID-19 pandemic.
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Affiliation(s)
- Sara Bernini
- Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Mondino Foundation, Pavia, Italy
| | | | - Silvia Panzarasa
- Department of Electrical, Computer, and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Silvana Quaglini
- Department of Electrical, Computer, and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Elena Sinforiani
- Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Mondino Foundation, Pavia, Italy
| | - Giorgio Sandrini
- Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Tomaso Vecchi
- Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Cristina Tassorelli
- Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Sara Bottiroli
- Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Mondino Foundation, Pavia, Italy
- Faculty of Law, Giustino Fortunato University, Benevento, Italy
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199
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Assenza C, Catania H, Antenore C, Gobbetti T, Gentili P, Paolucci S, Morelli D. Continuity of Care During COVID-19 Lockdown: A Survey on Stakeholders' Experience With Telerehabilitation. Front Neurol 2021; 11:617276. [PMID: 33519697 PMCID: PMC7838679 DOI: 10.3389/fneur.2020.617276] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/04/2020] [Indexed: 12/30/2022] Open
Abstract
Objective: To explore professionals', adult patients', and children's caregivers' perception and satisfaction with telerehabilitation during COVID-19 lockdown. Design: An observational transversal study on a web-based survey was conducted in order to explore participants' perception and satisfaction of telerehabilitation during COVID-19 lockdown. Setting: The study was conducted at our Outpatient Neurorehabilitation Service. Subjects: All rehabilitation professionals, adult patients, and children's caregivers who accepted telerehabilitation were recruited. Interventions: Participants had to respond to the Client Satisfaction Questionnaire-8 and to a purpose-built questionnaire on their perception and satisfaction of the service provided. Main Measures: Data were analyzed by qualitative statistics and logistic regression models. Results: All 144 caregivers, 25 adult patients, and 50 professionals reported a medium-high level of perception and a high level of satisfaction. Results showed a correlation among caregivers of children aged 0-3 and feeling overwhelmed with remote care (OR = 3.27), a low perception of telerehabilitation for enhancing goals (OR = 6.51), and a high perception of feeling helped in organizing daily activity (OR = 2.96). For caregivers of children aged over 6 years, changes in the therapy plan were related to a low perception of feeling in line with the in-person therapy (OR = 2.61 and OR = 9.61) and a low satisfaction (OR = 5.54 and OR = 4.97). Changes in therapy were related to concern (OR = 4.20). Caregivers under 40 and professionals showed a high probability to perceive telerehabilitation as supportive (OR = 2.27 and OR = 5.68). Level of experience with remote media was shown to influence perception and satisfaction. Interpretation: Telerehabilitation can be a useful practice both during a health emergency and in addition to in-presence therapy.
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Affiliation(s)
- Carla Assenza
- Neurorehabilitation Outpatient Department, Santa Lucia Foundation (Scientific Institute for Research and Health Care), Rome, Italy
| | - Hilenia Catania
- Neurorehabilitation Outpatient Department, Santa Lucia Foundation (Scientific Institute for Research and Health Care), Rome, Italy
| | - Clementina Antenore
- Neurorehabilitation Outpatient Department, Santa Lucia Foundation (Scientific Institute for Research and Health Care), Rome, Italy
| | - Tiziana Gobbetti
- Neurorehabilitation Outpatient Department, Santa Lucia Foundation (Scientific Institute for Research and Health Care), Rome, Italy
| | - Paola Gentili
- Neurorehabilitation Outpatient Department, Santa Lucia Foundation (Scientific Institute for Research and Health Care), Rome, Italy
| | - Stefano Paolucci
- Clinical Laboratory of Experimental Neurorehabilitation, Santa Lucia Foundation (Scientific Institute for Research and Health Care), Rome, Italy
| | - Daniela Morelli
- Neurorehabilitation Outpatient Department, Santa Lucia Foundation (Scientific Institute for Research and Health Care), Rome, Italy
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200
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Iodice F, Romoli M, Giometto B, Clerico M, Tedeschi G, Bonavita S, Leocani L, Lavorgna L. Stroke and digital technology: a wake-up call from COVID-19 pandemic. Neurol Sci 2021; 42:805-809. [PMID: 33433756 PMCID: PMC7801773 DOI: 10.1007/s10072-020-04993-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/11/2020] [Indexed: 12/23/2022]
Abstract
Introduction The pandemic has implemented the need for new digital technologies as useful tools during the emergency and the long recovery phase that will follow. SARS-CoV-2 has strongly impacted stroke care with significant contraction in a number of patients treated. Methods This mini-review is an initiative of the “Digital Technologies, Web and Social Media Study Group” of the Italian Society of Neurology and briefly discusses digital tools for managing the acute phase and the rehabilitation after stroke, even considering the new apps that will improve the process of remote monitoring of patients after discharge at home. Results Telemedicine and digital technologies could play a role in each of the three stroke-belt stages: hyperacute treatment and reperfusion, acute care, etiological classification and secondary prevention and rehabilitation. Conclusion The global emergency represented by the COVID-19 pandemic can be the stimulus to accelerate the digitalization process in the field of stroke for the use of new methods on a large scale.
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Affiliation(s)
- Francesco Iodice
- Institute of Neurology, Fondazione Policlinico Gemelli, IRCCS, Rome, Italy. .,Department of Neuroscience and Neurorehabilitation, San Raffaele Pisana IRCCS, Rome, Italy. .,Digital Technologies, Web and Social Media Study Group of the Italian Society of Neurology Francesco Iodice (Member), Largo A. Gemelli 8, 00168, Rome, Italy.
| | - Michele Romoli
- Department of Neurology and Metropolitan Stroke Center, IRCCS Istituto delle Scienze Neurologiche di Bologna, "C.A. Pizzardi" Maggiore Hospital, Bologna, Italy.,Neurology Clinic, University of Perugia, Perugia, Italy
| | - Bruno Giometto
- Department of Neurology, "Santa Chiara" Hospital APSS, Trento, Italy
| | - Marinella Clerico
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Simona Bonavita
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Letizia Leocani
- Department of Neurorehabilitation and INSPE-Institute of Experimental Neurology, IRCCS San Raffaele Hospital and University Vita-Salute, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Luigi Lavorgna
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
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