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Liljestrand C, Zingmark M. Use of information and communication technology in occupational therapy for older adults. Scand J Occup Ther 2024; 31:2271035. [PMID: 37878825 DOI: 10.1080/11038128.2023.2271035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Information and communication technology (ICT) provides one solution to meet increasing demands for occupational therapy for older adults. AIMS/OBJECTIVES To examine if and how municipality-based occupational therapists (OTs) include ICT in their work, and which factors are associated with use of occupational therapy at a distance. MATERIAL AND METHODS Survey study including 167 OTs. Data were presented descriptively. Associations were analysed by Chi2 test and logistic regression models. RESULTS Forty-eight percent of OTs used ICT once a month or more. OTs belief on possibilites to use ICT is associated with replacement of physical home visits. Managers expectations and support also seem to be important factors. CONCLUSION ICT solutions are frequently used by OTs in home health care and can be considered complementing rather than replacing physical home visits. More knowledge is needed on when and how ICT solutions can be used by OTs and how factors that impact the use of ICT can be managed.
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Affiliation(s)
| | - Magnus Zingmark
- Health and Social Care Administration, Municipality of Östersund, Sweden
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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2
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Lee K. Agreement between 3D Motion Analysis and Tele-Assessment Using a Video Conferencing Application for Telerehabilitation. Healthcare (Basel) 2021; 9:healthcare9111591. [PMID: 34828636 PMCID: PMC8622086 DOI: 10.3390/healthcare9111591] [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: 10/27/2021] [Revised: 11/15/2021] [Accepted: 11/18/2021] [Indexed: 11/29/2022] Open
Abstract
The global pandemic of the coronavirus disease 2019 (COVID-19) has highlighted the need for remote healthcare services. This study aimed to evaluate the concurrent validity and reliability of tele-assessment using 3D motion analysis and video conferencing applications. The subjects of this study were 14 Pilates instructors and 14 healthy adults, who repeated five exercises of “side spine stretch”, “bridge”, “toe taps”, “quadruped leg raise”, and “cat and cow” five times each. We performed 3D kinematic analysis with 16 infrared cameras while the subject performed each exercise, and the image captured by one webcam was transmitted to the evaluators through a video conferencing application, and eight raters evaluated the mobility, stability, and symmetry of the movement. The result was then compared with the gold standard 3D motion analysis to evaluate the teleassessment system. The concurrent validity of the data obtained using both methods was analyzed. In addition, the inter-rater reliability of the data from the eight raters was evaluated. As a result, mobility showed excellent (ICC > 0.75, ICCs: intraclass correlation coefficients) or good agreement (ICC = 0.6–0.74) with 3D motion analysis and tele-assessment in all motions. The analysis of stability showed high agreement in general, but it was not significant in “cat and cow.” Symmetry showed moderate agreement only in “bridge” and “toe taps”, showing low agreement compared to other components. In addition, the inter-rater reliability of the tele-assessment showed good agreement (ICC = 0.744). Although there were few components with weaker agreements, the results of this study confirmed that it is a valid and reliable method of tele-assessment using video conferencing applications and showed feasibility as an alternative to the existing face-to-face examination.
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Affiliation(s)
- Kyeongjin Lee
- Department of Physical Therapy, College of Health Science, Kyungdong University, Wonju 24764, Korea
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Reeves JJ, Ayers JW, Longhurst CA. Telehealth in the COVID-19 Era: A Balancing Act to Avoid Harm. J Med Internet Res 2021; 23:e24785. [PMID: 33477104 PMCID: PMC7857524 DOI: 10.2196/24785] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/20/2020] [Accepted: 01/16/2021] [Indexed: 12/15/2022] Open
Abstract
The telehealth revolution in response to COVID-19 has increased essential health care access during an unprecedented public health crisis. However, virtual patient care can also limit the patient-provider relationship, quality of examination, efficiency of health care delivery, and overall quality of care. As we witness the most rapidly adopted medical trend in modern history, clinicians are beginning to comprehend the many possibilities of telehealth, but its limitations also need to be understood. As outcomes are studied and federal regulations reconsidered, it is important to be precise in the virtual patient encounter approach. Herein, we offer some simple guidelines that could assist health care providers and clinic schedulers in determining the appropriateness of a telehealth visit by considering visit types, patient characteristics, and chief complaint or disease states.
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Affiliation(s)
- J Jeffery Reeves
- Department of Surgery, University of California San Diego, La Jolla, CA, United States
| | - John W Ayers
- Department of Medicine, Division of Biomedical Informatics, University of California San Diego, La Jolla, CA, United States
| | - Christopher A Longhurst
- Department of Medicine, Division of Biomedical Informatics, University of California San Diego, La Jolla, CA, United States
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Venkataraman K, Amis K, Landerman LR, Caves K, Koh GC, Hoenig H. Teleassessment of Gait and Gait Aids: Validity and Interrater Reliability. Phys Ther 2020; 100:708-717. [PMID: 31984420 PMCID: PMC7439231 DOI: 10.1093/ptj/pzaa005] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/02/2019] [Accepted: 08/06/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Gait and mobility aid assessments are important components of rehabilitation. Given the increasing use of telehealth to meet rehabilitation needs, it is important to examine the feasibility of such assessments within the constraints of telerehabilitation. OBJECTIVE The objective of this study was to examine the reliability and validity of the Tinetti Performance-Oriented Mobility Assessment gait scale (POMA-G) and cane height assessment under various video and transmission settings to demonstrate the feasibility of teleassessment. DESIGN This repeated-measures study compared the test performances of in-person, slow motion (SM) review, and normal-speed (NS) video ratings at various fixed frame rates (8, 15, and 30 frames per second) and bandwidth (128, 384, and 768 kB/s) configurations. METHODS Overall bias, validity, and interrater reliability were assessed for in-person, SM video, and NS video ratings, with SM video rating as the gold standard, as well as for different frame rate and bandwidth configurations within NS videos. RESULTS There was moderate to good interrater reliability for the POMA-G (intraclass correlation coefficient [ICC] = 0.66-0.77 across all configurations) and moderate validity for in-person (β = 0.62; 95% confidence interval [CI] = 0.37-0.87) and NS video (β = 0.74; 95% CI = 0.67-0.80) ratings compared with the SM video rating. For cane height, interrater reliability was good (ICC = 0.66-0.77), although it was significantly lower at the lowest frame rate (8 frames per second) (ICC = 0.66; 95% CI = 0.54-0.76) and bandwidth (128 kB/s) (ICC = 0.69; 95% CI = 0.57-0.78) configurations. Validity for cane height was good for both in-person (β = 0.80; 95% CI = 0.62-0.98) and NS video (β = 0.86; 95% CI = 0.81-0.90) ratings compared with SM video rating. LIMITATIONS Some lower frame rate and bandwidth configurations may limit the reliability of remote cane height assessments. CONCLUSIONS Teleassessment for POMA-G and cane height using typically available internet and video quality is feasible, valid, and reliable.
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Affiliation(s)
- Kavita Venkataraman
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Kristopher Amis
- Physical Medicine and Rehabilitation Service, Durham VA Health Care System, Durham, North Carolina
| | - Lawrence R Landerman
- Center for Aging and Human Development, Duke University Medical Center, Durham, North Carolina
| | - Kevin Caves
- Speech and Audiology, Department of Surgery, Duke University Medical Center
| | - Gerald C Koh
- Saw Swee Hock School of Public Health, National University of Singapore; and National University Health System
| | - Helen Hoenig
- Department of Medicine/Geriatrics, Duke University Medical Center; Physical Medicine and Rehabilitation Service, Durham VA Health Care System; and 508 Fulton St, Durham, NC 27705 (USA),Address all correspondence to Dr Hoenig at:
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Nobakht Z, Rassafiani M, Hosseini SA, Ahmadi M. Telehealth in occupational therapy: A scoping review. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2017. [DOI: 10.12968/ijtr.2017.24.12.534] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Zahra Nobakht
- PhD candidate, Occupational Therapy Department, University of Social Welfare and Rehabilitation Science, Tehran, Iran
| | - Mehdi Rassafiani
- Associate Professor, Occupational Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait
| | - Seyed Ali Hosseini
- Professor, Social Determinants Of Health Research And Occupational Therapy Departments., University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mina Ahmadi
- PhD candidate, Department of Occupational Therapy, School Of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran
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Hoenig HM, Amis K, Edmonds C, Morgan MS, Landerman L, Caves K. Testing fine motor coordination via telehealth: Effects of video characteristics on reliability and validity. J Telemed Telecare 2017; 24:365-372. [PMID: 28350283 DOI: 10.1177/1357633x17700032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background There is limited research about the effects of video quality on the accuracy of assessments of physical function. Methods A repeated measures study design was used to assess reliability and validity of the finger-nose test (FNT) and the finger-tapping test (FTT) carried out with 50 veterans who had impairment in gross and/or fine motor coordination. Videos were scored by expert raters under eight differing conditions, including in-person, high definition video with slow motion review and standard speed videos with varying bit rates and frame rates. Results FTT inter-rater reliability was excellent with slow motion video (ICC 0.98-0.99) and good (ICC 0.59) under the normal speed conditions. Inter-rater reliability for FNT 'attempts' was excellent (ICC 0.97-0.99) for all viewing conditions; for FNT 'misses' it was good to excellent (ICC 0.89) with slow motion review but substantially worse (ICC 0.44) on the normal speed videos. FTT criterion validity (i.e. compared to slow motion review) was excellent (β = 0.94) for the in-person rater and good ( β = 0.77) on normal speed videos. Criterion validity for FNT 'attempts' was excellent under all conditions ( r ≥ 0.97) and for FNT 'misses' it was good to excellent under all conditions ( β = 0.61-0.81). Conclusions In general, the inter-rater reliability and validity of the FNT and FTT assessed via video technology is similar to standard clinical practices, but is enhanced with slow motion review and/or higher bit rate.
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Affiliation(s)
- Helen M Hoenig
- 1 Physical Medicine & Rehabilitation Service, Durham VA Health Care System, Durham, NC, USA.,2 Department of Medicine/Geriatrics, Duke University Medical Center, Durham, NC, USA
| | - Kristopher Amis
- 1 Physical Medicine & Rehabilitation Service, Durham VA Health Care System, Durham, NC, USA
| | - Carol Edmonds
- 1 Physical Medicine & Rehabilitation Service, Durham VA Health Care System, Durham, NC, USA
| | - Michelle S Morgan
- 3 Center for Aging & Human Development, Duke University, Durham, NC, USA
| | - Lawrence Landerman
- 3 Center for Aging & Human Development, Duke University, Durham, NC, USA
| | - Kevin Caves
- 4 Speech and Audiology, Department of Surgery, Duke University Medical Center, Durham, NC, USA
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Schwamm LH, Chumbler N, Brown E, Fonarow GC, Berube D, Nystrom K, Suter R, Zavala M, Polsky D, Radhakrishnan K, Lacktman N, Horton K, Malcarney MB, Halamka J, Tiner AC. Recommendations for the Implementation of Telehealth in Cardiovascular and Stroke Care: A Policy Statement From the American Heart Association. Circulation 2017; 135:e24-e44. [DOI: 10.1161/cir.0000000000000475] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The aim of this policy statement is to provide a comprehensive review of the scientific evidence evaluating the use of telemedicine in cardiovascular and stroke care and to provide consensus policy suggestions. We evaluate the effectiveness of telehealth in advancing healthcare quality, identify legal and regulatory barriers that impede telehealth adoption or delivery, propose steps to overcome these barriers, and identify areas for future research to ensure that telehealth continues to enhance the quality of cardiovascular and stroke care. The result of these efforts is designed to promote telehealth models that ensure better patient access to high-quality cardiovascular and stroke care while striving for optimal protection of patient safety and privacy.
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Venkataraman K, Morgan M, Amis KA, Landerman LR, Koh GC, Caves K, Hoenig H. Tele-Assessment of the Berg Balance Scale: Effects of Transmission Characteristics. Arch Phys Med Rehabil 2016; 98:659-664.e1. [PMID: 27894732 DOI: 10.1016/j.apmr.2016.10.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 10/07/2016] [Accepted: 10/27/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare Berg Balance Scale (BBS) rating using videos with differing transmission characteristics with direct in-person rating. DESIGN Repeated-measures study for the assessment of the BBS in 8 configurations: in person, high-definition video with slow motion review, standard-definition videos with varying bandwidths and frame rates (768 kilobytes per second [kbps] videos at 8, 15, and 30 frames per second [fps], 30 fps videos at 128, 384, and 768 kbps). SETTING Medical center. PARTICIPANTS Patients with limitations (N=45) in ≥1 of 3 specific aspects of motor function: fine motor coordination, gross motor coordination, and gait and balance. INTERVENTIONS Not applicable. MAIN OUTCOMES MEASURES Ability to rate the BBS in person and using videos with differing bandwidths and frame rates in frontal and lateral views. RESULTS Compared with in-person rating (7%), 18% (P=.29) of high-definition videos and 37% (P=.03) of standard-definition videos could not be rated. Interrater reliability for the high-definition videos was .96 (95% confidence interval, .94-.97). Rating failure proportions increased from 20% in videos with the highest bandwidth to 60% (P<.001) in videos with the lowest bandwidth, with no significant differences in proportions across frame rate categories. Both frontal and lateral views were critical for successful rating using videos, with 60% to 70% (P<.001) of videos unable to be rated on a single view. CONCLUSIONS Although there is some loss of information when using videos to rate the BBS compared to in-person ratings, it is feasible to reliably rate the BBS remotely in standard clinical spaces. However, optimal video rating requires frontal and lateral views for each assessment, high-definition video with high bandwidth, and the ability to carry out slow motion review.
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Affiliation(s)
- Kavita Venkataraman
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
| | | | - Kristopher A Amis
- Physical Medicine and Rehabilitation Service, Durham Veterans Administration Medical Center, Durham, NC
| | | | - Gerald C Koh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Kevin Caves
- Speech and Audiology, Department of Surgery, Duke University Medical Center, Durham, NC
| | - Helen Hoenig
- Physical Medicine and Rehabilitation Service, Durham Veterans Administration Medical Center, Durham, NC; Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, NC
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Stout NL, Silver JK, Raj VS, Rowland J, Gerber L, Cheville A, Ness KK, Radomski M, Nitkin R, Stubblefield MD, Morris GS, Acevedo A, Brandon Z, Braveman B, Cunningham S, Gilchrist L, Jones L, Padgett L, Wolf T, Winters-Stone K, Campbell G, Hendricks J, Perkin K, Chan L. Toward a National Initiative in Cancer Rehabilitation: Recommendations From a Subject Matter Expert Group. Arch Phys Med Rehabil 2016; 97:2006-2015. [DOI: 10.1016/j.apmr.2016.05.002] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 05/17/2016] [Accepted: 05/18/2016] [Indexed: 11/29/2022]
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Tan KK, Narayanan AS, Koh CH, Caves K, Hoenig H. Extraction of spatial information for low-bandwidth telerehabilitation applications. ACTA ACUST UNITED AC 2015; 51:825-40. [PMID: 25509058 DOI: 10.1682/jrrd.2013.09.0217] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Telemedicine applications, based on two-dimensional (2D) video conferencing technology, have been around for the past 15 to 20 yr. They have been demonstrated to be acceptable for face-to-face consultations and useful for visual examination of wounds and abrasions. However, certain telerehabilitation assessments need the use of spatial information in order to accurately assess the patient's condition and sending three-dimensional video data over low-bandwidth networks is extremely challenging. This article proposes an innovative way of extracting the key spatial information from the patient's movement during telerehabilitation assessment based on 2D video and then presenting the extracted data by using graph plots alongside the video to help physicians in assessments with minimum burden on existing video data transfer. Some common rehabilitation scenarios are chosen for illustrations, and experiments are conducted based on skeletal tracking and color detection algorithms using the Microsoft Kinect sensor. Extracted data are analyzed in detail and their usability discussed.
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Tan KK, Narayanan AS, Koh GCH, Kyaw KKH, Hoenig HM. Development of telerehabilitation application with designated consultation categories. JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT 2014; 51:1383-96. [PMID: 25785371 DOI: 10.1682/jrrd.2014.02.0052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 07/21/2014] [Indexed: 11/05/2022]
Abstract
Telerehabilitation (TR) is getting ever more popular because it is effective in bringing rehabilitation services to rural populations by means of audiovisual systems and its initial implementation studies presented encouraging results. TR is proven to be helpful, with benefits in terms of reduced travel time, cost, and availability of specialists' support in local communities. However, TR systems that are usable under low-bandwidth network environments are rare. This article introduces the development of a TR system with customized consultation categories for users to choose from, depending on requirements. Each category, with its preset parameter values, is discussed in detail by demonstrating relevant rehabilitation exercises. A novel bandwidth adaptation algorithm is also presented for optimal utilization of the dynamic network conditions, which ensures the system functionality even under narrow-bandwidth environments. Experiment results show that the system is able to perform effectively in each consultation category while the rehabilitation exercises are being performed. The proposed algorithm is also verified for its ability to adapt the content quality and effectively utilize the network under constrained conditions. A survey conducted on the video quality of the system under low-bandwidth conditions shows encouraging results for a large scale deployment of the application.
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