Efficacy of a telerehabilitation intervention programme using biofeedback among computer operators

Comparison of the Effects of Two Different Exercise Programs on Lower Limb Functions, Posture, and Physical Activity in Office Workers Working at Home and in Office Alternately: A Randomized Controlled Trial

OBJECTIVE

The aim of this study was to compare the effects of online functional exercises and posture exercises on lower limb functions, posture, and physical activity in office workers working at home and in office alternately during the COVID-19 pandemic.

DESIGN

Forty individuals were included in the study and were randomized into two groups: group I (functional exercise group, 20 participants) and group II (posture exercise group, 20 participants). The exercises programs were performed online for 2 days/in a week/8 wk. Lower limb functions, posture, and physical activity were evaluated before and after the exercise program.

RESULT

Significant improvement was obtained in lower limb functions (muscular endurance, balance, and functional capacity), posture, and physical activity in group I, while significant improvement was obtained in balance and functional capacity in group II after treatment. The change in scores of lower limb functions, posture, and physical activity after treatment was statistically superior in group I compared with group II ( P < 0.05).

CONCLUSIONS

It was found that both online exercise programs provided effective results in office workers working at home and in office alternately due to the COVID-19 pandemic, but the functional exercise program had superior effects on lower limb functions, posture, and physical activity compared with the posture exercise program.

The use and effects of telemedicine on complementary, alternative, and integrative medicine practices: a scoping review

BACKGROUND

Telemedicine includes the delivery of health-care services and sharing of health information across distances. Past research has found that telemedicine can play a role in enhancing complementary, alternative, and integrative medicine (CAIM) while allowing the maintenance of cultural values and ancestral knowledge. This scoping review synthesized evidence regarding the use of telemedicine in the context of CAIM.

METHODS

Following Arksey and O'Malley's scoping review framework, CINAHL, PsycINFO, MEDLINE, EMBASE and AMED databases were searched systematically. The CADTH website was also searched for grey literature. Eligible articles included a CAIM practice or therapy offered through telemedicine, with no restrictions placed on the type of telemedicine technology used. Inductive thematic analysis was conducted to synthesise common themes among the included studies.

RESULTS

Sixty-two articles were included in this synthesis. The following themes emerged: 1) the practitioner view of CAIM delivered through telemedicine, 2) the patient view of CAIM delivered through telemedicine, and 3) the technological impacts of telemedicine delivery of CAIM.

CONCLUSIONS

Studies have shown that telemedicine delivery of CAIM is feasible, acceptable, and results in positive health outcomes. Some barriers remain such as the presence of chronic illness and morbidity, inability to form strong patient-provider relationships relative to face-to-face approaches, and technological difficulties. Future intervention research should focus on reducing such barriers, as well as explore which patient population would realize the greatest benefit from CAIM delivered via telemedicine, and the impact of interventions on providers and caregivers.

Feedback for the prevention and rehabilitation of work-related musculoskeletal disorders: A systematic review

BACKGROUND

Work-related musculoskeletal disorders (WRMSDs) remain a challenge despite research aimed at improving their prevention and treatment. Extrinsic feedback has been suggested for the prevention and rehabilitation of WRMSDs to improve sensorimotor control, and ultimately to reduce pain and disability. However, there are few systematic reviews on the effectiveness of extrinsic feedback for WRMSDs.

OBJECTIVE

To perform a systematic review investigating the effect of extrinsic feedback for the prevention and rehabilitation of WRMSDs.

METHODS

Five databases (CINAHL, Embase, Ergonomics Abstract, PsycInfo, PubMed) were searched. Studies of various designs assessing the effects of extrinsic feedback during work tasks on three outcomes (function, symptoms, sensorimotor control) in the context of prevention and rehabilitation of WRMSDs were included.

RESULTS

Forty-nine studies were included, for a total sample of 3387 participants (including 925 injured) who performed work-related tasks in the workplace (27 studies) or in controlled environments (22 studies). The use of extrinsic feedback was shown to be effective in controlled environments for short-term prevention of functional limitations and sensorimotor alterations (very limited to moderate evidence) and for improving, in injured participants, function, symptoms and sensorimotor control (moderate evidence). In the workplace, it was shown to be effective for short-term prevention of functional limitations (limited evidence). There was conflicting evidence regarding its effect for WRMSD rehabilitation in the workplace.

CONCLUSION

Extrinsic feedback is an interesting complementary tool for the prevention and rehabilitation of WRMSDs in controlled environments. More evidence is needed regarding its effect for the prevention and rehabilitation of WRMSDs in the workplace.

Heart Rate Variability biofeedback therapy for children and adolescents with chronic pain: A pilot study

PURPOSE

As a brief, noninvasive, cost-effective, and technology-driven therapy, biofeedback is a promising and welcomed clinical intervention for children and adolescents with pediatric chronic pain conditions. The aim of this pilot study was to explore the application of a brief Heart Rate Variability (HRV) biofeedback intervention supplemented by at-home breathing practice as a tool for reducing symptomatology associated with chronic pain in a pediatric urban hospital setting.

DESIGN AND METHODS

Twenty-one participants aged 10-17 years (M = 14.05, SD = 1.91; 76% female) and their caregivers completed the study. Participants were randomized to either 1) receive immediate biofeedback treatment including at-home breathing practice or 2) to be placed on a 4-week waitlist and then enrolled in the biofeedback treatment. Study outcomes included self-reported pain intensity, health-related quality of life (HRQOL), and anxiety sensitivity. HRV data were obtained from biofeedback sessions.

RESULTS

Following biofeedback treatment, participants achieved significant reductions in self-reported pain intensity, higher levels of self-reported school functioning, and increased HRV, as measured by Blood Volume Pulse (BVP) amplitude. Participants in the waitlist group experienced an increase in pain intensity during the waitlist period.

CONCLUSION

Further research is needed to understand the mechanisms underlying HRV biofeedback and its treatment of pediatric chronic pain.

PRACTICE IMPLICATIONS

Nurses are ideal practitioners for biofeedback given their training in physiology and background in healthcare and should be encouraged to explore training in this area. Suggested biofeedback-related apps and mobile devices to share with patients at bedside are provided.

A case study detailing key considerations for implementing a telehealth approach to office ergonomics

Telehealth approaches to delivering ergonomics assessment hold great potential to improve service delivery in rural and remote settings. This case study describes a telehealth-based ergonomics service delivery process, and compares in-person and telehealth-based ergonomics approaches at an Alberta-based non-profit advocacy group. This project demonstrates that telehealth approaches to ergonomics do not lead to significantly different scoring outcomes for assessment of ergonomics issues, when compared to in-person assessments. This project also outlines the importance of live real-time video conferencing to improving communication, attaining key assessment information, and demonstrating ergonomic adjustments. However, some key considerations of bandwidth and hardware capabilities need to be taken into account. Key communication strategies are outlined to improve rapport, maintain employee confidentiality, and reduce client anxiety around telehealth ergonomics assessments. This project provides further support for telehealth approaches to office ergonomics, and outlines some key implementation strategies and barriers that should be considered.

Workplace interventions to improve sitting posture: A systematic review

PURPOSE

Evaluate the effectiveness of workplace interventions to improve sitting posture of workers that spend long periods of time seated at a visual display terminal.

METHODS

A systematic review of randomised controlled trials, non-randomised controlled trials and single-group intervention trials featuring workplace interventions with pre- and follow-up measurements of sitting posture was conducted (registered in PROSPERO, CRD#42015027648). Nine databases were searched for studies available between January 2005 and February 2016.

RESULTS

2519 articles were screened with 12 studies meeting the inclusion criteria. The included studies featured various ergonomic workplace interventions and comprised 4 randomised controlled trial (n=457), 2 non-randomised controlled trials (n=416) and 6 single-group intervention trials (n=328). Due to clinical and methodological heterogeneity, pooling of data was not completed and a narrative summary of findings was developed using the Grading of Recommendations Assessment Development and Evaluation (GRADE) framework. The evidence for four review outcomes was assessed with medium to large positive improvements obtained for the majority of studies investigating changes to gross sitting posture, whereas mixed findings were obtained for more specific local segment assessments of sitting posture. The overall evidence quality for all review outcomes were identified as either 'low' or 'very low'.

CONCLUSION

There is evidence which is limited in quality to indicate that ergonomic workplace interventions can improve gross sitting posture. More high quality research across a range of intervention types is required with longer follow-up durations and more advanced methods to assess sitting posture with greater frequency and less bias.