1
|
Paris Ferrer T, Masaracchio M, Kirker K, Madi Dewan B, Manthripragada M, Ojha H. Outcomes of direct access telehealth physical therapy for patients with musculoskeletal pain: a single cohort observational retrospective study. Physiother Theory Pract 2024; 40:2233-2240. [PMID: 37585711 DOI: 10.1080/09593985.2023.2245032] [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: 05/03/2023] [Revised: 08/02/2023] [Accepted: 08/02/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Telehealth direct access physical therapy is becoming more prevalent in the management of outpatient musculoskeletal pain. This innovative model affords more opportunity to reach potential patients who otherwise would not be able to access services due to geographical isolation, travel barriers, and timely access to quality care. OBJECTIVE The purpose of the study was to investigate if pain, function, and ability to perform jobs improved after direct access telehealth physical therapy in patients with musculoskeletal pain. METHODS A single cohort retrospective design was implemented to offer telehealth physical therapy to patients with musculoskeletal pain from March to November 2021. Eligible patients were at least 18 years old, located in California, and had a history of peripartum pelvic dysfunction, muscle pain, joint pain, or neural symptoms. Paired-samples t-tests and the Wilcoxon signed-rank test were used to analyze normally distributed and non-parametric data (α = 0.05), respectively, to compare pretest and post scores. RESULTS Based on 89 participants, paired-samples t-tests showed statistically significant differences in function [t(87) = 20.71, p < .0001] and pain [t(82) = -8.15, p < .0001]. Wilcoxon's signed-rank test showed statistically significant differences in ability to perform job (Z = -7.345, p < .0001). CONCLUSION This study demonstrated that in a cohort of individuals with multiregional musculoskeletal pain, there was a decrease in pain and improvements in function and ability to perform job after direct access telehealth physical therapy.
Collapse
Affiliation(s)
- Tiffany Paris Ferrer
- Department of Physical Therapy, Malcom Randall VA Medical Center, Gainesville, FL, USA
| | | | - Kaitlin Kirker
- Department of Physical Therapy, Long Island University, Brooklyn, NY, USA
| | | | | | - Heidi Ojha
- Department of Physical Therapy, Aware Health, Lafayette, CA, USA
| |
Collapse
|
2
|
Lawford BJ, Bennell KL, Kimp A, Campbell PK, Hinman RS. Understanding Negative and Positive Feelings About Telerehabilitation in People With Chronic Knee Pain: A Mixed-Methods Study. J Orthop Sports Phys Ther 2024; 54:594-607. [PMID: 39207737 DOI: 10.2519/jospt.2024.12383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
OBJECTIVES: To explore (1) initial feelings of people with knee osteoarthritis who are unexpectedly offered telerehabilitation, and (2) if their experiences met their expectations, and their willingness to use telerehabilitation in the future. DESIGN: Mixed-methods study of 122 people with knee osteoarthritis who were randomized to receive physiotherapist-delivered telerehabilitation in a clinical trial. METHODS: At enrollment in the trial, participants were unaware care would be delivered via telerehabilitation. At completion, quantitative (Likert scales, analyzed descriptively) and qualitative (open-text, underwent content/thematic analysis) questions asked participants about their initial feelings when randomized to telerehabilitation, if experiences met expectations, and willingness to use telerehabilitation in the future. RESULTS: Data were collected between October 2021 to March 2023. At enrollment, 44 (36% of 122) participants initially felt negative toward telerehabilitation (doubts about effectiveness, physiotherapist can't see/touch, believe in-person is better, can't communicate effectively, not good with technology), 18 (15%) were neutral, and 60 (49%) felt positive. After experiencing telerehabilitation, 43 (72%) people who were initially positive and 27 (61%) who were initially negative believed telerehabilitation exceeded their expectations (easier than expected, surprised by benefits/effectiveness, strong rapport with physiotherapist, convenience). Twenty-eight (23% of 122) people were not at all or slightly willing to use telerehabilitation in future (prefer hands-on, doesn't allow adequate assessment/observation, prefer in-person, don't like telerehabilitation). CONCLUSION: One in 2 people were positive about telerehabilitation from the outset, and 6 in 10 people who initially felt negative about telerehabilitation found that their experiences were better than expected. One in 4 people were unwilling to use telerehabilitation in the future, even after they had experienced it. J Orthop Sports Phys Ther 2024;54(9):1-14. Epub 11 June 2024. doi:10.2519/jospt.2024.12383.
Collapse
Affiliation(s)
- Belinda J Lawford
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Alexander Kimp
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Penny K Campbell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
3
|
Cook D, Pearson J. Musculoskeletal physiotherapists' experiences of using remote consultations during the COVID-19 pandemic: A qualitative study. Musculoskelet Sci Pract 2024; 72:102930. [PMID: 38552401 DOI: 10.1016/j.msksp.2024.102930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/22/2024] [Accepted: 03/07/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND The coronavirus (COVID-19) pandemic resulted in the rapid implementation of remote consultations to maintain musculoskeletal physiotherapy services. However, little is known about UK musculoskeletal physiotherapists' experiences of providing services during the COVID-19 pandemic. OBJECTIVES To explore musculoskeletal physiotherapists' experiences of using remote consultations in one area of England during the COVID-19 pandemic. DESIGN Qualitative study using hermeneutic phenomenology based on the approach of Gadamer. METHODS Semi-structured interviews with twelve musculoskeletal physiotherapists were conducted online using Microsoft Teams. Data were analysed using frameworks based on the philosophical concepts of Gadamer's hermeneutics. FINDINGS Musculoskeletal physiotherapists' experience of using remote consultations during the COVID-19 pandemic was framed by three concepts: therapeutic relationship, transformational change, and uncertainty. These concepts are underpinned by four main themes capturing their experiences: (1) Disconnection: Difficulties building a rapport and reduced non-verbal communication affected building an effective therapeutic relationship, (2) Necessity: Transformation of services to remote consultations was positive, although technology and connectivity issues had a negative impact, (3) Loss of control: Diagnostic uncertainty, being unprepared, and experience affected physiotherapists' clinical practice, (4) Protection: Peer support and the use of technology facilitated a feeling of protection for physiotherapists. CONCLUSION The findings of this study contribute to a better understanding of musculoskeletal physiotherapists' experience of using remote consultations during the COVID-19 pandemic. Implications for practice include the need to provide training for all musculoskeletal physiotherapists and undergraduates to enable the effective delivery of remote physiotherapy. Furthermore, digital infrastructure should be optimised to support future delivery of remote musculoskeletal physiotherapy services.
Collapse
Affiliation(s)
- Darren Cook
- School of Health and Social Wellbeing, University of the West of England, Glenside Campus, Blackberry Hill, Bristol, BS16 1DD, United Kingdom.
| | - Jennifer Pearson
- School of Health and Social Wellbeing, University of the West of England, Glenside Campus, Blackberry Hill, Bristol, BS16 1DD, United Kingdom.
| |
Collapse
|
4
|
Simmich J, Ross MH, Russell T. Real-time video telerehabilitation shows comparable satisfaction and similar or better attendance and adherence compared with in-person physiotherapy: a systematic review. J Physiother 2024; 70:181-192. [PMID: 38879432 DOI: 10.1016/j.jphys.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/13/2024] [Accepted: 06/03/2024] [Indexed: 07/06/2024] Open
Abstract
QUESTION How does physiotherapy delivered by real-time, video-based telerehabilitation compare with in-person delivery for the outcomes of attendance, adherence and satisfaction? DESIGN Systematic review of randomised control trials indexed in PubMed, CINAHL, Embase, Cochrane and PEDro on 12 March 2024. PARTICIPANTS Adults aged > 18 years. INTERVENTION Physiotherapy delivered via real-time video telerehabilitation. OUTCOME MEASURES Attendance, adherence and satisfaction. RESULTS Eight studies were included for attendance (n = 1,110), nine studies for adherence (n = 1,190) and 12 studies for satisfaction (n = 1,247). Telerehabilitation resulted in attendance at treatment sessions that was 8% higher (95% CI -1 to 18) and adherence to exercise programs that was 9% higher (95% CI 2 to 16) when compared with in-person physiotherapy. Satisfaction was similar with both modes of delivery (SMD 0.03 in favour of telerehabilitation, 95% CI -0.23 to 0.28). The level of certainty assessed by GRADE ranged from very low to low, primarily due to inconsistency and high risk of bias. DISCUSSION Attendance at appointments among participants assigned to telerehabilitation was somewhere between similar to and considerably higher than among control participants. Adherence to self-management with telerehabilitation was better than with in-person delivery, although with some uncertainty about the magnitude of the effect. Reported satisfaction levels were similar between the two modes of treatment delivery. Given the significance of attendance, adherence and satisfaction for successful outcomes, telerehabilitation offers a valuable alternative mode for physiotherapy delivery. CONCLUSION Real-time telerehabilitation has potentially favourable effects on attendance at treatment appointments and adherence to exercise programs, with similar satisfaction when compared with traditional in-person physiotherapy. REGISTRATION PROSPERO CRD42022329906.
Collapse
Affiliation(s)
- Joshua Simmich
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia.
| | - Megan H Ross
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
| | - Trevor Russell
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
| |
Collapse
|
5
|
Sia LL, Sharma S, Ing JBM, Kumar S, Singh DKA. Physiotherapists' perceptions, readiness, enablers, and barriers to use telerehabilitation: A scoping review. J Back Musculoskelet Rehabil 2024:BMR240009. [PMID: 38905032 DOI: 10.3233/bmr-240009] [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] [Indexed: 06/23/2024]
Abstract
BACKGROUND The growing use of telerehabilitation within the healthcare community has garnered substantial attention. In congruence with other healthcare fields, examining perceptions, barriers, and facilitators assumed paramount significance in the continuation and fortification of telerehabilitation practices among physiotherapists. OBJECTIVE In this scoping review, we aimed to systematically map the literature on the perceptions of physiotherapists as well as the barriers and enablers of telerehabilitation in their daily practice. METHODS The five-stage methodological framework recommended by Arksey and O'Malley (2005) was used for this scoping review. In the framework, eight databases were searched using key search terms such as "telerehabilitation", "physiotherapists", "readiness", "enablers" and "barriers" All findings were organised into perceptions and readiness, enablers, and barriers. RESULTS Fourteen articles met the inclusion criteria and were categorized as: (1) perception and readiness, (2) enablers, and (3) barriers. In the perception and readiness category, new trends in healthcare, advancement in physiotherapy practices and the benefits to clients were identified. The enablers identified included prior training, personal experience, familiarity with technology, functional equipment and space, and client selection. The barriers to the adoption of telerehabilitation in physiotherapy practice are pinpointed to poor technology, communication hurdles, limited availability, lack of familiarity, and client-related concerns. CONCLUSION While initial evidence suggests a generally positive perceptions it is important to consider both facilitators and barriers when understanding adoption. This review's findings revealed a wide research gap, with unequal weightage towards barriers compared to enablers, and highlights the need for further research. Developing telerehabilitation guidelines that cater to both physiotherapists and clients is necessary.
Collapse
Affiliation(s)
- Lee Lee Sia
- Physiotherapy Program and Centre of Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Miri Hospital, Ministry of Health Malaysia, Miri Sarawak, Malaysia
| | - Shobha Sharma
- Speech Sciences Program and Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Janet Bong May Ing
- Physiotherapy Program and Centre of Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Sarawak General Hospital, Ministry of Health Malaysia, Jalan Hospital, Kuching Sarawak, Malaysia
| | - Saravana Kumar
- Allied Health and Human Performance, Level 8, Centenary Building, City East Campus, University of South Australia, Adelaide, SA, Australia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Program and Centre of Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
6
|
Erturan S, Burak M, Elbasan B. Breaking barriers: exploring physiotherapists' willingness and challenges in embracing telerehabilitation in a developing country. Ir J Med Sci 2024; 193:1359-1367. [PMID: 38148393 DOI: 10.1007/s11845-023-03589-y] [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: 10/25/2023] [Accepted: 12/05/2023] [Indexed: 12/28/2023]
Abstract
INTRODUCTION Telerehabilitation (TR) is an innovative approach that can address the limited availability and restricted access to rehabilitation services, particularly during challenging times such as pandemics and natural disasters. This study focuses on understanding the desires, perceptions, and barriers that physiotherapists face when implementing TR in a developing country. METHOD The study was conducted with 219 physiotherapists residing in a developing country using a web-based survey on Google Docs. RESULT The findings revealed that a significant majority of physiotherapists (88.1%) recognized TR as a potential solution for individuals with physical problems during the pandemic. Additionally, 89.5% expressed satisfaction with the opportunity to receive consultations from different hospitals, indicating a positive perception of TR. However, the study also highlighted certain barriers that hindered the implementation of TR. Around 40.2% of physiotherapists reported having training deficiencies, suggesting a need for educational support in utilizing TR effectively. Furthermore, the analysis of demographic factors revealed interesting insights. It was noteworthy that the age and years of experience of physiotherapists had an impact on their willingness and adoption of TR. CONCLUSION The study reveals that physiotherapists in the developing country exhibit a positive attitude towards TR and recognize its potential benefits. However, various barriers, such as training deficiencies, need to be addressed to facilitate a broader adoption of TR in their practices. Overcoming these barriers is anticipated to heighten physiotherapists' readiness to embrace TR, ultimately enhancing the accessibility and delivery of rehabilitation services.
Collapse
Affiliation(s)
- Sinem Erturan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ataturk University, Erzurum, Turkey.
| | - Mustafa Burak
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Firat University, Elazığ, Turkey
| | - Bülent Elbasan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| |
Collapse
|
7
|
Lee AC, Deutsch JE, Holdsworth L, Kaplan SL, Kosakowski H, Latz R, McNeary LL, O’Neil J, Ronzio O, Sanders K, Sigmund-Gaines M, Wiley M, Russell T. Telerehabilitation in Physical Therapist Practice: A Clinical Practice Guideline From the American Physical Therapy Association. Phys Ther 2024; 104:pzae045. [PMID: 38513257 PMCID: PMC11140266 DOI: 10.1093/ptj/pzae045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/01/2024] [Indexed: 03/23/2024]
Abstract
A clinical practice guideline on telerehabilitation was developed by an American Physical Therapy Association volunteer guideline development group consisting of international physical therapists and physiotherapists, a physician, and a consumer. The guideline was based on systematic reviews of current scientific literature, clinical information, and accepted approaches to telerehabilitation in physical therapist practice. Seven recommendations address the impact of, preparation for, and implementation of telerehabilitation in physical therapist practice. Research recommendations identify current gaps in knowledge. Overall, with shared decision-making between clinicians and patients to inform patients of service delivery options, direct and indirect costs, barriers, and facilitators of telerehabilitation, the evidence supports the use of telerehabilitation by physical therapists for both examination and intervention. The Spanish and Chinese versions of this clinical practice guideline, as well as the French version of the recommendations, are available as supplementary material (Suppl. Materials).
Collapse
Affiliation(s)
- Alan C Lee
- Physical Therapy Department, Mount Saint Mary’s University, Los Angeles, California, USA
| | - Judith E Deutsch
- Rivers Lab, Department of Rehabilitation and Movement Sciences, Program Physical Therapy, Rutgers University, New Brunswick, New Jersey, USA
- Department of Rehabilitation and Movement Sciences, Program Physical Therapy, Graduate School, Rutgers University, New Brunswick, New Jersey, USA
| | - Lesley Holdsworth
- NHS 24, Caledonia House, 140 Fifty Pitches Rd, Cardinals, Glasgow, Scotland, United Kingdom
| | - Sandra L Kaplan
- Department of Rehabilitation and Movement Sciences, Program Physical Therapy, Rutgers University, New Brunswick, New Jersey, USA
| | - Heidi Kosakowski
- World Physiotherapy, Head of Membership and Policy, Unit 17, Empire Square, London, United Kingdom
| | - Robert Latz
- Chief Information Office (CIO), Trinity Rehabilitation Services, Florence, Kentucky, USA
| | - Lydia Lennox McNeary
- School of Medicine, Virginia Tech Carilion Research Institute, Roanoke, Virginia, USA
| | - Jennifer O’Neil
- Physiotherapy Program, School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Oscar Ronzio
- Member of World Physiotherapy, Argentine Association of Kinesiology, Buenos Aires, Argentina
| | - Kelly Sanders
- Movement for Life Physical Therapy, Atascadero, California, USA
| | | | - Michele Wiley
- Department of Physical Therapy, Shenandoah University, Winchester, Virginia, USA
| | - Trevor Russell
- RECOVER Injury Research Centre, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
8
|
e Siqueira TB, Parraça J, Sousa JP. Available rehabilitation technology with the potential to be incorporated into the clinical practice of physiotherapists: A systematic review. Health Sci Rep 2024; 7:e1920. [PMID: 38605728 PMCID: PMC11007654 DOI: 10.1002/hsr2.1920] [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: 09/21/2023] [Revised: 11/29/2023] [Accepted: 02/02/2024] [Indexed: 04/13/2024] Open
Abstract
Background The development of prototypes capable of intervening in the area of rehabilitation in physical therapy clinical practice activities that were previously carried out in a traditional way, that is, manually, demonstrates how technology is having an impact on professional careers such as physiotherapy. Objective The purpose of this study is to present a comprehensive examination of various technologies employed in the facilitation of patient rehabilitation, with a focus on their potential integration within the clinical practice of physical therapists. Methods We conducted a systematic search in four electronic databases (CINAHL, Embase, PEDro, and PubMed) for research on rehabilitation technologies. The eligible studies should demonstrate a clear utilization of technology in various aspects of the clinical approach to the rehabilitation process and have been published between 2000 and 2021 in either Portuguese or English. Results A total of 18 articles that satisfied the selection criteria were included in the study. The studies were classified into four distinct categories of rehabilitation technologies, which were determined by the specific characteristics of the technology employed and its integration with the therapeutic approach to rehabilitation. These categories include digital technologies, artificial intelligence and/or robotics, virtual technologies, and hybrid technologies. Implications on Physiotherapy Practice Rehabilitation technologies possess the capacity to effectively facilitate clinical activities performed by physical therapy professionals, including injury prevention, movement monitoring, and coordination of rehabilitation programs, with minimal or negligible intervention from the physical therapist. Further research is required to ascertain the precise capabilities of various technologies in collaborating with physiotherapists to deliver comprehensive care for patients' physical well-being, encompassing both therapeutic and preventive approaches. Trial Registration PROSPERO registration number CRD42020222288.
Collapse
Affiliation(s)
- Tarciano Batista e Siqueira
- School of Health and Human DevelopmentUniversity of ÉvoraÉvoraPortugal
- Comprehensive Health Research Centre (CHRC)EvoraPortugal
| | - José Parraça
- School of Health and Human DevelopmentUniversity of ÉvoraÉvoraPortugal
- Comprehensive Health Research Centre (CHRC)EvoraPortugal
| | - João Paulo Sousa
- School of Health and Human DevelopmentUniversity of ÉvoraÉvoraPortugal
- Comprehensive Health Research Centre (CHRC)EvoraPortugal
| |
Collapse
|
9
|
Dissanayaka T, Nakandala P, Sanjeewa C. Physiotherapists' perceptions and barriers to use of telerehabilitation for exercise management of people with knee osteoarthritis in Sri Lanka. Disabil Rehabil Assist Technol 2024; 19:769-778. [PMID: 36098949 DOI: 10.1080/17483107.2022.2122606] [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: 02/24/2022] [Accepted: 09/02/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE To assess physiotherapists' perceptions and barriers to using telerehabilitation via video and telephone for exercise management for people with knee osteoarthritis (OA) in Sri Lanka. MATERIALS AND METHODS Currently registered and practising Sri Lankan physiotherapists who care for knee OA patients were invited to participate in a cross-sectional online survey framed according to a previous study. A logistic regression analysis was used to assess the effect of physiotherapists' characteristics on their interest in telerehabilitation. RESULTS A total of 268 physiotherapists completed the survey, which was broadly representative of locations and work settings across Sri Lanka. Only three out of 16 statements received majority agreement; these were that telephone-delivered care would save patients' time (72%), save money (68%) and improve patients' privacy (67%). There was a consensus that video-based care would save money (79%), and many favoured this medium over telephone-delivered care. Lack of experience with telerehabilitation was associated with reduced interest in telephone-delivered care. Increased interest in video-based care was associated with frequent care of knee OA patients. Most physiotherapists perceived technical issues with telerehabilitation as a significant barrier to implementing it. CONCLUSIONS Physiotherapists perceived video-based telerehabilitation more positively than care over the telephone. Reduced interest in telerehabilitation was associated with having no prior experience with it. Moreover, technical issues with telerehabilitation were perceived as the main barrier to its use. A training programme for physiotherapists, appropriate guidelines and a framework for better implementing telereahabilitation may yield substantial benefits for knee OA patients.IMPLICATIONS FOR REHABILITATIONPhysiotherapists in Sri Lanka perceive telerehabilitation for exercise management for knee OA patients positively.Telerehabilitation via video or telephone is a viable option for delivering exercise management for knee OA patients in Sri Lanka.The widespread practice of telerehabilitation by physiotherapists in Sri Lanka requires appropriate strategies to mitigate barriers to its implementation.
Collapse
Affiliation(s)
- Thusharika Dissanayaka
- Department of Physiotherapy, Faculty of Medicine, School of Primary and Allied Health Care, Nursing and Health Sciences, Monash University, Melbourne, Australia
- Food and Mood Centre, Deakin University, Melbourne, Australia
| | | | | |
Collapse
|
10
|
Naqvi WM, Naqvi I, Mishra GV, Vardhan V. The Dual Importance of Virtual Reality Usability in Rehabilitation: A Focus on Therapists and Patients. Cureus 2024; 16:e56724. [PMID: 38646260 PMCID: PMC11032731 DOI: 10.7759/cureus.56724] [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: 03/10/2024] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Virtual reality (VR) has advanced in medical education and rehabilitation from basic graphical applications due to its ability to generate a virtual three-dimensional (3D) environment. This environment is mostly used to practice professional skills, plan surgery procedures, simulate surgeries, display 3D anatomy, and rehabilitate various disorders. VR has transformed the field of rehabilitation therapy by providing immersive and engaging experiences that go beyond traditional bounds, significantly improving patient care and therapeutic results. Considering the direct impact of VR on the efficacy of the treatment for both therapists and patients, its dual significance for usability and user experience cannot be overstated. The purpose of this article is to determine the synergistic association between VR accessibility and the rehabilitation process, highlighting the significance of VR technology in designing the future of rehabilitation therapy and demonstrating how advancing VR technology can improve therapeutic outcomes despite overcoming obstacles encountered during VR usage. In conclusion, VR offers a personalized, efficient, interesting, and engaging rehabilitative environment for patients, while also assisting therapists in cultivating empathy and efficiency and encouraging innovative approaches in treatment procedures.
Collapse
Affiliation(s)
- Waqar M Naqvi
- Interdisciplinary Sciences, Datta Meghe Institute of Higher Education and Research, Wardha, IND
- Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, ARE
| | - Ifat Naqvi
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Gaurav V Mishra
- Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vishnu Vardhan
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
11
|
Pritwani S, Shrivastava P, Pandey S, Kumar A, Malhotra R, Maddison R, Devasenapathy N. Mobile and Computer-Based Applications for Rehabilitation Monitoring and Self-Management After Knee Arthroplasty: Scoping Review. JMIR Mhealth Uhealth 2024; 12:e47843. [PMID: 38277195 PMCID: PMC10858429 DOI: 10.2196/47843] [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: 04/04/2023] [Revised: 10/10/2023] [Accepted: 12/01/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Successful post-knee replacement rehabilitation requires adequate access to health information, social support, and periodic monitoring by a health professional. Mobile health (mHealth) and computer-based technologies are used for rehabilitation and remote monitoring. The extent of technology use and its function in post-knee replacement rehabilitation care in low and middle-income settings are unknown. OBJECTIVE To inform future mHealth intervention development, we conducted a scoping review to map the features and functionality of existing technologies and determine users' perspectives on telerehabilitation and technology for self-management. METHODS We followed the Joanna Briggs Institute methodology for scoping reviews. We searched the Embase, Medline, PsycINFO via OVID, and Cochrane Central Register of Controlled Trials databases for manuscripts published from 2001 onward. We included original research articles reporting the use of mobile or computer-based technologies by patients, health care providers, researchers, or family members. Studies were divided into the following 3 categories based on the purpose: validation studies, clinical evaluation, and end user feedback. We extracted general information on study design, technology features, proposed function, and perspectives of health care providers and patients. The protocol for this review is accessible in the Open Science Framework. RESULTS Of the 5960 articles, 158 that reported from high-income settings contributed to the qualitative summary (64 studies on mHealth or telerehabilitation programs, 28 validation studies, 38 studies describing users' perceptions). The highest numbers of studies were from Europe or the United Kingdom and North America regarding the use of a mobile app with or without wearables and reported mainly in the last decade. No studies were from low and middle-income settings. The primary functions of technology for remote rehabilitation were education to aid recovery and enable regular, appropriate exercises; monitoring progress of pain (n=19), activity (n=20), and exercise adherence (n=30); 1 or 2-way communication with health care professionals to facilitate the continuum of care (n=51); and goal setting (n=23). Assessment of range of motion (n=16) and gait analysis (n=10) were the commonly validated technologies developed to incorporate into a future rehabilitation program. Few studies (n=14) reported end user involvement during the development stage. We summarized the reasons for satisfaction and dissatisfaction among users across various technologies. CONCLUSIONS Several existing mobile and computer-based technologies facilitate post-knee replacement rehabilitation care for patients and health care providers. However, they are limited to high-income settings and may not be extrapolated to low-income settings. A systematic needs assessment of patients undergoing knee replacement and health care providers involved in rehabilitation, involving end users at all stages of development and evaluation, with clear reporting of the development and clinical evaluation can make post-knee replacement rehabilitation care in resource-poor settings accessible and cost-effective.
Collapse
Affiliation(s)
- Sabhya Pritwani
- Department of Research & Development, The George Institute for Global Health India, Delhi, India
| | - Purnima Shrivastava
- Department of Research & Development, The George Institute for Global Health India, Delhi, India
| | - Shruti Pandey
- Department of Research & Development, The George Institute for Global Health India, Delhi, India
| | - Ajit Kumar
- Department of Orthopaedics, All India Institute of Medical Sciences, Delhi, India
| | - Rajesh Malhotra
- Department of Orthopaedics, All India Institute of Medical Sciences, Delhi, India
| | - Ralph Maddison
- Department of School of Exercise & Nutrition, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Niveditha Devasenapathy
- Department of Research & Development, The George Institute for Global Health India, Delhi, India
| |
Collapse
|
12
|
Das L, Sharma PK, Singh G, Goyal T. Telerehabilitation is as effective as outpatient visits in the management of early osteoarthritis knee and mechanical low backache. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2024; 34:405-413. [PMID: 37566137 DOI: 10.1007/s00590-023-03673-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 08/02/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE Teleconsultation services can be used to overcome the barriers imposed by the Covid-19 pandemic in providing basic orthopaedic rehabilitation services. Aim of the study is to compare the effectiveness of rehabilitation provided via outpatient and teleconsultation in patients with mechanical low backache (LBA) and early osteoarthritis (OA) of the knee joint utilizing Patient-Reported Outcome Measures. The satisfaction level of patients receiving teleconsultation will also be assessed. METHODOLOGY This study was a hospital-based prospective observational study. The study's participants were divided into two groups (Outpatient and Teleconsultation, respectively), and each group was further divided into two subgroups of 100 participants each (Knee-pain subgroup 1; LBA subgroup 2). SF-12 questionnaire, visual analogue scale (VAS) score for pain, and functional outcome scores (KOOS score for knee pain and the modified Oswestry Disability Index-MODI for LBA) were assessed at initial presentation and 6 months follow-up. Participants' satisfaction for teleconsultation service was assessed at final follow-up by 5 points Likert scale (5, very satisfied; 1, very dissatisfied). RESULTS Mean consultation time was significantly longer in the outpatient group (p < 0.001). No statistically significant difference in the VAS score, KOOS score (58.0 ± 7.6 vs. 57.8 ± 9.2; p = 0.893), and MODI Score (24.7 ± 13.3 vs. 27.4 ± 12.4; p = 0.128) between the corresponding subgroups of the two groups at final follow-up. Eighty-seven percentage of the participants were satisfied (Likert score ≥ 4) with the teleconsultation services. CONCLUSION Teleconsultation is equally effective to that as face-to-face outpatient consultation in the rehabilitation of patients with early OA knee and mechanical LBA. LEVEL OF STUDY Level 2, Prospective comparative study.
Collapse
Affiliation(s)
- Lakshmana Das
- Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda , Punjab, 151001, India
| | - Pankaj Kumar Sharma
- Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda , Punjab, 151001, India
| | - Gaganpreet Singh
- Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda , Punjab, 151001, India
| | - Tarun Goyal
- Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda , Punjab, 151001, India.
| |
Collapse
|
13
|
Gerassi RC, de Andrade LP, Tsen C, Pereira ABS, Pereira GN, Aily JB, Gomes GADO, Ansai JH. Family caregivers' satisfaction with telerehabilitation and follow-up intervention for older people with dementia: Randomized clinical trial. Geriatr Nurs 2023; 54:66-75. [PMID: 37703692 DOI: 10.1016/j.gerinurse.2023.08.011] [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: 05/10/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 09/15/2023]
Abstract
The present study aimed to assess caregiver satisfaction with a telerehabilitation program and remote monitoring for older adults with dementia and their caregivers during the COVID-19 pandemic, as well as to identify the factors influencing caregiver satisfaction. This study adopted a mixed-methods approach and was part of a randomized clinical trial, with blinded assessors, comprising two groups: the Intervention Group (IG) receiving a telerehabilitation program involving standardized physical exercises for older adults with dementia, along with caregiver guidelines for the caregiver; and the Control Group (CG) receiving remote monitoring. At baseline, factors related to older adults with dementia and their caregivers were measured. After 12 weeks, caregiver satisfaction with the interventions was assessed. The final sample consisted of 64 pairs of family caregivers and older people with dementia. Caregivers in the IG showed higher satisfaction levels with the intervention, Internet-based treatment, and healthcare received compared to caregivers in the CG. Both groups expressed positive views towards the treatment, with excellent ratings for audio and video quality, and a preference for Internet-based treatment over face-to-face. In the IG, only the amount of time dedicated to caregiving influenced satisfaction with the intervention, whereas in the CG, cognitive and functional performance of the older people influenced satisfaction with remote monitoring. Our findings suggest the potential of the program in providing effective care for older people with dementia and their caregivers.
Collapse
Affiliation(s)
- Renata Carolina Gerassi
- Gerontology Graduate Program, Department of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, km 235, São Carlos, SP 13565-905, Brazil
| | | | - Carolina Tsen
- Department of Physical Therapy, Federal University of São Carlos São Carlos, SP, Brazil
| | | | | | - Jéssica Bianca Aily
- Department of Physical Therapy, Federal University of São Carlos São Carlos, SP, Brazil
| | - Grace Angélica de Oliveira Gomes
- Gerontology Graduate Program, Department of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, km 235, São Carlos, SP 13565-905, Brazil
| | - Juliana Hotta Ansai
- Gerontology Graduate Program, Department of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, km 235, São Carlos, SP 13565-905, Brazil.
| |
Collapse
|
14
|
Pereira TAB, Santos IB, Mota RF, Fukusawa L, Azevedo-Santos IF, DeSantana JM. Beliefs and expectations of patients with fibromyalgia about telerehabilitation during Covid-19 pandemic: A qualitative study. Musculoskelet Sci Pract 2023; 67:102852. [PMID: 37639980 DOI: 10.1016/j.msksp.2023.102852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Telerehabilitation as an alternative to physiotherapeutic care has been increasingly implemented in diverse populations. However, this mode of service can evoke beliefs and expectations in patients with fibromyalgia, depending on sociocultural and clinical context, that can cause poor adaptation and dropout from treatment. OBJECTIVE To explore beliefs and expectations of individuals with fibromyalgia about physical exercises delivered through telerehabilitation. METHODS Thirty individual semi-structured interviews were conducted via videoconference with women with fibromyalgia recruited during COVID-19 pandemic through intentional sampling. These interviews were guided by four questions addressing the beliefs and expectations about telerehabilitation. The interviews were recorded after consent and transcribed using the MAXQDA® software. The inductive approach was performed in which raw data were coded into categories and subcategories. RESULTS Participants expect to benefit from telerehabilitation due to flexible hours, no need of travel, socialization, and lower risk of contamination. However, they believe they have difficulties related to the physical absence of the therapist, complexity of the exercises, internet connection problems, adaptation to the domestic routine and availability of schedules. CONCLUSION Women with fibromyalgia showed positive expectations about telerehabilitation, relating better socialization with other individuals diagnosed with fibromyalgia, home care with flexible schedule and, to provide needed service to underserved. However, they listed barriers such as the physical absence of the therapist and instability of the internet connection and, the FM symptoms themselves.
Collapse
Affiliation(s)
- Thaís Alves Barreto Pereira
- Graduate Program in Health Sciences, Federal University of Sergipe, Av. Marechal Rondon, s/n, São Cristovão, Sergipe, 49100-000, Brazil.
| | - Itanara Barboza Santos
- Department of Physical Therapy, Federal University of Sergipe, São Cristovão, Sergipe, Brazil.
| | - Riziane Ferreira Mota
- Graduate Program in Health Sciences, Federal University of Sergipe, Av. Marechal Rondon, s/n, São Cristovão, Sergipe, 49100-000, Brazil.
| | - Leandro Fukusawa
- Health Sciences Graduate Program, Medical Sciences Faculty of Santa Casa of São Paulo, Brazil.
| | | | - Josimari Melo DeSantana
- Department of Physical Therapy, Graduate Program in Health Sciences, Graduate Program in Physiological Sciences, Federal University of Sergipe, São Cristovão, Sergipe, Brazil.
| |
Collapse
|
15
|
Brehon K, Carriere J, Churchill K, Loyola-Sanchez A, Papathanassoglou E, MacIsaac R, Tavakoli M, Ho C, Manhas KP. Evaluating Efficiency of a Provincial Telerehabilitation Service in Improving Access to Care During the COVID-19 Pandemic. Int J Telerehabil 2023; 15:e6523. [PMID: 38046552 PMCID: PMC10687995 DOI: 10.5195/ijt.2023.6523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
Scope Early in the COVID-19 pandemic, community rehabilitation stakeholders from a provincial health system designed a novel telerehabilitation service. The service provided wayfinding and self-management advice to individuals with musculoskeletal concerns, neurological conditions, or post-COVID-19 recovery needs. This study evaluated the efficiency of the service in improving access to care. Methodology We used multiple methods including secondary data analyses of call metrics, narrative analyses of clinical notes using artificial intelligence (AI) and machine learning (ML), and qualitative interviews. Conclusions Interviews revealed that the telerehabilitation service had the potential to positively impact access to rehabilitation during the COVID-19 pandemic, for individuals living rurally, and for individuals on wait lists. Call metric analyses revealed that efficiency may be enhanced if call handling time was reduced. AI/ML analyses found that pain was the most frequently-mentioned keyword in clinical notes, suggesting an area for additional telerehabilitation resources to ensure efficiency.
Collapse
Affiliation(s)
- Katelyn Brehon
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Jay Carriere
- Department of Electrical and Software Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Katie Churchill
- Allied Health Professional Practice and Education, Alberta Health Services, Alberta, Canada
- Department of Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada
| | | | - Elizabeth Papathanassoglou
- Neurosciences, Rehabilitation, and Vision Strategic Clinical Network, Alberta Health Services, Alberta, Canada
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Rob MacIsaac
- Spinal Cord Injury Alberta, Edmonton, Alberta, Canada
| | - Mahdi Tavakoli
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Chester Ho
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Neurosciences, Rehabilitation, and Vision Strategic Clinical Network, Alberta Health Services, Alberta, Canada
| | - Kiran Pohar Manhas
- Neurosciences, Rehabilitation, and Vision Strategic Clinical Network, Alberta Health Services, Alberta, Canada
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
16
|
Moulaei K, Bahaadinbeigy K, Haghdoostd AA, Nezhad MS, Sheikhtaheri A. Overview of the role of robots in upper limb disabilities rehabilitation: a scoping review. Arch Public Health 2023; 81:84. [PMID: 37158979 PMCID: PMC10169358 DOI: 10.1186/s13690-023-01100-8] [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: 11/25/2022] [Accepted: 04/29/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Neuromotor rehabilitation and improvement of upper limb functions are necessary to improve the life quality of patients who have experienced injuries or have pathological outcomes. Modern approaches, such as robotic-assisted rehabilitation can help to improve rehabilitation processes and thus improve upper limb functions. Therefore, the aim of this study was to investigate the role of robots in upper limb disability improvement and rehabilitation. METHODS This scoping review was conducted by search in PubMed, Web of Science, Scopus, and IEEE (January 2012- February 2022). Articles related to upper limb rehabilitation robots were selected. The methodological quality of all the included studies will be appraised using the Mixed Methods Appraisal Tool (MMAT). We used an 18-field data extraction form to extract data from articles and extracted the information such as study year, country, type of study, purpose, illness or accident leading to disability, level of disability, assistive technologies, number of participants in the study, sex, age, rehabilitated part of the upper limb using a robot, duration and frequency of treatment, methods of performing rehabilitation exercises, type of evaluation, number of participants in the evaluation process, duration of intervention, study outcomes, and study conclusions. The selection of articles and data extraction was made by three authors based on inclusion and exclusion criteria. Disagreements were resolved through consultation with the fifth author. Inclusion criteria were articles involving upper limb rehabilitation robots, articles about upper limb disability caused by any illness or injury, and articles published in English. Also, articles involving other than upper limb rehabilitation robots, robots related to rehabilitation of diseases other than upper limb, systematic reviews, reviews, and meta-analyses, books, book chapters, letters to the editor, and conference papers were also excluded. Descriptive statistics methods (frequency and percentage) were used to analyses the data. RESULTS We finally included 55 relevant articles. Most of the studies were done in Italy (33.82%). Most robots were used to rehabilitate stroke patients (80%). About 60.52% of the studies used games and virtual reality rehabilitate the upper limb disabilities using robots. Among the 14 types of applied evaluation methods, "evaluation and measurement of upper limb function and dexterity" was the most applied evaluation method. "Improvement in musculoskeletal functions", "no adverse effect on patients", and "Safe and reliable treatment" were the most cited outcomes, respectively. CONCLUSIONS Our findings show that robots can improve musculoskeletal functions (musculoskeletal strength, sensation, perception, vibration, muscle coordination, less spasticity, flexibility, and range of motion) and empower people by providing a variety of rehabilitation capabilities.
Collapse
Affiliation(s)
- Khadijeh Moulaei
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Kambiz Bahaadinbeigy
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Akbar Haghdoostd
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mansour Shahabi Nezhad
- Department of Physical Therapy, Faculty of Allied Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Sheikhtaheri
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
17
|
Moulaei K, Bahaadinbeigy K, Haghdoostd A, Nezhad MS, Gheysari M, Sheikhtaheri A. An analysis of clinical outcomes and essential parameters for designing effective games for upper limb rehabilitation: A scoping review. Health Sci Rep 2023; 6:e1255. [PMID: 37187505 PMCID: PMC10175549 DOI: 10.1002/hsr2.1255] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/18/2023] [Accepted: 04/22/2023] [Indexed: 05/17/2023] Open
Abstract
Background and Aims Upper limb disabilities are one of the most common disabilities among different groups of people who always need rehabilitation. One of the important methods in helping to carry out efficient rehabilitation processes and exercises is the use of games. The aim of this study is to identify the parameters necessary to design a successful rehabilitation game and the outcomes of using these games in upper limb disabilities rehabilitation. Methods This scoping review was conducted by searching the Web of Science, PubMed, and Scopus. The eligibility criteria were: any form of game-based upper limb rehabilitation, published in a peer-reviewed journal, published in English, and not include articles that did not focus upper limb disabilities rehabilitation games, review, meta-analysis, or conference papers. Analysis of collected data was done using descriptive statistics (frequency and percentage). Results The search strategy retrieved 537 relevant articles. Finally, after removing irrelevant and repetitive articles, 21 articles were included in this study. Among the six categories of diseases or complications of upper limb disabilities, games were mostly designed for stroke patients. Smart wearables, robots and telerehabilitation were three technologies that were used for rehabilitation along with games. Sports and shooters were the most used games for upper limb disability rehabilitation. Among 99 necessary parameters for designing and implementing a successful rehabilitation game in ten categories. "Increasing the patient's motivation to perform rehabilitation exercises", "Game difficulty levels", "Enjoying and the attractiveness of the game for patients", and "Providing positive or negative audiovisual feedback" were the most important parameters. "Improvement in musculoskeletal performance" and "Increasing users' enjoyment/joy of therapeutic exercises and their motivation to perform these exercises" were the most important positive outcomes, and "Mild discomfort such as nausea and dizziness when using games" was the only negative outcome. Conclusions The successful design of a game according to the parameters identified in the present study can lead to an increase in the positive outcomes of using games in the rehabilitation of disabilities. The study results indicate that upper limb therapeutic exercise augmented with virtual reality games may be highly effective in enhancing motor rehabilitation outcomes.
Collapse
Affiliation(s)
- Khadijeh Moulaei
- Medical Informatics Research Center, Institute for Futures Studies in HealthKerman University of Medical SciencesKermanIran
| | - Kambiz Bahaadinbeigy
- Medical Informatics Research Center, Institute for Futures Studies in HealthKerman University of Medical SciencesKermanIran
| | - AliAkbar Haghdoostd
- HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in HealthKerman University of Medical SciencesKermanIran
| | - Mansour S. Nezhad
- Department of Physical Therapy, Faculty of Allied MedicineKerman University of Medical SciencesKermanIran
| | - Mohammad Gheysari
- Business Administration Management (Digital Transformation), Faculty of ManagementTehran UniversityTehranIran
| | - Abbas Sheikhtaheri
- Department of Health Information Management, School of Health Management and Information SciencesIran University of Medical SciencesTehranIran
| |
Collapse
|
18
|
Duruflé A, Le Meur C, Piette P, Fraudet B, Leblong E, Gallien P. Cost effectiveness of a telerehabilitation intervention vs home based care for adults with severe neurologic disability: A randomized clinical trial. Digit Health 2023; 9:20552076231191001. [PMID: 37545632 PMCID: PMC10403989 DOI: 10.1177/20552076231191001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/13/2023] [Indexed: 08/08/2023] Open
Abstract
Context Several options are available for the care of neurological conditions including care delivered in rehabilitation centres, at home or remotely. While economic studies are available comparing centres and homes, very little economic data relates to mobile teams comparing face-to-face and remote care. Objective To conduct an economic study comparing face-to-face care at home and care delivered remotely (tele-rehabilitation). Method A randomised clinical study with two groups; a control group receiving home care and an experimental group receiving tele-rehabilitation. The primary outcome measure was the ICER (Incremental Cost Effectiveness Ratio). Participants Patients with severe neurological disabilities. Results 80 patients were enrolled in the study; 77 were analysed to calculate the ICER, which was positive and located in the SW quadrant. A bootstrap with 1000 replications was positioned at 72.8% in the SW quadrant. Conclusion Tele-rehabilitation is an acceptable alternative to the management of neurological patients at home. In the mildest cases, remote-rehabilitation may even be dominant. More extensive studies are needed to specify the indications.
Collapse
Affiliation(s)
| | - Claire Le Meur
- Rehabilitation Center, Pôle Saint Helier, Rennes, France
| | - Patrice Piette
- Rehabilitation Center, Pôle Saint Helier, Rennes, France
| | | | - Emilie Leblong
- Rehabilitation Center, Pôle Saint Helier, Rennes, France
| | | |
Collapse
|
19
|
de Rezende DRB, Neto IA, Iunes DH, Carvalho LC. Analysis of the effectiveness of remote intervention of patients affected by chronic diseases: A systematic review and meta-analysis. THE JOURNAL OF MEDICINE ACCESS 2023; 7:27550834231197316. [PMID: 37781504 PMCID: PMC10540568 DOI: 10.1177/27550834231197316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/04/2023] [Indexed: 10/03/2023]
Abstract
Objectives The aim of the study was to verify the effectiveness of telemedicine in randomized controlled trials (RCTs) in terms of its influence on physical conditioning, quality of life, and health conditions in adults/elderly people affected by chronic diseases. Design This was a systematic review and meta-analysis. Methods The search covered RCTs published from 2011 to 2021 and was conducted using the PubMed, Embase, PEDro, Lilacs, and Cochrane Library databases, on volunteers of both sexes, that were rehabilitated, and/or monitored, and/or evaluated, specifically, via remote care. The extraction, quality of studies, and risk of bias were assessed using the RoB2 (risk of bias) tool, for analysis of the strength of evidence, the GRADE (Grading of Recommendations Assessment, Developing, and Evaluation) method was used, and for the preparation of meta-analysis was used at RevMan 5.4 (Review Manager) was used. Results The database search identified 3949 potential articles for screening, 13 of which were eligible for the present systematic review, involving 1469 participants with chronic diseases (chronic obstructive pulmonary disease (COPD), asthma, heart failure, diabetes mellitus, and fibromyalgia). Through the meta-analysis, an advantage was identified for the remote intervention on physical conditioning (p = 0.001), with an estimated effect of 0.29 (0.11, 0.46) and on health conditions (p = 0.0004), -0.30 (-0.47, -0.14), while for quality of life, no significant difference was identified (p = 0.90), 0.01 (-0.13, 0.14). Conclusion Telemedicine has clinical effectiveness for the outcome of physical conditioning and general health conditions in adults with chronic diseases when compared to usual care without face-to-face intervention.
Collapse
Affiliation(s)
| | | | - Denise Hollanda Iunes
- Physiotherapy Course at the Federal University of Alfenas, Alfenas, Brazil
- Department of Postgraduate Program in Rehabilitation Sciences, Federal University of Alfenas, Alfenas, Brazil
| | - Leonardo César Carvalho
- Department of Postgraduate Program in Applied Health Biosciences, Federal University of Alfenas, Alfenas, Brazil
- Physiotherapy Course at the Federal University of Alfenas, Alfenas, Brazil
- Department of Postgraduate Program in Rehabilitation Sciences, Federal University of Alfenas, Alfenas, Brazil
- Institute of Motricity Sciences, Federal University of Alfenas, Alfenas, Brazil
| |
Collapse
|
20
|
De Berardinis L, Senarighi M, Ciccullo C, Forte F, Spezia M, Gigante AP. Fast-track surgery and telerehabilitation protocol in unicompartmental knee arthroplasty leads to superior outcomes when compared with the standard protocol: a propensity-matched pilot study. Knee Surg Relat Res 2022; 34:44. [PMID: 36510279 PMCID: PMC9743114 DOI: 10.1186/s43019-022-00173-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Several strategies have been devised to reduce the length of stay after orthopedic surgery. Telerehabilitation has proved effective in functional outcomes after orthopedic procedures and is appreciated by patients. There is limited information on fast-track surgery and telerehabilitation protocols for unicompartmental knee arthroplasty (UKA). The purpose of this pilot study was to report and compare functional outcomes and satisfaction levels during first 12 months of recovery in patients who underwent UKA according to a fast-track and telerehabilitation protocol (G1) or standard surgery and rehabilitation program (G2). METHODS Data were retrospectively collected and reviewed for all elective UKAs from January 2018 to November 2019. A total of seven patients undergoing UKA according to the fast-track and telerehabilitation protocol were propensity score matched (1:3 ratio) to 21 patients undergoing standard surgery and rehabilitation. Patients were matched for age, sex, body mass index (BMI), and laterality. The Western Ontario and McMaster University (WOMAC) osteoarthritis index and range of motion (ROM) were collected pre- and postoperatively in both groups for 12 months. In addition, patient' satisfaction was collected at 40 days. RESULTS The G1 group demonstrated significantly better outcomes in WOMAC index scores at 2, 15, and 40 days (p < 0.001, p < 0.001, p < 0.020, respectively) and a significantly greater knee ROM after surgery and at 2, 15, 40, and 12 months (p < 0.001, p < 0.001, p = 0.014, p < 0.001, p = 0.003, respectively). No patients in either group had postoperative complications. One patient was not completely satisfied in the G2, while no one in G1 reported not being completely satisfied (p = 1.000). CONCLUSIONS This fast-track and telerehabilitation protocol after UKA can potentially be applied to patients as it is safe and effective. At 12-months follow-up, both groups reported favorable outcomes after UKA. However, the G1 score was better regarding WOMAC and ROM when compared with the propensity score-matched G2 program. A larger study is warranted to explore the role of fast-track and telerehabilitation in clinical and functional outcomes of UKA.
Collapse
Affiliation(s)
- Luca De Berardinis
- grid.7010.60000 0001 1017 3210Clinical Orthopedics, Department of Clinical and Molecular Science, School of Medicine, Università Politecnica delle Marche, Via Tronto, 10/a, 60126 Ancona, AN Italy
| | - Marco Senarighi
- grid.7010.60000 0001 1017 3210Clinical Orthopedics, Department of Clinical and Molecular Science, School of Medicine, Università Politecnica delle Marche, Via Tronto, 10/a, 60126 Ancona, AN Italy
| | - Carlo Ciccullo
- grid.7010.60000 0001 1017 3210Clinical Orthopedics, Department of Clinical and Molecular Science, School of Medicine, Università Politecnica delle Marche, Via Tronto, 10/a, 60126 Ancona, AN Italy
| | - Fabiana Forte
- Specialist of Physical Medicine & Rehabilitation, COQ (Centro Ortopedico di Quadrante), Madonna del Popolo Hospital, Via Lungolago Buozzi 25, 28887 Omegna, VB Italy
| | - Marco Spezia
- Surgical Director of Department of Orthopaedics, COQ (Centro Ortopedico di Quadrante), Madonna del Popolo Hospital, Via Lungolago Buozzi 25, 28887 Omegna, VB Italy
| | - Antonio Pompilio Gigante
- grid.7010.60000 0001 1017 3210Clinical Orthopedics, Department of Clinical and Molecular Science, School of Medicine, Università Politecnica delle Marche, Via Tronto, 10/a, 60126 Ancona, AN Italy
| |
Collapse
|
21
|
Coulibaly LP, Poder TG, Tousignant M. Attributes Underlying Patient Choice for Telerehabilitation Treatment: A Mixed-Methods Systematic Review to Support a Discrete Choice Experiment Study Design. Int J Health Policy Manag 2022; 11:1991-2002. [PMID: 34861762 PMCID: PMC9808290 DOI: 10.34172/ijhpm.2021.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 11/02/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Across most healthcare systems, patients are the primary focus. Patient involvements enhance their adherence to treatment, which in return, influences their health. The objective of this study was to determine the characteristics (ie, attributes) and associated levels (ie, values of the characteristics) that are the most important for patients regarding telerehabilitation (TR) healthcare to support a future discrete choice experiment (DCE) study design. METHODS A mixed-methods systematic review was conducted from January 2005 to the end of July 2020 and the search strategy was applied to five different databases. The initial selection of articles that met the eligibility criteria was independently made by one researcher, two researchers verified the accuracy of the extracted data, and all researchers discussed about relevant variables to include. Reporting of this systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the study. A qualitative synthesis was used to summarize findings. RESULTS From a total of 928 articles, 11 (qualitative [n = 5], quantitative [n = 3] and mixed-methods [n = 3] design) were included, and 25 attributes were identified and grouped into 13 categories: Accessibility, Distance, Interaction, Technology experience, Treatment mode, Treatment location, Physician contact mode, Physician contact frequency, Cost, Confidence, Ease of use, Feeling safer, and Training session. The attributes levels varied from two to five. The DCE studies identified showed the main stages to undertake these types of studies. CONCLUSION This study could guide the development of interview grid for individual interviews and focus groups to support a DCE study design in the TR field. By understanding the characteristics that enhance patients' preferences, healthcare providers can create or improve TR programs that provide high-quality and accessible care. Future research via a DCE is needed to determine the relative importance of the attributes.
Collapse
Affiliation(s)
- Lucien P. Coulibaly
- Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche sur le Vieillissement, Sherbrooke, QC, Canada
| | - Thomas G. Poder
- Département de Gestion, Évaluation et Politique de Santé, École de santé publique de l'Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
| | - Michel Tousignant
- Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche sur le Vieillissement, Sherbrooke, QC, Canada
| |
Collapse
|
22
|
Algarni FS, Alshammari MO, Sidimohammad U, Khayat SA, Aljabbary A, Altowaijri AM. Tele-Rehabilitation Service from the Patient's Perspective: A Cross-Sectional Study. J Patient Exp 2022; 9:23743735221130820. [PMID: 36226035 PMCID: PMC9549184 DOI: 10.1177/23743735221130820] [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] [Indexed: 11/29/2022] Open
Abstract
This study aimed to describe patients' perceptions of tele-rehabilitation (TR) and investigate the association between TR-related factors and both the patients' age and type of rehabilitation services. A cross-sectional survey was conducted to obtain data about patients' demographic and medical information, technological familiarity as well as patients' experience and opinions about TR. The 227 patients completing the survey reported a mean ± SD age of 40.7 ± 13.9 years and musculoskeletal disorders as the most common condition treated by TR. The majority of patients expressed satisfaction and confidence with their therapists' ability to assess and treat their problems using TR. Approximately 75.3% of participants stated that therapists demonstrated a strong understanding of their health conditions, while 82% reported that TR entailed a convenient service during COVID-19. The study found associations between age and patient's ability and confidence to use technology as well as a relationship between the type of treatment received and participants' overall opinions. Patients demonstrated acceptance, confidence, and satisfaction with TR during COVID-19. Patient age and treatment type fulfill a major role in patients' perceptions of TR.
Collapse
Affiliation(s)
- Fahad Saad Algarni
- Department of Rehabilitation Sciences, College of Applied Medical
Sciences, King Saud University, Riyadh, Saudi Arabia,Fahad Saad Algarni, Department of Health
Rehabilitation Sciences at College of Applied Medical Sciences, King Saud
University, Riyadh, Saudi Arabia.
| | - Majed O Alshammari
- Department of Rehabilitation Medicine, King Saud University Medical
City, King Saud University, Riyadh, Saudi Arabia
| | - Umkalthoum Sidimohammad
- Department of Rehabilitation Medicine, King Saud University Medical
City, King Saud University, Riyadh, Saudi Arabia
| | - Sarah A Khayat
- Department of Rehabilitation Medicine, King Saud University Medical
City, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Aljabbary
- Department of Rehabilitation Medicine, King Saud University Medical
City, King Saud University, Riyadh, Saudi Arabia
| | | |
Collapse
|
23
|
Telerrehabilitación en tiempos de COVID: una encuesta de satisfacción a cuidadores y pacientes con daño cerebral. FISIOTERAPIA 2022. [PMCID: PMC8941493 DOI: 10.1016/j.ft.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivo Material y métodos Resultados Conclusión
Collapse
|
24
|
Moulaei K, Sheikhtaheri A, Nezhad MS, Haghdoost A, Gheysari M, Bahaadinbeigy K. Telerehabilitation for upper limb disabilities: a scoping review on functions, outcomes, and evaluation methods. Arch Public Health 2022; 80:196. [PMID: 35999548 PMCID: PMC9400266 DOI: 10.1186/s13690-022-00952-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Upper limb (UL) disabilities have attracted worldwide attention due to the high economic costs of health care and the negative effects on the quality of life of patients with these disabilities. Telerehabilitation technologies are one of the most important ways to reduce rehabilitation costs and increase the quality of life of patients. Therefore, the aim of this study was to investigate the role of telerehabilitation in improving the health status of patients with upper limb disabilities.
Methods
This scoping review was conducted by searching the Web of Science, PubMed, and Scopus until July 30, 2021. We used a data extraction form with 18 fields to extract data from primary studies. The selection of articles and data extraction was made by four researchers using a data collection form based on inclusion and exclusion criteria. Disagreements were resolved through consultation with the fifth and sixth researchers.Inclusion criteria were studies published in English, studies on upper limb disability, and telerehabilitation based on any technology (synchronous telerehabilitation, asynchronous, or both). Exclusion criteria were articles that did not focus on telerehabilitation and upper limb disabilities. Also, books, book chapters, letters to the editor, and conference abstracts were also removed.
Results
A total of 458 articles were retrieved, and after removing irrelevant and duplicate articles, 29 articles were finally included in this review. Most telerehabilitation was performed for patients with stroke (65%). Among the 15 different services provided with telerehabilitation technologies, "Evaluation of exercises and also a musculoskeletal function of patients by the therapist","Recording of patients' rehabilitation exercises and sending them to the therapist” and "Prescribing new rehabilitation exercises by the therapist" were the most widely used services, respectively. Virtual reality technologies, smart wearables, and robots were used to provide telerehabilitation services. Among the 13 types of evaluation used for telerehabilitation systems, “Evaluation and measurement of upper limb function” was the most used evaluation in the studies. "Improvement in musculoskeletal functions”, "Increasing patients' interest and motivation to perform rehabilitation exercises", and "Increasing adherence to rehabilitation exercises and greater participation in treatment processes" were the most important outcomes, respectively.
Conclusion
Our findings indicate that telerehabilitation provides individuals with equitable access to rehabilitation services, improves musculoskeletal function, and empowers individuals by providing a variety of rehabilitation capabilities.
Collapse
|
25
|
Brigo E, Rintala A, Kossi O, Verwaest F, Vanhoof O, Feys P, Bonnechère B. Using Telehealth to Guarantee the Continuity of Rehabilitation during the COVID-19 Pandemic: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610325. [PMID: 36011959 PMCID: PMC9408792 DOI: 10.3390/ijerph191610325] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 06/12/2023]
Abstract
COVID-19 has abruptly disrupted healthcare services; however, the continuity of rehabilitation could be guaranteed using mobile technologies. This review aims to analyze the feasibility and effectiveness of telehealth solutions proposed to guarantee the continuity of rehabilitation during the COVID-19 pandemic. The PubMed, Cochrane Library, Web of Science and PEDro databases were searched; the search was limited to randomized controlled trials, observational and explorative studies published up to 31 May 2022, assessing the feasibility and effectiveness of telerehabilitation during the COVID-19 pandemic. Twenty studies were included, for a total of 224,806 subjects: 93.1% with orthopedic complaints and 6.9% with non-orthopedic ones. The main strategies used were video and audio calls via commonly available technologies and free videoconferencing tools. Based on the current evidence, it is suggested that telerehabilitation is a feasible and effective solution, allowing the continuity of rehabilitation while reducing the risk of infection and the burden of travel. However, it is not widely used in clinical settings, and definitive conclusions cannot be currently drawn. Telerehabilitation seems a feasible and safe option to remotely deliver rehabilitation using commonly available mobile technologies, guaranteeing the continuity of care while respecting social distancing. Further research is, however, needed to strengthen and confirm these findings.
Collapse
Affiliation(s)
- Elisabetta Brigo
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Aki Rintala
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- Faculty of Social Services and Health Care, LAB University of Applied Sciences, 15210 Lahti, Finland
| | - Oyéné Kossi
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- ENATSE, National School of Public Health and Epidemiology, University of Parakou, Parakou 03 BP 10, Benin
| | - Fabian Verwaest
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Olivier Vanhoof
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Peter Feys
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| |
Collapse
|
26
|
Rehabilitation Professional and Patient Satisfaction with Telerehabilitation of Musculoskeletal Disorders: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7366063. [PMID: 35958819 PMCID: PMC9363217 DOI: 10.1155/2022/7366063] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 04/08/2022] [Accepted: 06/26/2022] [Indexed: 11/18/2022]
Abstract
Telerehabilitation offers an alternative healthcare delivery remotely in a patient's environment at a lower cost, better accessibility, and equivalent quality to the standard approach. Several studies had examined the effectiveness of telerehabilitation inpatients with musculoskeletal disorders, and although there is evidence that it is at least equally effective as the standard care, the patient and rehabilitation professional satisfaction with the delivery method is not conclusive. A systematic review was conducted to study the patients' and rehabilitation professionals' satisfaction with telerehabilitation for musculoskeletal disorders. A search for relevant studies on 29 April 2021 was carried out in Medline/PubMed, Scopus, and Web of Science (WOS). The search terms included “telerehabilitation,” AND “satisfaction” AND “musculoskeletal disorders,” “telehealth,” “telemedicine,” “patient experience,” and “pain”. Fifteen eligible studies with 12,341 patients were included in this systematic review. A report was included if it (a) assessed the satisfaction of patients or professionals or both as one of the outcomes of a telerehabilitation intervention, (b) included adults 18 years and above with musculoskeletal disorders, and (c) is an intervention study using a quantitative approach. The quality of studies was assessed using the critical appraisal checklist tool developed by Joanna Briggs Institute (JBI). Most of the studies reported that patients were satisfied with both telerehabilitation and face-to-face intervention. However, few studies reported that patients were more satisfied with telerehabilitation compared to face-to-face of intervention. Patients in one study had preferred the incorporation of telerehabilitation and face-to-face sessions. Two of three studies had reported overall satisfaction with telerehabilitation by the professionals. Overall, there is evidence that patients and rehabilitation professional are satisfied with telerehabilitation compared to face-to-face consultation.
Collapse
|
27
|
Zheng J, Hou M, Liu L, Wang X. Knowledge Structure and Emerging Trends of Telerehabilitation in Recent 20 Years: A Bibliometric Analysis via CiteSpace. Front Public Health 2022; 10:904855. [PMID: 35795695 PMCID: PMC9251196 DOI: 10.3389/fpubh.2022.904855] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Telerehabilitation, as an effective means of treatment, is not inferior to traditional rehabilitation, and solves the problem of many patients who do not have access to hospital-based training due to costs and distance. So far, the knowledge structure of the global use of telerehabilitation has not been formed. This study aimed to demonstrate the state of emerging trends and frontiers concerning the studies of telerehabilitation through bibliometric software. Methods Literature about telerehabilitation from 2000 to 2021 was retrieved from the Web of Science Core Collection. We used CiteSpace 5.8.R3 to analyze the publication years, journals/cited journals, countries, institutions, authors/cited authors, references, and keywords. Based on the analysis results, we plotted the co-citation map to more intuitively observe the research hotspots and knowledge structure. Results A total of 1,986 records were obtained. The number of annual publications gradually increased over the investigated period. The largest increase occurred between 2019 and 2020. J TELEMED TELECARE was the most prolific and the most cited journal. The United States was the most influential country, with the highest number of publications and centrality. The University of Queensland was the most productive institution. The author Tousignant M ranked the highest in the number of publications and Russell TG ranked the first in the cited authors. Respectively, the articles published by Cottrell MA and Russell TG ranked the first in the frequency and centrality of cited references. The four hot topics in telerehabilitation were “care”,“stroke”, “telemedicine” and “exercise”. The keyword “stroke” showed the strongest citation burst. The two frontier keywords were “physical therapy” and “participation”. The keywords were clustered to form 21 labels. Conclusion This study uses visualization software CiteSpace to provide the current status and trends in clinical research of telerehabilitation over the past 20 years, which may help researchers identify new perspectives concerning potential collaborators and cooperative institutions, hot topics, and research frontiers in the research field. Bibliometric analysis of telerehabilitation supplements and improves the knowledge field of telemedicine from the concept of rehabilitation medicine and provides new insights into therapists during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Jiaqi Zheng
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Meijin Hou
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fuzhou, China
| | - Lu Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiangbin Wang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- *Correspondence: Xiangbin Wang
| |
Collapse
|
28
|
Bezuidenhout L, Joseph C, Thurston C, Rhoda A, English C, Conradsson DM. Telerehabilitation during the COVID-19 pandemic in Sweden: a survey of use and perceptions among physiotherapists treating people with neurological diseases or older adults. BMC Health Serv Res 2022; 22:555. [PMID: 35473602 PMCID: PMC9038993 DOI: 10.1186/s12913-022-07968-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/20/2022] [Indexed: 12/26/2022] Open
Abstract
Background Telerehabilitation, i.e. rehabilitation at a distance using Information and Communication Technology (ICT), is a promising avenue for improving health among people with neurological diseases or older adults who often experience limited access to services. Still, little is known about physiotherapists’ use, perceptions and needs with regards to telerehabilitation services. Aims To describe physiotherapists use and perceptions of, as well as needs for, telerehabilitation services for the rehabilitation of people with neurological diseases or older adults in Sweden. Methods In this cross-sectional study, an author-created survey was sent out to members of the Swedish Association of Physiotherapists including questions about the use and perceptions of existing telerehabilitation services (e.g. telephone, internet-based applications and mobile applications) as well as needs of future telerehabilitation services. The results were presented descriptively as numbers and percentages. Results Three hundred seven physiotherapists were included in this study with 139 (45%) treating people with neurological diseases and 168 (55%) treating older adults. Most respondents did not provide telerehabilitation before (74%) or during (51%) the COVID-19 pandemic. Telephone, which was predominantly used for administrative tasks, was the most frequent utilised ICT used by 68% of the physiotherapist using ICTs several days/week. Few respondents used internet-based applications (12%), mobile applications (3%) or SMS services (8%) and videoconferencing (3%). A majority of the respondents were interested in ICT (78%), felt comfortable using ICT (57%) and were interested in learning how ICT can be used in rehabilitation (92%). Still, few respondents perceived that people with neurological diseases or older adults can use existing ICTs for rehabilitation purposes (18%) and that existing reimbursement system within health care facilitates remote rehabilitation (16%). Important functionality of future ICT perceived by physiotherapists covered patient communication (e.g. chat, SMS and video), assessments (e.g. digital surveys and assessment of physical activity) and treatment (e.g. exercise prescription). Conclusion While physiotherapists had an overall positive perception to use and willingness to learn about telerehabilitation, few used telerehabilitation services before nor during the COVID-19 pandemic and they also perceived multilevel barriers for implementation, ranging from patients ability to use ICT to existing reimbursement systems within health care. Our findings emphasize the need to strengthen the expertise regarding remote services among physiotherapists. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07968-6.
Collapse
Affiliation(s)
- Lucian Bezuidenhout
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Faculty of Community and Health Sciences; Deanery, University of the Western Cape, Bellville, South Africa
| | - Conran Joseph
- Department of Health and Rehabilitation Sciences, Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa
| | - Charlotte Thurston
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Anthea Rhoda
- Faculty of Community and Health Sciences; Deanery, University of the Western Cape, Bellville, South Africa
| | - Coralie English
- School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia
| | - David Moulaee Conradsson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden. .,Medical unit Occupational therapy & Physiotherapy, Theme Women's Health and Allied Health Professional, Karolinska University Hospital, Stockholm, Sweden.
| |
Collapse
|
29
|
Zanatta F, Giardini A, Pierobon A, D'Addario M, Steca P. A systematic review on the usability of robotic and virtual reality devices in neuromotor rehabilitation: patients' and healthcare professionals' perspective. BMC Health Serv Res 2022; 22:523. [PMID: 35443710 PMCID: PMC9020115 DOI: 10.1186/s12913-022-07821-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/14/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The application of virtual reality (VR) and robotic devices in neuromotor rehabilitation has provided promising evidence in terms of efficacy, so far. Usability evaluations of these technologies have been conducted extensively, but no overviews on this topic have been reported yet. METHODS A systematic review of the studies on patients' and healthcare professionals' perspective through searching of PubMed, Medline, Scopus, Web of Science, CINAHL, and PsychINFO (2000 to 2021) was conducted. Descriptive data regarding the study design, participants, technological devices, interventions, and quantitative and qualitative usability evaluations were extracted and meta-synthetized. RESULTS Sixty-eight studies were included. VR devices were perceived as having good usability and as a tool promoting patients' engagement and motivation during the treatment, as well as providing strong potential for customized rehabilitation sessions. By contrast, they suffered from the effect of learnability and were judged as potentially requiring more mental effort. Robotics implementation received positive feedback along with high satisfaction and perceived safety throughout the treatment. Robot-assisted rehabilitation was considered useful as it supported increased treatment intensity and contributed to improved patients' physical independence and psychosocial well-being. Technical and design-related issues may limit the applicability making the treatment difficult and physically straining. Moreover, cognitive and communication deficits were remarked as potential barriers. CONCLUSIONS Overall, VR and robotic devices have been perceived usable so far, reflecting good acceptance in neuromotor rehabilitation programs. The limitations raised by the participants should be considered to further improve devices applicability and maximise technological rehabilitation effectiveness. TRIAL REGISTRATION PROSPERO registration ref. CRD42021224141 .
Collapse
Affiliation(s)
- Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Anna Giardini
- Information Technology Department, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Antonia Pierobon
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy.
| | - Marco D'Addario
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| |
Collapse
|
30
|
Ceprnja D, Clark T, Young J, Lee R, Flynn K, Maka K. Evaluating experiences, usability and patient satisfaction with telehealth for tertiary outpatient physiotherapy services during COVID-19: A mixed-methods study. Physiother Theory Pract 2022:1-9. [PMID: 35387568 DOI: 10.1080/09593985.2022.2059423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION In response to the COVID-19 pandemic, telehealth has been rapidly implemented in outpatient services worldwide. However, little is known about the experiences of telehealth in a tertiary outpatient physiotherapy setting. OBJECTIVE 1) describe the experience of physiotherapists and patients who utilized telehealth services in a tertiary health facility; and 2) identify the challenges and opportunities of physiotherapy service provision via telehealth in a tertiary health facility. METHODS A mixed-methods approach was undertaken in the physiotherapy outpatient department between June and October 2020. Patients utilizing telehealth services were invited to complete a purposely designed survey. Physiotherapists completed the Telehealth Usability Questionnaire (TUQ) and provided open-ended responses. Descriptive analysis of quantitative data was completed and thematic analysis was used for qualitative data. RESULTS Patients reported positive experiences with telehealth, with 93% finding it easy to use and 90% satisfied with the time it took to get an appointment. Scores on the TUQ by physiotherapists were highest for usefulness with a mean (SD) score of 6.02 (1.09), while lower scores were seen for reliability with a score of 3.24 (1.48). Five broad themes were identified: 1) connecting with patients during a pandemic; 2) keeping treatment on track; 3) unprepared for the technology challenges; 4) telehealth - not quite the real thing; and 5) better resources to facilitate moving forwards. CONCLUSION While the overall patient experience was high, physiotherapist's satisfaction with telehealth was more varied. Additional work may be needed to improve the technical and logistical aspects of telehealth to support ongoing use in physiotherapy clinical practice.
Collapse
Affiliation(s)
- Dragana Ceprnja
- PO Box 533, Physiotherapy Department, Westmead Hospital, Wentworthville, NSW 2145, Australia
| | - Tracey Clark
- PO Box 533, Physiotherapy Department, Westmead Hospital, Wentworthville, NSW 2145, Australia
| | - Jonathan Young
- PO Box 533, Physiotherapy Department, Westmead Hospital, Wentworthville, NSW 2145, Australia
| | - Rebecca Lee
- PO Box 533, Physiotherapy Department, Westmead Hospital, Wentworthville, NSW 2145, Australia
| | - Kylie Flynn
- PO Box 533, Physiotherapy Department, Westmead Hospital, Wentworthville, NSW 2145, Australia
| | - Katherine Maka
- PO Box 533, Physiotherapy Department, Westmead Hospital, Wentworthville, NSW 2145, Australia
| |
Collapse
|
31
|
Jansons P, Fyfe J, Via JD, Daly RM, Gvozdenko E, Scott D. Barriers and enablers for older adults participating in a home-based pragmatic exercise program delivered and monitored by Amazon Alexa: a qualitative study. BMC Geriatr 2022; 22:248. [PMID: 35337284 PMCID: PMC8953055 DOI: 10.1186/s12877-022-02963-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/17/2022] [Indexed: 11/12/2022] Open
Abstract
Background The remote delivery and monitoring of individually-tailored exercise programs using voice-controlled intelligent personal assistants (VIPAs) that support conversation-based interactions may be an acceptable alternative model of digital health delivery for older adults. The aim of this study was to evaluate the enablers and barriers for older adults participating in a home-based exercise program delivered and monitored by VIPAs. Method This qualitative study used videoconferencing to conduct semi-structured interviews following a 12-week, prospective single-arm pilot study in 15 adults aged 60 to 89 years living alone in the community. All participants were prescribed an individualized, brief (10 min, 2–4 times per day), home-based muscle strengthening and balance exercise program delivered and monitored using an Amazon Echo Show 5 device (Alexa). Qualitative interview data were analysed using inductive thematic analysis. Results All 15 participants (aged 70.3 ± 4.3 years, mean ± SD) attended the semi-structured interview. Themes including enjoyability and ease of use, social engagement and motivation were enablers for participation in the exercise program. Errors in voice recognition, lack of feedback, and preference for other existing digital health modes of exercise delivery were barriers associated with the Alexa technology. Conclusions This qualitative study identified enablers and barriers associated with using an Alexa device to deliver and monitor an individualized, home-based exercise program in older adults living alone. Future interventions using VIPAs should focus on reducing technical errors, providing regular exercise feedback, and comparing participants’ experiences of exercise programs delivered by VIPAs to programs delivered via other digital health tools. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02963-2.
Collapse
Affiliation(s)
- Paul Jansons
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia. .,Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.
| | - Jackson Fyfe
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jack Dalla Via
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.,Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | | | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.,Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| |
Collapse
|
32
|
OpenTera: A microservice architecture solution for rapid prototyping of robotic solutions to COVID-19 challenges in care facilities. HEALTH AND TECHNOLOGY 2022; 12:583-596. [PMID: 35223361 PMCID: PMC8863515 DOI: 10.1007/s12553-021-00636-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/16/2021] [Indexed: 11/09/2022]
Abstract
As telecommunications technology progresses, telehealth frameworks are becoming more widely adopted in the context of long-term care (LTC) for older adults, both in care facilities and in homes. Today, robots could assist healthcare workers when they provide care to elderly patients, who constitute a particularly vulnerable population during the COVID-19 pandemic. Previous work on user-centered design of assistive technologies in LTC facilities for seniors has identified positive impacts. The need to deal with the effects of the COVID-19 pandemic emphasizes the benefits of this approach, but also highlights some new challenges for which robots could be interesting solutions to be deployed in LTC facilities. This requires customization of telecommunication and audio/video/data processing to address specific clinical requirements and needs. This paper presents OpenTera, an open source telehealth framework, aiming to facilitate prototyping of such solutions by software and robotic designers. Designed as a microservice-oriented platform, OpenTera is an end-to-end solution that employs a series of independent modules for tasks such as data and session management, telehealth, daily assistive tasks/actions, together with smart devices and environments, all connected through the framework. After explaining the framework, we illustrate how OpenTera can be used to implement robotic solutions for different applications identified in LTC facilities and homes, and we describe how we plan to validate them through field trials.
Collapse
|
33
|
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: 33] [Impact Index Per Article: 11.0] [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.
Collapse
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
| |
Collapse
|
34
|
McKeon JF, Alvarez PM, Vajapey AS, Sarac N, Spitzer AI, Vajapey SP. Expanding Role of Technology in Rehabilitation After Lower-Extremity Joint Replacement: A Systematic Review. JBJS Rev 2021; 9:01874474-202109000-00010. [PMID: 34516463 DOI: 10.2106/jbjs.rvw.21.00016] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The effectiveness of telehealth programs in the administration of rehabilitation and the monitoring of postoperative progress after joint replacement is not well studied. The purpose of the present study was to systematically review the currently available evidence on the use of smart-device technology and telehealth programs to guide and monitor postoperative rehabilitation following total joint arthroplasty and to assess their impact on outcomes following surgery. METHODS A literature search of the MEDLINE database was performed using keywords "mobile," "app," "telehealth," "virtual," "arthroplasty," "outcomes," "joint replacement," "web based," "telemedicine," "TKA," "THA," "activity tracker," "fitness tracker," "monitor," "rehab," "online," and "stepcounter" in all possible combinations. All English studies with a level of evidence of I to III that were published from January 1, 2010, to December 19, 2020 were considered for inclusion. Quantitative and qualitative analysis was performed on the data collected. RESULTS A total of 28 articles meeting the inclusion criteria were identified and reviewed. With regard to objective functional outcome measures, such as strength, range of motion, or results of the Timed Up and Go (TUG) test, the virtual physical therapy group had equivalent or slightly superior outcomes compared with in-person physical therapy. There was similar improvement overall in patient-reported outcome measures (PROMs) and patient satisfaction between virtual and in-person physical therapy. Virtual physical therapy resulted in cost savings ranging from $206 to $4,100 per patient compared with in-person physical therapy. CONCLUSIONS Telerehabilitation following lower-extremity joint replacement is less expensive compared with in-person physical therapy, with equivalent outcomes and patient satisfaction. Telerehabilitation and electronic health adjuncts can be used to substitute for traditional rehabilitation and augment postoperative care following total joint arthroplasty, respectively. Telerehabilitation that provides outcomes equivalent to in-person physical therapy not only increases convenience for patients but also decreases the cost burden on the health-care system. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Collapse
Affiliation(s)
- John F McKeon
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Paul M Alvarez
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Anuhya S Vajapey
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio
- Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, California
| | - Nikolas Sarac
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Andrew I Spitzer
- Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, California
| | - Sravya P Vajapey
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio
| |
Collapse
|
35
|
Shah N, Costello K, Mehta A, Kumar D. Applications of Digital Health Technologies in Knee Osteoarthritis: A Narrative Review (Preprint). JMIR Rehabil Assist Technol 2021; 9:e33489. [PMID: 35675102 PMCID: PMC9218886 DOI: 10.2196/33489] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/12/2022] [Accepted: 05/06/2022] [Indexed: 12/23/2022] Open
Abstract
Background With the increasing adoption of high-speed internet and mobile technologies by older adults, digital health is a promising modality to enhance clinical care for people with knee osteoarthritis (KOA), including those with knee replacement (KR). Objective This study aimed to summarize the current use, cost-effectiveness, and patient and clinician perspectives of digital health for intervention delivery in KOA and KR. Methods In this narrative review, search terms such as mobile health, smartphone, mobile application, mobile technology, ehealth, text message, internet, knee osteoarthritis, total knee arthroplasty, and knee replacement were used in the PubMed and Embase databases between October 2018 and February 2021. The search was limited to original articles published in the English language within the past 10 years. In total, 91 studies were included. Results Digital health technologies such as websites, mobile apps, telephone calls, SMS text messaging, social media, videoconferencing, and custom multi-technology systems have been used to deliver interventions in KOA and KR populations. Overall, there was significant heterogeneity in the types and applications of digital health used in these populations. Digital patient education improved disease-related knowledge, especially when used as an adjunct to traditional methods of patient education for both KOA and KR. Digital health that incorporated person-specific motivational messages, biofeedback, or patient monitoring was more successful at improving physical activity than self-directed digital interventions for both KOA and KR. Many digital exercise interventions were found to be as effective as in-person physical therapy for people with KOA. Many digital exercise interventions for KR incorporated both in-person and web-based treatments (blended format), communication with clinicians, and multi-technology systems and were successful in improving knee range of motion and self-reported symptoms and reducing the length of hospital stays. All digital interventions that incorporated cognitive behavioral therapy or similar psychological interventions showed significant improvements in knee pain, function, and psychological health when compared with no treatment or traditional treatments for both KOA and KR. Although limited in number, studies have indicated that digital health may be cost-effective for these populations, especially when travel costs are considered. Finally, although patients with KOA and KR and clinicians had positive views on digital health, concerns related to privacy and security and concerns related to logistics and training were raised by patients and clinicians, respectively. Conclusions For people with KOA and KR, many studies found digital health to be as effective as traditional treatments for patient education, physical activity, and exercise interventions. All digital interventions that incorporated cognitive behavioral therapy or similar psychological treatments were reported to result in significant improvements in patients with KOA and KR when compared with no treatment or traditional treatments. Overall, technologies that were blended and incorporated communication with clinicians, as well as biofeedback or patient monitoring, showed favorable outcomes.
Collapse
Affiliation(s)
- Nirali Shah
- Department of Physical Therapy and Athletic Training, Boston University, Boston, MA, United States
| | - Kerry Costello
- Department of Physical Therapy and Athletic Training, Boston University, Boston, MA, United States
| | - Akshat Mehta
- Department of Physical Therapy and Athletic Training, Boston University, Boston, MA, United States
| | - Deepak Kumar
- Department of Physical Therapy and Athletic Training, Boston University, Boston, MA, United States
| |
Collapse
|
36
|
Choi JS, Kim JH, Park S, Lin M, Abdur-Rahman F, Mack WJ, Volker CCJ. Telemedicine in Otolaryngology During COVID-19: Patient and Physician Satisfaction. Otolaryngol Head Neck Surg 2021; 167:56-64. [PMID: 34491856 DOI: 10.1177/01945998211041921] [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] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To examine patient and physician satisfaction with telemedicine in otolaryngology during COVID-19 and identify associated factors. STUDY DESIGN Prospective cohort study. SETTING Tertiary care center. METHODS Patient satisfaction was rated by patients (age ≥18 years) who had encounters from May to July 2020 (n = 407). Physician satisfaction was rated by 15 otolaryngologists for specific encounters delivered from May to June 2020 (n = 1011). Patient satisfaction was measured with a Press Ganey questionnaire and a Telemedicine Satisfaction Questionnaire. Mean Press Ganey satisfaction scores of telemedicine encounters during COVID-19 were compared with the pre-COVID-19 Press Ganey scores from in-person encounters (n = 3059) to test a noninferiority hypothesis. Physician satisfaction was measured with a Provider Satisfaction Questionnaire. RESULTS The mean Press Ganey patient satisfaction score for telemedicine encounters was 94.5 (SD, 8.8), no worse than that for in-person encounters prior to COVID-19 at 93.7 (SD, 15.5; Δ = 0.8 [95% CI, -0.5 to 2.1, excluding the noninferiority margin of -1]). Encounters with videoconference (vs telephone) and patients reporting higher income were associated with higher Telemedicine Satisfaction Questionnaire scores. Physician satisfaction scores during COVID-19 with telemedicine encounters were overall high at 83.3 (95% CI, 77.5-89.1), slightly lower when compared with the scores with in-person encounters at 88.4 (95% CI, 82.5-94.3; Δ = -5.2 [95% CI, -6.6 to -3.8]). Encounters with videoconference (vs telephone) and patients with English as a preferred language and follow-up visits were associated with higher Provider Satisfaction Questionnaire scores. CONCLUSIONS Telemedicine is a feasible alternative format in otolaryngology during COVID-19 with overall high patient and physician satisfaction. Patient satisfaction with telemedicine encounters during COVID-19 was no worse than in-person encounters prior to the pandemic. Physician satisfaction with telemedicine was relatively lower in comparison with in-person encounters.
Collapse
Affiliation(s)
- Janet S Choi
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - James H Kim
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Soyun Park
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Matthew Lin
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Faiz Abdur-Rahman
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Wendy J Mack
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Courtney C J Volker
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| |
Collapse
|
37
|
Bucki FM, Clay MB, Tobiczyk H, Green BN. Scoping Review of Telehealth for Musculoskeletal Disorders: Applications for the COVID-19 Pandemic. J Manipulative Physiol Ther 2021; 44:558-565. [PMID: 35249750 PMCID: PMC8892222 DOI: 10.1016/j.jmpt.2021.12.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The purpose of this scoping review was to identify information about telehealth and rehabilitation for the evaluation and management of musculoskeletal disorders, patient satisfaction, cost, and access as may be applicable during the COVID-19 pandemic. METHODS We searched MEDLINE for studies published between January 1, 2000, and June 1, 2019. Search terms consisted of MEDLINE medical subject headings and other words relevant to this review, including "telerehabilitation," "musculoskeletal," "telemedicine," "therapy," "chiropractic," "ergonomics," and "exercise." This review targeted studies of people aged 18 years and older with musculoskeletal concerns. Articles on diagnostic tests, effectiveness of treatment, patient satisfaction, access to care, and cost were included. RESULTS Eleven studies were included in this review. Interrater reliability and agreement were moderate to high for several assessment procedures for the lower limb, elbow, and low back. Two clinical trials demonstrated that provider and patient simultaneous telehealth were equally as effective as in-office care. Patient and provider satisfaction with telehealth were reported to be equal to or higher than for conventional rehabilitation. We found no studies reporting cost or access. CONCLUSION In the COVID-19 pandemic environment, telehealth is feasible for health care providers to provide rehabilitation services for their patients with various musculoskeletal conditions. Current evidence suggests that for some musculoskeletal disorders, telehealth evaluation may be reliable, treatment may be effective, and patient satisfaction may be good or better than for in-office care. Results from this study may help physiatry, physical therapy, and chiropractic health care providers in their decisions to implement telehealth during and after the COVID-19 pandemic.
Collapse
Affiliation(s)
- Frank M. Bucki
- Cincinnati VA Medical Center, Cincinnati, Ohio,Corresponding author: Frank M. Bucki, Cincinnati VA Medical Center, 3219 Lookout Drive, Cincinnati, OH 45208
| | | | | | | |
Collapse
|
38
|
Kuroda Y, Young M, Shoman H, Punnoose A, Norrish AR, Khanduja V. Advanced rehabilitation technology in orthopaedics-a narrative review. INTERNATIONAL ORTHOPAEDICS 2021; 45:1933-1940. [PMID: 33051693 PMCID: PMC8338874 DOI: 10.1007/s00264-020-04814-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 09/15/2020] [Indexed: 12/29/2022]
Abstract
INTRODUCTION As the demand for rehabilitation in orthopaedics increases, so too has the development in advanced rehabilitation technology. However, to date, there are no review papers outlining the broad scope of advanced rehabilitation technology used within the orthopaedic population. The aim of this study is to identify, describe and summarise the evidence for efficacy for all advanced rehabilitation technologies applicable to orthopaedic practice. METHODS The relevant literature describing the use of advanced rehabilitation technology in orthopaedics was identified from appropriate electronic databases (PubMed and EMBASE) and a narrative review undertaken. RESULTS Advanced rehabilitation technologies were classified into two groups: hospital-based and home-based rehabilitation. In the hospital-based technology group, we describe the use of continuous passive motion and robotic devices (after spinal cord injury) and their effect on improving clinical outcomes. We also report on the use of electromagnetic sensor technology for measuring kinematics of upper and lower limbs during rehabilitation. In the home-based technology group, we describe the use of inertial sensors, smartphones, software applications and commercial game hardware that are relatively inexpensive, user-friendly and widely available. We outline the evidence for videoconferencing for promoting knowledge and motivation for rehabilitation as well as the emerging role of virtual reality. CONCLUSIONS The use of advanced rehabilitation technology in orthopaedics is promising and evidence for its efficacy is generally supportive.
Collapse
Affiliation(s)
- Yuichi Kuroda
- Young Adult Hip Service, Department of Trauma and Orthopaedic Surgery, Addenbrooke's-Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 37, Cambridge, CB2 0QQ, UK
| | - Matthew Young
- Young Adult Hip Service, Department of Trauma and Orthopaedic Surgery, Addenbrooke's-Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 37, Cambridge, CB2 0QQ, UK
| | - Haitham Shoman
- Young Adult Hip Service, Department of Trauma and Orthopaedic Surgery, Addenbrooke's-Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 37, Cambridge, CB2 0QQ, UK
| | - Anuj Punnoose
- Young Adult Hip Service, Department of Trauma and Orthopaedic Surgery, Addenbrooke's-Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 37, Cambridge, CB2 0QQ, UK
| | - Alan R Norrish
- Department of Academic Orthopaedics, Trauma and Sports Medicine, Queens Medical Centre, University of Nottingham, Nottingham, UK
| | - Vikas Khanduja
- Young Adult Hip Service, Department of Trauma and Orthopaedic Surgery, Addenbrooke's-Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 37, Cambridge, CB2 0QQ, UK.
| |
Collapse
|
39
|
Rubinger L, Gazendam A, Wood T, Yardley D, Shanthanna H, Bhandari M. Team Approach: Virtual Care in the Management of Orthopaedic Patients. JBJS Rev 2021; 9:01874474-202107000-00010. [PMID: 34270503 DOI: 10.2106/jbjs.rvw.20.00299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
» Telemedicine and remote care administered through technology are among the fastest growing sectors in health care. The utilization and implementation of virtual-care technologies have further been accelerated with the recent COVID-19 pandemic. » Remote, technology-based patient care is not a "one-size-fits-all" solution for all medical and surgical conditions, as each condition presents unique hurdles, and no true consensus exists regarding the efficacy of telemedicine across surgical fields. » When implementing virtual care in orthopaedics, as with standard in-person care, it is important to have a well-defined team structure with a deliberate team selection process. As always, a team with a shared vision for the care they provide as well as a supportive and incentivized environment are integral for the success of the virtual-care mechanism. » Future studies should assess the impact of primarily virtual, integrated, and multidisciplinary team-based approaches and systems of care on patient outcomes, health-care expenditure, and patient satisfaction in the orthopaedic population.
Collapse
Affiliation(s)
- Luc Rubinger
- Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Aaron Gazendam
- Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Thomas Wood
- Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | | | - Harsha Shanthanna
- Department of Anesthesia, St. Joseph's Healthcare Hamilton, McMaster University, Hamilton, Ontario, Canada
| | - Mohit Bhandari
- Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.,Centre for Evidence-Based Orthopaedics, Hamilton, Ontario, Canada
| |
Collapse
|
40
|
Abstract
The increasing cost of healthcare services is accelerating the development of the telehealth system to fulfill the necessity of delivering an efficient and cost-effective remote healthcare services. Moreover, the ageing of the global population and the disruption of the COVID-19 pandemic are creating a rapid rise of demand for healthcare services. This includes those who are in need of remote monitoring for chronic conditions through rehabilitation exercises. Therefore, this paper presents a telehealth system using PoseNet for in-home rehabilitation, with built-in statistical computation for doctors to analyze the patient’s recovery status. This system enables patients to perform rehabilitation exercises at home using an ordinary webcam. The PoseNet skeleton-tracking method is applied to detect and track the patients’ angular movements for both elbows and knees. By using this system, the measurement of the elbow and knee joint angles can be calculated and recorded while patients are performing rehabilitation exercises in front of the laptop webcam. After the patients complete their rehabilitation exercises, the skeleton results of four body parts will be generated. Based on the same actions performed by patients on selected days, the doctors can examine and evaluate the deviation rate of patients’ angular movements between different days to determine the recovery rate.
Collapse
|
41
|
Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak 2021; 21:122. [PMID: 33832473 PMCID: PMC8028577 DOI: 10.1186/s12911-021-01478-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Telerehabilitation has been considered a suitable alternative healthcare delivery system during the COVID-19 outbreak, and many studies have promoted its feasibility in delivering physical care to patients who live with pain and disability. Physiotherapists' perceptions and willingness are two key factors that influence the provision of remote physiotherapy. AIM To investigate physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic and to explore the barriers that may hinder the use of telerehabilitation in this sector. METHODS The following methods were used: (1) a cross-sectional survey and (2) face-to-face semi-structured interviews. In the cross-sectional survey, an electronic questionnaire was sent to 747 physiotherapists who were working in the governmental health sector. The questionnaire included four sections: perceptions of telerehabilitation, comfort with technology, willingness to use telerehabilitation, and barriers to using telerehabilitation. Six interviews were conducted with physiotherapy managers to explore the barriers and facilitators of telerehabilitation practice. DATA ANALYSIS In this study, descriptive data analysis was conducted, and a cross-tabulation technique was used to find the associations between the variables, in which chi-square tests were used to identify the significance of the results, where p < 0.05. Thematic content analysis was used for the interviews. RESULTS Only 273 completed questionnaires were received, giving a response rate of 36.5%. Most of the respondents (237; 86.8%) considered telerehabilitation a viable option to deliver healthcare to patients during the COVID-19 pandemic. In spite of the lack of information and communication technology (ICT) (156; 57.1%), 89% (243) of the respondents were willing to integrate telerehabilitation into their conventional practice, as cultural and social norms were not against the use of telerehabilitation systems. The results indicate that the more the physiotherapists used the internet and email in their work and the more comfortable they were with technology, the more willing they were to use telerehabilitation systems (p = 0.01). The physiotherapy managers reported that patients' privacy and the confidentiality of their data were considered barriers. CONCLUSION In Kuwait, physiotherapists show overall positive perceptions towards and a willingness to use telerehabilitation to facilitate patients' access to physiotherapy services. There are several barriers to employing telerehabilitation. Accordingly, recommendations are suggested.
Collapse
Affiliation(s)
- Sarah Ibraheem Albahrouh
- Department of Physical Therapy, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Ali Jasem Buabbas
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
| |
Collapse
|
42
|
The efficacy of remote virtual care in comparison to traditional clinical visits for elective orthopaedic patients: A meta-analysis of prospective randomised controlled trials. Surgeon 2021; 20:177-186. [PMID: 33762159 DOI: 10.1016/j.surge.2021.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/27/2021] [Accepted: 02/10/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The Orthopaedic Trauma Association has recommended limitation of in-person encounters to absolute necessity. One method of ensuring standard patient care within these guidelines is through the implementation of telemedicine. AIMS To evaluate the efficacy of telemedicine for elective orthopaedic patients in the recovery and/or rehabilitation period. METHODS A systematic review and meta-analysis of articles in Medline/PubMed and The Cochrane Library databases was performed according to the PRISMA guidelines for prospective randomised controlled trials to compare clinical and symptomatic measures for elective patients managed routinely with remote care compared to those managed with standard in-clinic management. To be included for meta-analysis, parameters must be evaluated in ≥3 studies. RESULTS Eleven studies were included in the meta-analyses. Both telemedicine and control cohorts were comparable for patient satisfaction (RR, 0.98; 95% CI, 0.90-1.07; I2 = 0%; p = 0.52) and patient retention analysis (RR, 1.25; 95% CI, 0.51-3.06; p = 0.54; I2 = 0%). Similarly, there was no statistical difference appreciated between cohorts for overall Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (p = 0.30), Timed Up and Go Test (p = 0.40), and Stair Test (p = 0.18). Significant difference did exist for visual analogue scale (VAS) scores (p = 0.02) in favour of in-clinic management. CONCLUSION Telemedicine will serve an integral aspect of healthcare delivery throughout the current COVID-19 pandemic and beyond in an effort to deliver safe, efficient and time-sensitive care to the orthopaedic patient population. The results of our meta-analyses indicate that virtual consultations are as effective as traditional in-person consultations for the care of elective orthopaedic patients in the recovery and rehabilitation period. However, further studies are needed to evaluate for initial consultations and certain sub-specialties of orthopaedics.
Collapse
|
43
|
Abstract
Advancements in medical science and technology, along with global increases in life expectancy, are changing the way health care services are delivered to the aging society. Telerehabilitation refers to rehabilitation services involving evaluation and treatment. It is an attractive option for older adults who may have multiple comorbidities. Limited access to in-person services and the concern about potential exposure to severe acute respiratory syndrome coronavirus-2 during this pandemic accelerated the implementation of telerehabilitation. This article review the scope, need, and implementation of telehealth and telerehabilitation in the aging population from the perspective of clinicians, patients, and caregivers.
Collapse
Affiliation(s)
- Mooyeon Oh-Park
- Department of Rehabilitation Medicine, Albert Einstein College of Medicine, Montefiore Health System, Burke Rehabilitation Hospital, 785 Mamaroneck Avenue, White Plains, NY 10605, USA.
| | - Henry L Lew
- Department of Communication Sciences and Disorders, University of Hawai'i at Mānoa, John A. Burns School of Medicine, 677 Ala Moana Boulevard, Suite 625, Honolulu, HI 96813, USA; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Preeti Raghavan
- Department of Physical Medicine and Rehabilitation and Neurology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA
| |
Collapse
|
44
|
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.
Collapse
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.
| |
Collapse
|
45
|
The Efficacy of Tele-Rehabilitation Program for Improving Upper Limb Function among Adults Following Elbow Fractures: A Pilot Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11041708] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Active mobilization post-elbow fractures reduces the incidence of complications. Occupational therapists use tele-rehabilitation, incorporating technology into their practices. There is a lack of evidence-based trials regarding the integration of tele-rehabilitation during treatment. We therefore aimed to compare tele-rehabilitation treatment outcomes with conventional rehabilitation in improving the upper limb function post-elbow fractures. Methods: Eighteen participants post-elbow surgery due to fracture were divided into two groups according to age and fracture type. The groups received one month of treatment: the tele-rehabilitation group (N = 9, median age 33.0 ± 27.9 years, range 18.5–61.0) received 1–2 tele-rehabilitation treatments per week via a biofeedback system of elbow motion (the ArmTutor and 3D Tutor systems, MediTouch Ltd., Netanya, Israel) and 1–2 treatments in an outpatient clinic, and the control group (N = 9, median age 60.0 ± 37.0 years, range 20.5–73.0) received 3–4 treatments per week in the clinic. Both groups were instructed to self-practice at home. Four evaluations were performed: before and after the intervention, and 3 months and 1 year from surgery. The outcome measures included the Jebsen–Taylor hand function test; the disabilities of the arm, shoulder, and hand questionnaire; the patient-rated elbow evaluation; satisfaction; passive and active range of motion (ROM); and strength measurements. Results: Findings demonstrated a significant improvement in the ROM and in functional assessments in both groups. No statistically significant differences were found between the groups. The subjects in the tele-rehabilitation group reported a higher level of satisfaction and needed less help from a family member during practice. Conclusions: Tele-rehabilitation programs could be incorporated in the framework of treatment following elbow fractures. Tele-rehabilitation is a cost-effective treatment, suitable for patients with accessibility difficulties or who have difficulty arriving at the clinic.
Collapse
|
46
|
Hasani F, Malliaras P, Haines T, Munteanu SE, White J, Ridgway J, Nicklen P, Moran A, Jansons P. Telehealth sounds a bit challenging, but it has potential: participant and physiotherapist experiences of gym-based exercise intervention for Achilles tendinopathy monitored via telehealth. BMC Musculoskelet Disord 2021; 22:138. [PMID: 33541314 PMCID: PMC7860049 DOI: 10.1186/s12891-020-03907-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/14/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Although telehealth is becoming more popular for delivery of care for individuals with musculoskeletal pain, to our knowledge telehealth has not been used to manage Achilles tendinopathy. This research aimed to explore the experience of participants and physiotherapists with gym-based exercise interventions for Achilles tendinopathy monitored via videoconference. METHODS A qualitative, interpretive description design was performed using semi-structured interviews (8 participants) and a focus group (7 physiotherapists). Participants and physiotherapists were interviewed about their experiences of the use of telehealth during a gym-based exercise intervention incorporating different calf load parameters for Achilles tendinopathy. We employed an inductive thematic analysis approach to analyse the data. RESULTS Three themes identified from both participants and physiotherapists included i) acceptability of telehealth; ii) enablers to adherence with telehealth; and iii) barriers to adherence with telehealth. Two extra themes arose from participants regarding adherence with gym-based exercise, including enablers to adherence with the exercise intervention, and barriers to adherence with the exercise intervention. Both participants and physiotherapists expressed overall satisfaction and acceptability of telehealth monitoring of gym-based exercise. CONCLUSION Gym-based exercise intervention for Achilles tendinopathy involving weekly telehealth monitoring was acceptable to both participants and physiotherapists. Potential enablers and barriers were identified that may improve adherence to this type of intervention.
Collapse
Affiliation(s)
- F. Hasani
- Physiotherapy Department, School of Primary and Allied Health Care, Monash University, Frankston, Victoria 3199 Australia
- Physiotherapy Department, Security Forces Hospital, Riyadh, 11481 Kingdom of Saudi Arabia
| | - P. Malliaras
- Physiotherapy Department, School of Primary and Allied Health Care, Monash University, Frankston, Victoria 3199 Australia
| | - T. Haines
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Frankston, Victoria 3199 Australia
| | - S. E. Munteanu
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria 3086 Australia
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria 3086 Australia
| | - J. White
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
| | - J. Ridgway
- Physiotherapy Department, Peninsula Health, Frankston, Victoria 3199 Australia
| | - P. Nicklen
- Physiotherapy Department, School of Primary and Allied Health Care, Monash University, Frankston, Victoria 3199 Australia
| | - A. Moran
- Back in Motion Physical Therapy, Melbourne, Victoria 3195 Australia
| | - P. Jansons
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria Australia
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| |
Collapse
|
47
|
Monardo G, Pavese C, Giorgi I, Godi M, Colombo R. Evaluation of Patient Motivation and Satisfaction During Technology-Assisted Rehabilitation: An Experiential Review. Games Health J 2021; 10:13-27. [DOI: 10.1089/g4h.2020.0024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Giulia Monardo
- Service of Psychology and Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Chiara Pavese
- Neurorehabilitation and Spinal Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
- Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Ines Giorgi
- Service of Psychology and Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Marco Godi
- Division of Physical Medicine and Rehabilitation and Istituti Clinici Scientifici Maugeri, IRCCS, Veruno, Italy
| | - Roberto Colombo
- Service of Bioengineering, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno, Italy
| |
Collapse
|
48
|
Niknejad N, Ismail W, Bahari M, Nazari B. Understanding Telerehabilitation Technology to Evaluate Stakeholders' Adoption of Telerehabilitation Services: A Systematic Literature Review and Directions for Further Research. Arch Phys Med Rehabil 2021; 102:1390-1403. [PMID: 33484693 DOI: 10.1016/j.apmr.2020.12.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 12/12/2020] [Accepted: 12/26/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To examine the adoption of telerehabilitation services from the stakeholders' perspective and to investigate recent advances and future challenges. DATA SOURCES A systematic review of English articles indexed by PubMed, Thomson Institute of Scientific Information's Web of Science, and Elsevier's Scopus between 1998 and 2020. STUDY SELECTION The first author (N.N.) screened all titles and abstracts based on the eligibility criteria. Experimental and empirical articles such as randomized and nonrandomized controlled trials, pre-experimental studies, case studies, surveys, feasibility studies, qualitative descriptive studies, and cohort studies were all included in this review. DATA EXTRACTION The first, second, and fourth authors (N.N., W.I., B.N.) independently extracted data using data fields predefined by the third author (M.B.). The data extracted through this review included study objective, study design, purpose of telerehabilitation, telerehabilitation equipment, patient/sample, age, disease, data collection methods, theory/framework, and adoption themes. DATA SYNTHESIS A telerehabilitation adoption process model was proposed to highlight the significance of the readiness stage and to classify the primary studies. The articles were classified based on 6 adoption themes, namely users' perception, perspective, and experience; users' satisfaction; users' acceptance and adherence; TeleRehab usability; individual readiness; and users' motivation and awareness. RESULTS A total of 133 of 914 articles met the eligibility criteria. The majority of papers were randomized controlled trials (27%), followed by surveys (15%). Almost 49% of the papers examined the use of telerehabilitation technology in patients with nervous system problems, 23% examined physical disability disorders, 10% examined cardiovascular diseases, and 8% inspected pulmonary diseases. CONCLUSION Research on the adoption of telerehabilitation is still in its infancy and needs further attention from researchers working in health care, especially in resource-limited countries. Indeed, studies on the adoption of telerehabilitation are essential to minimize implementation failure, as these studies will help to inform health care personnel and clients about successful adoption strategies.
Collapse
Affiliation(s)
- Naghmeh Niknejad
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam; Faculty of Information Technology, Duy Tan University, Da Nang, Vietnam; School of Computing, Faculty of Engineering, Universiti Teknologi Malaysia, Johor Bahru, Malaysia
| | - Waidah Ismail
- Faculty of Science and Technology, Universiti Sains Islam Malaysia, Negeri Sembilan, Malaysia; Information System Study Program, Universitas Airlangga, Indonesia Kampus C, Mulyorejo, Surabaya, Indonesia.
| | - Mahadi Bahari
- Department of Information Systems, Azman Hashim International Business School, Universiti Teknologi Malaysia, Johor Bahru, Malaysia
| | - Behzad Nazari
- Department of Information Systems, Azman Hashim International Business School, Universiti Teknologi Malaysia, Johor Bahru, Malaysia
| |
Collapse
|
49
|
Wang Q, Lee RLT, Hunter S, Chan SWC. The effectiveness of internet-based telerehabilitation among patients after total joint arthroplasty: A systematic review and meta-analysis of randomised controlled trials. J Telemed Telecare 2021; 29:247-260. [PMID: 33459120 DOI: 10.1177/1357633x20980291] [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] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The aim of this review was to systematically evaluate the available evidence on the effectiveness of internet-based telerehabilitation among patients after total joint arthroplasty regarding pain, range of motion, physical function, health-related quality of life, satisfaction, and psychological well-being. METHODS This was a systematic review with meta-analysis based on the Cochrane Handbook for Systematic Reviews of Interventions guidelines. Studies published in English or Chinese were searched using defined search periods, databases, and search terms. Two reviewers assessed independently the quality of studies. RevMan 5.3 was used for meta-analysis. Heterogeneity was assessed using the χ2 and I2 statistic. A random effect model and mean difference (MD) with 95% confidence interval (CI) was adopted. Standardised mean difference (SMD) was used if the outcome was measured by different scales. RESULTS Eleven studies with 1020 participants were analysed. Compared to face-to-face rehabilitation, internet-based telerehabilitation showed no significant difference in outcomes of pain (SMD-0.11, 95% CI-0.32 to 0.10), range of motion in flexion (MD 0.65, 95% CI-1.18 to 2.48) and extension (MD-0.38, 95% CI-1.16 to 0.40), patient-reported physical function (SMD 0.01, 95% CI-0.15 to 0.17), health-related quality of life (SMD-0.09, 95% CI-0.26 to 0.07), satisfaction (SMD-0.04, 95% CI-0.21 to 0.14), and psychological well-being (SMD 0.10, 95% CI-0.13 to 0.33). Internet-based telerehabilitation showed better outcomes in physical functional tests (SMD-0.54, 95% CI-1.08 to-0.01). DISCUSSION This review suggests that internet-based telerehabilitation has comparable effectiveness to face-to-face rehabilitation on rehabilitation outcomes among patients after total joint arthroplasty.
Collapse
Affiliation(s)
- Qingling Wang
- School of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China.,School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia
| | - Regina L-T Lee
- School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia
| | - Sharyn Hunter
- School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia
| | - Sally W-C Chan
- University of Newcastle Singapore Campus, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Brain and Mental Health, University of Newcastle, Callaghan, NSW, Australia
| |
Collapse
|
50
|
Wang Q, Lee RLT, Hunter S, Chan SWC. The effectiveness of internet-based telerehabilitation among patients after total joint arthroplasty: An integrative review. Int J Nurs Stud 2020; 115:103845. [PMID: 33360248 DOI: 10.1016/j.ijnurstu.2020.103845] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 09/18/2020] [Accepted: 11/19/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Total joint arthroplasty is one of the most commonly performed orthopaedic procedures globally. Telerehabilitation has recently been used as a supplement or an alternative to face-to-face rehabilitation services among patients after total joint arthroplasty. OBJECTIVES To synthesise the evidence on the effectiveness of internet-based telerehabilitation regarding pain relief, range of motion, physical function, health-related quality of life, self-efficacy, psychological well-being/problems, and satisfaction among patients after total joint arthroplasty. METHODS An integrative review was conducted using defined search periods, databases, and search terms. This review adopted a five-stage approach: problem identification, literature search, data evaluation, data analysis and presentation. Studies published in English and Chinese were included. The Mixed Methods Appraisal Tool was used to assess the quality of included studies. RESULTS Twenty-two eligible studies with 1,179 participants were included in this review. Nineteen of them were conducted in North America, Europe and Australia, and three in China. There were 20 quantitative and two qualitative studies. Synchronous mode using videoconferencing (n = 11) was predominant in the studies between 2003 and 2017, while asynchronous mode using mobile apps (n = 7) has become the main mode since 2017. Internet-based telerehabilitation was delivered by physiotherapists in 17 studies and by nurses in three. Most of the included studies reported that, compared to face-to-face rehabilitation, internet-based telerehabilitation showed a comparable improvement in pain relief, range of motion, physical function, and health-related quality of life. Patients had a high satisfaction level. Very few studies addressed the patients' psychological well-being/problems and self-efficacy as the outcome measures. CONCLUSIONS Internet-based telerehabilitation appears to be effective for and accepted by patients after total joint arthroplasty. Telerehabilitation could be delivered by nurses in collaboration with physiotherapists and surgeons as a team. The mobile app is an accessible and flexible delivery medium for telerehabilitation. Robust randomised controlled trials are warranted to enhance the quality of evidence on the effectiveness of mobile app-based telerehabilitation and nurse-delivered program. Qualitative components are suggested to be included in future research. Psychological outcomes should also be measured.
Collapse
Affiliation(s)
- Qingling Wang
- School of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China; School of Nursing and Midwifery, the University of Newcastle, Callaghan, New South Wales, Australia.
| | - Regina Lai Tong Lee
- School of Nursing and Midwifery, the University of Newcastle, Callaghan, New South Wales, Australia.
| | - Sharyn Hunter
- School of Nursing and Midwifery, the University of Newcastle, Callaghan, New South Wales, Australia.
| | - Sally Wai-Chi Chan
- University of Newcastle Singapore Campus, the University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Brain and Mental Health, the University of Newcastle, Callaghan, New South Wales, Australia.
| |
Collapse
|