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Su WC, Cleffi C, Srinivasan S, Bhat AN. Does Delivery Format Matter? A Pilot Study Comparing Telehealth Versus Face-to-Face Movement Interventions for Children With Autism Spectrum Disorder. Pediatr Phys Ther 2024:00001577-990000000-00102. [PMID: 39073049 DOI: 10.1097/pep.0000000000001131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
PURPOSE Children with Autism Spectrum Disorder (ASD) have motor, social communication, and behavioral challenges. During the pandemic, children lost access to face-to-face (F2F) services and had to revert to telehealth (TH) options. We compared the efficacy, fidelity, acceptability, and feasibility of a general motor (GM) intervention using an F2F or telehealth (TH) format. METHODS Fifteen children with ASD participated in an 8-week program involving gross motor games to promote motor and social communication skills. Differences across TH and F2F formats for motor and socially directed verbalization as well as stakeholder feedback on formats were collected. RESULTS Gross motor and socially directed verbalization did not differ between the F2F and TH subgroups, and parents and trainers were satisfied with either format. However, TH interventions were longer, had more technological challenges, and required more parental effort. CONCLUSIONS The findings of this study support the use of TH as a comparable and viable substitute for F2F interactions for children with ASD.
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Affiliation(s)
- Wan-Chun Su
- Department of Physical Therapy (Dr Su, Ms Cleffi, and Dr Bhat), Biomechanics & Movement Science Program (Dr Su, Ms Cleffi, and Dr Bhat), Department of Psychological & Brain Sciences (Dr Bhat), University of Delaware, Newark, Delaware; and Physical Therapy Program, Department of Kinesiology (Dr Srinivasan), Institute for Health, Intervention, and Policy (Dr Srinivasan), Connecticut Institute for the Brain and Cognitive Sciences (Dr Srinivasan), , University of Connecticut, Storrs, Connecticut
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Hurtubise K, Phoenix M, Camden C, Gauthier R, Stratford P, Dostie R, Beaudoin AJ, Maltais D, Berbari J, Gaboury I. The Development and Pilot Testing of a Fidelity Checklist for a Family-Centered Telehealth Intervention for Parents of Children with Motor Delay. Int J Telerehabil 2024; 16:e6603. [PMID: 39022432 PMCID: PMC11249651 DOI: 10.5195/ijt.2024.6603] [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: 07/20/2024] Open
Abstract
This multi-methods study describes the development of a pediatric rehabilitation telehealth intervention fidelity checklist, estimates its inter-rater reliability, and documents raters' implementation experience. A literature scan and expert consultation identified eighteen key behaviors and categorized them into three subdomains, measured using a 5-point measurement system. To estimate the checklist's inter-rater reliability, three raters scored 33 video recordings. A Shrout and Fleiss Class 1,1 intraclass correlation (ICC)) and 95% confidence intervals (CI) calculated ICCs = 0.5 (CI: 0, 0.9) for both the Therapist and the Parent-Therapists subdomains, and the Parent subdomain an ICC = 0.3 (CI: 0, 0.8). In the implementation surveys, raters reported high levels of satisfaction (100%), ease of use (84% to 88%), and confidence in their video ratings (87% to 100%). Changes in procedures and scoring were recommended. Capturing raters' implementation experiences is crucial in the early evaluation of the fidelity checklists for telehealth.
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Affiliation(s)
- Karen Hurtubise
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Faculté de Médicine et Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Michelle Phoenix
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Chantal Camden
- Faculté de Médicine et Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Raphaëlle Gauthier
- Faculté de Médicine et Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Paul Stratford
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Rosalie Dostie
- Faculté de Médicine et Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Audrée Jeanne Beaudoin
- Faculté de Médicine et Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Désirée Maltais
- École de sciences de réadaptation, Faculté de Médecine, Université Laval, Québec, Québec, Canada
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Québec, Québec, Canada
| | - Jade Berbari
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Isabelle Gaboury
- Faculté de Médicine et Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
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Lindsay S, Ragunathan S, Kingsnorth S, Zhou C, Kakonge L, Cermak C, Hickling A, Wright FV. Understanding the benefits and challenges of outpatient virtual care during the COVID-19 pandemic in a Canadian pediatric rehabilitation hospital. Disabil Rehabil 2024; 46:2396-2404. [PMID: 37306595 DOI: 10.1080/09638288.2023.2221902] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/01/2023] [Indexed: 06/13/2023]
Abstract
PURPOSE The evolving virtual health care experience highlights the potential of technology to serve as a way to enhance care. Having virtual options for assessment, consultation and intervention were essential during the coronavirus (COVID-19) pandemic, especially for children with disabilities and their families. The purpose of our study was to describe the benefits and challenges of outpatient virtual care during the pandemic within pediatric rehabilitation. METHODS This qualitative study, part of a larger mixed methods project, involved in-depth interviews with 17 participants (10 parents, 2 youth, 5 clinicians) from a Canadian pediatric rehabilitation hospital. We analyzed the data using a thematic approach. RESULTS Our findings demonstrated three main themes: (1) benefits of virtual care (e.g., continuity of care, convenience, stress reduction and flexibility, and comfort within the home environment and enhanced rapport); (2) challenges related to virtual care (e.g., technical difficulties and lack of technology, environmental distractions and constraints, communication difficulty, and health impacts); and (3) advice for the future of virtual care (i.e., offering choice to families, enhanced communication and addressing health equity issues). CONCLUSIONS Clinicians and hospital leaders should consider addressing the modifiable barriers in accessing and delivering virtual care to optimize its effectiveness.
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Affiliation(s)
- Sally Lindsay
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | | | - Shauna Kingsnorth
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Chuanlin Zhou
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Lisa Kakonge
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Department of Speech-Language Pathology, University of Toronto, Toronto, Canada
- School of Rehabilitation Science, McMaster University, Toronto, Canada
| | - Carly Cermak
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Andrea Hickling
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - F Virginia Wright
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Canada
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Ambrosino C, Beharry K, Kallem M, Johnson SB, Connor KA, Collins ME. Maryland School Health partners' Perspectives on the Impact of COVID-19 on School Health Services for Grades K-12. THE JOURNAL OF SCHOOL HEALTH 2024; 94:529-538. [PMID: 38594811 DOI: 10.1111/josh.13453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 02/29/2024] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND The COVID-19 pandemic disrupted routine school operations, including school health programs. This study aims to describe the pandemic's impact on school health service delivery from the perspective of Maryland school health partners. METHODS We conducted semi-structured interviews with health service representatives from public schools (K-12) between July and December 2021. Interviews were recorded, transcribed, and coded through an iterative process to develop analytic themes. RESULTS Twenty school health partners from 15 Maryland school districts participated. Participants identified key impacts of COVID-19 on school health: (1) COVID-19 disrupted delivery of services such as dental, mental health, and preventative care, (2) COVID-19 necessitated changes in service delivery platforms, (3) COVID-19 affected school health staff through increased responsibilities and staffing shortages, and (4) COVID-19 prompted schools to become hubs for community outreach and health education. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Consideration of school health service disruptions and the increased demands on service providers may inform future priorities for school administrators, health departments, and policymakers. CONCLUSIONS COVID-19 impacted the timing and method of service delivery as well as the roles of school health staff and schools themselves in public health and education.
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Affiliation(s)
| | - Kelly Beharry
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Medha Kallem
- Johns Hopkins School of Education, Baltimore, MD, USA
| | - Sara B Johnson
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Katherine A Connor
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Megan E Collins
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD; Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
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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).
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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
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Pozniak K, Rosenbaum P, Kwok EYL. Tasks performed by parents to enable telepractice for children with communication disorders: an interview study with clinicians and parents. Disabil Rehabil 2024; 46:1547-1558. [PMID: 37078372 DOI: 10.1080/09638288.2023.2201509] [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: 07/20/2022] [Accepted: 04/04/2023] [Indexed: 04/21/2023]
Abstract
PURPOSE Current service models in childhood rehabilitation promote the active participation of parents/caregivers in their children's therapies. The existing literature provides a limited understanding of the tasks and responsibilities parents undertake in their children's therapies, especially over telepractice. This study describes the tasks undertaken by parents in their children's speech therapy delivered virtually during the COVID-19 pandemic. METHODS A qualitative descriptive study was conducted with parents and speech-language pathologists, using open-ended interviews. Interviews were analyzed using a combination qualitative content analysis and thematic analysis. RESULTS Parents performed many tasks to enable telepractice. These tasks happened before (e.g., setting up both physical and virtual space for therapy), during (e.g., managing child's behavior), and after the virtual therapy session (e.g., carrying out home practice). While parents were willing to perform these tasks in order to help their children, some expressed the toll that it can take on them. CONCLUSIONS Compared to what is known from in-person visits, some of these tasks were novel and unique to telepractice. We recommend that clinicians and parents collaboratively decide on tasks and responsibilities to avoid burdening parents, and that they weigh the costs associated with performing these tasks against the benefits of teletherapy.IMPLICATIONS FOR REHABILITATIONParents perform many tasks to support their children's therapies, both during and outside of therapy sessionsTherapies delivered virtually require parents to assume additional tasks to support their childrenFor services to be Family-Centered, tasks and responsibilities need to be decided collaboratively between parents and clinicians.
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Affiliation(s)
- Kinga Pozniak
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Elaine Yuen Ling Kwok
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
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Lee HM, Mercimek-Andrews S, Horvath G, Marchese D, Poulin RE, Krolick A, Tierney KL, Turna J, Wei J, Hwu WL. A position statement on the post gene-therapy rehabilitation of aromatic I-amino acid decarboxylase deficiency patients. Orphanet J Rare Dis 2024; 19:17. [PMID: 38238766 PMCID: PMC10797739 DOI: 10.1186/s13023-024-03019-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/11/2024] [Indexed: 01/22/2024] Open
Abstract
Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare genetic disorder of monoamine neurotransmitter synthesis that presents with a range of symptoms, including motor dysfunction and limited attainment of developmental motor milestones. The approval of eladocagene exuparvovec, a gene therapy for AADC deficiency with demonstrated efficacy for motor improvements, now expands the range of motor outcomes possible for patients with this disorder. However, recommendations and guidelines for therapy following treatment with gene therapy are lacking. To ensure patients can reach their full potential following treatment with gene therapy, it is essential they receive rehabilitation therapies designed specifically with their impairments and goals in mind. Therefore, we highlight specific rehabilitative needs of patients following gene therapy and propose a set of recommendations for the post-treatment period based on collective experiences of therapists, physicians, and caregivers treating and caring for patients with AADC deficiency who have been treated with gene therapy. These recommendations include a focus on periods of intensive therapy, facilitating active movements, training for functional abilities, cognitive and communication training, parent/caregiver empowerment, collaboration between therapists and caregivers to develop in-home programs, and the incorporation of supplemental forms of therapy that patients and their families may find more enjoyable and engaging. Many of these rehabilitative strategies may be employed prior to gene therapy. However, these recommendations will be valuable for therapists, caregivers, and wider treatment teams as they prepare for the post-treatment journey with these patients. Furthermore, the considerations and recommendations presented here may prove beneficial outside the AADC deficiency community as gene therapies and other treatments are developed and approved for other rare diseases.
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Affiliation(s)
- Hui-Min Lee
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 8, Chung-Shan South Road, Taipei, 100226, Taiwan
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Linong St. Beitou Dist, No. 155, Sec. 2, Taipei, 112304, Taiwan
| | - Saadet Mercimek-Andrews
- Department of Medical Genetics, University of Alberta, 8613 114 Street, Edmonton, AB, T6G 2H7, Canada
| | - Gabriella Horvath
- Division of Biochemical Genetics, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Diana Marchese
- Department of Pediatric Rehabilitation, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA
- Department of Pediatrics, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO, 64108, USA
| | - Richard E Poulin
- Thai-Chinese International School, 101/177 Moo 7 Soi Mooban Bangpleenives, Prasertsin Road, Bangplee Yai, Samut Prakan, 10540, Thailand
| | - Alexis Krolick
- PTC Therapeutics Inc, 100 Corporate Ct #2400, South Plainfield, NJ, 07080, USA
| | - Kati-Lyn Tierney
- Texas Children's Hospital, 6621 Fannin Street, Houston, TX, 77030, USA
| | - Jasmine Turna
- PTC Therapeutics Inc, 100 Corporate Ct #2400, South Plainfield, NJ, 07080, USA
| | - Judy Wei
- Ruamrudee International School, 6 Soi Ramkhamhaeng 184, Khwaeng Min Buri, Min Buri, Bangkok, 10510, Thailand
| | - Wuh-Liang Hwu
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 8, Chung-Shan South Road, Taipei, 100226, Taiwan.
- Center for Precision Medicine, China Medical University Hospital, 2 Yude Road, 404, Taichung City, Taiwan.
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McKenzie C, Titzer M, Hutchinson A, Dodge C, Fergus A. Analysis of a model for pediatric physical therapy and clinical education via telehealth. J Pediatr Rehabil Med 2024; 17:271-288. [PMID: 38457162 PMCID: PMC11307064 DOI: 10.3233/prm-220112] [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: 12/01/2022] [Accepted: 10/23/2023] [Indexed: 03/09/2024] Open
Abstract
A novel entry-level collaborative clinical learning experience (CLE) in pediatric physical therapy (PT) delivered via telehealth was implemented involving 12 families, 54 DPT students, and 12 clinical instructors (CIs). Children of various ages, a wide range of home environments, and diagnoses received individualized PT via telehealth during a four-week CLE. Retrospective quantitative and qualitative analyses of student documentation, video recordings of sessions, and CI, student, and caregiver survey responses were performed. All children demonstrated qualitative improvements and 73% demonstrated quantitative improvements. CIs, students, and caregivers believed the children benefited from the experience and 98% believed the children were able to work toward their goals. Most students (95%) and CIs (100%) felt that it was a valuable and effective learning experience. Most (>71%) CIs and students believed students were able to learn in all relevant domains of the clinical performance instrument. This model provides a unique CLE for students in both pediatric PT and telehealth.
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Affiliation(s)
- Courtney McKenzie
- Division of Physical Therapy, Shenandoah University, Winchester, VA, USA
| | - Melanie Titzer
- Division of Physical Therapy, Shenandoah University, Winchester, VA, USA
| | - Alyssa Hutchinson
- Division of Physical Therapy, Shenandoah University, Winchester, VA, USA
| | - Camaran Dodge
- Division of Physical Therapy, Shenandoah University, Winchester, VA, USA
| | - Andrea Fergus
- Division of Physical Therapy, Shenandoah University, Winchester, VA, USA
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Hawley-Hague H, Lasrado R, Martinez E, Stanmore E, Tyson S. A scoping review of the feasibility, acceptability, and effects of physiotherapy delivered remotely. Disabil Rehabil 2023; 45:3961-3977. [PMID: 36325612 DOI: 10.1080/09638288.2022.2138574] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 10/10/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE To review the feasibility, acceptability, and effects of physiotherapy when delivered remotely. MATERIALS AND METHODS CINAHL, MEDLINE, EBM Reviews, and Cochrane Library databases (January 2015-February 2022) were searched and screened for papers (of any design) investigating remote physiotherapy. Data were extracted by two independent raters. Methodological quality of the identified papers was not assessed. Thematic content analysis drew out the key issues. RESULTS Forty-one papers (including nine systemic reviews and six with meta-analyses) were selected involving musculoskeletal, stroke and neurological, pulmonary, and cardiac conditions. The most commonly delivered intervention was remote exercise provision, usually following assessment which was completed in-person. All studies, which assessed it, found that remote physiotherapy was comparably effective to in-person delivery at lower cost. Patient satisfaction was high, they found remote physiotherapy to be more accessible and convenient. It boosted confidence and motivation by reminding patients when and how to exercise but adherence was mixed. No adverse events were reported. Barriers related to access to the technology; technical problems and concerns about therapists' workload. CONCLUSIONS Remote physiotherapy is safe, feasible, and acceptable to patients. Its effects are comparable with traditional care at lower cost.IMPLICATIONS FOR REHABILITATIONRemote physiotherapy is safe, feasible, and acceptable to patients with comparable effects to in-person care.Remote delivery increases access to physiotherapy especially for those who cannot travel to a treatment facility whether due to distance or disability.Remote physiotherapy may increase adherence to exercise by reminding patients when and how to exercise.Remote physiotherapy does not suit everyone, thus a hybrid system with both in-person and remote delivery may be most effective.
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Affiliation(s)
- Helen Hawley-Hague
- School of Health Sciences and Manchester Academic Health Science Centre (MAHSC), Jean McFarlane Building, University Place, University of Manchester, Manchester, UK
| | - Reena Lasrado
- School of Health Sciences and Manchester Academic Health Science Centre (MAHSC), Jean McFarlane Building, University Place, University of Manchester, Manchester, UK
| | - Ellen Martinez
- School of Health Sciences and Manchester Academic Health Science Centre (MAHSC), Jean McFarlane Building, University Place, University of Manchester, Manchester, UK
- Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Emma Stanmore
- School of Health Sciences and Manchester Academic Health Science Centre (MAHSC), Jean McFarlane Building, University Place, University of Manchester, Manchester, UK
- Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Sarah Tyson
- School of Health Sciences and Manchester Academic Health Science Centre (MAHSC), Jean McFarlane Building, University Place, University of Manchester, Manchester, UK
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Brown SE, Miller M, Darring J, Inamdar K, Salgaonkar A, Burnsed JC, Stevenson RD, Shall MS, Harper AD, Hendricks-Munoz KD, Thacker LR, Hyde M, Dusing SC. Impact of the COVID-19 Pandemic on a Clinical Trial: A Quantitative Report on Study Engagement and Strategies. Pediatr Phys Ther 2023; 35:439-448. [PMID: 37490303 PMCID: PMC10527461 DOI: 10.1097/pep.0000000000001036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
INTRODUCTION The COVID-19 pandemic impacted clinical research worldwide potentially altering research findings. The study purpose was to measure the effect of the pandemic on recruitment, retention, assessment, and intervention completion rates. METHODS Enrollment and participation data from a clinical trial evaluating efficacy of a physical therapy intervention for high-risk preterm infants were compared across 3 pandemic periods (February 2019 through November 2021). RESULTS Recruitment, retention, assessment, and intervention completion rates were lowest during the peak pandemic period. CONCLUSIONS In compliance with the Human Subjects Review Board, and for the participants' and staff safety, transition from in-person to telehealth or hybrid visits was required to continue this longitudinal study. Despite the negative effect of the pandemic, parental resilience and commitment to the study was clear. Flexibility, quick action, dedication, and efficiency of the research team were key elements enabling study continuation with successful transition to telehealth assessments/interventions during the peak pandemic period.
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Affiliation(s)
- Shaaron E Brown
- Departments of Physical Therapy (Drs Brown and Shall and Ms Miller) and Neurology (Dr Harper), Virginia Commonwealth University, Richmond, Virginia; Rehabilitation and Movement Science Program (Dr Brown and Ms Inamdar), Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia; University of Virginia Children's Hospital (Ms Darring and Dr Hyde), Charlottesville, Virginia; Division of Physical Therapy (Dr Inamdar), School of Medicine, West Virginia University, Morgantown, West Virginia; Division of Biokinesiology and Physical Therapy (Ms Salgaonkar and Dr Dusing), University of Southern California, Los Angeles, California; Division of Neonatology (Dr Burnsed), University of Virginia, Charlottesville, Virginia; Neuro-Developmental and Behavioral Pediatrics (Dr Stevenson), University of Virginia School of Medicine, Charlottesville, Virginia; Division of Neonatal Medicine (Dr Hendricks-Munoz), Department of Pediatrics, Children's Hospital of Richmond of VCU, Virginia Commonwealth University School of Medicine, and VCU Center on Health Disparities, Virginia Commonwealth University, Richmond, Virginia; Department of Biostatistics (Dr Thacker), School of Medicine, Virginia Commonwealth University, Richmond, Virginia
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King N, Wiley M, Rose A, Fergus A. Delivery of School-based Physical Therapy via Telehealth: Perceptions and Attitudes of School-based Physical Therapists. Phys Occup Ther Pediatr 2023; 44:180-197. [PMID: 38410919 DOI: 10.1080/01942638.2023.2228898] [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: 11/24/2022] [Accepted: 06/15/2023] [Indexed: 02/28/2024]
Abstract
AIMS School-based physical therapists (SBPTs) rapidly transitioned to telehealth during the pandemic. This study explored the perceptions of, and strategies utilized by, SBPTs delivering therapy via telehealth. METHODS Using a grounded theory qualitative design, semi-structured interviews were completed with 13 SBPTs. Interviews were transcribed and theme coded until saturation was achieved. RESULTS The following themes emerged: supports and education, challenges, strategies promoting success, and the outcomes of telehealth. SBPTs overcame challenges including those associated with technology, communication, space, equipment, and examination. Coaching techniques, incorporation into the daily routine, and the sharing of demonstrations promoted success. Telehealth service delivery was perceived to improve communication with educational teams and families, improve efficiency and productivity, increase access to students, promote an appreciation of the family and home context, and enhance family engagement. SBPTs believe incorporating elements of telehealth in conjunction with in-person delivery is ideal. CONCLUSIONS While the COVID-19 pandemic forced a rapid transition to telehealth for SBPTs, lessons learned could have a long-lasting positive impact on school-based services. The benefits of telehealth should be considered in the delivery of school-based physical therapy services.
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Affiliation(s)
- Natalie King
- Division of Physical Therapy, Shenandoah University, Winchester, VA, USA
| | - Michele Wiley
- Division of Physical Therapy, Shenandoah University, Winchester, VA, USA
| | - Alexa Rose
- Division of Physical Therapy, Shenandoah University, Winchester, VA, USA
| | - Andrea Fergus
- Division of Physical Therapy, Shenandoah University, Winchester, VA, USA
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12
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Rettinger L, Kuhn S. Barriers to Video Call-Based Telehealth in Allied Health Professions and Nursing: Scoping Review and Mapping Process. J Med Internet Res 2023; 25:e46715. [PMID: 37526957 PMCID: PMC10427933 DOI: 10.2196/46715] [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: 02/24/2023] [Revised: 05/01/2023] [Accepted: 05/17/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Telehealth interventions have become increasingly important in health care provision, particularly during the COVID-19 pandemic. Video calls have emerged as a popular and effective method for delivering telehealth services; however, barriers limit the adoption among allied health professionals and nurses. OBJECTIVE This review aimed to identify and map the perceived barriers to the use of video call-based telehealth interventions among allied health professionals and nurses. METHODS A comprehensive literature search was conducted in the PubMed and CINAHL databases on June 22, 2022, and updated on January 3, 2023, following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Only original studies published in English or German since June 2017 that reported barriers to the use of video call-based telehealth interventions were eligible for inclusion. The studies had to involve interviews, focus groups, or questionnaires with physical therapists, occupational therapists, speech and language therapists, audiologists, orthoptists, dieticians, midwives, or nurses. Each publication was coded for basic characteristics, including country, health profession, and target group. Inductive coding was used to identify the patterns, themes, and categories in the data. Individual codings were analyzed and summarized narratively, with similarities and differences in barriers identified across health professions and target groups. RESULTS A total of 56 publications were included in the review, with barriers identified and categorized into 8 main categories and 23 subcategories. The studies were conducted in various countries, predominantly the United States, Australia, the United Kingdom, Canada, Israel, and India. Questionnaires were the most commonly used evaluation method, with 10,245 health professionals involved. Interviews or focus groups were conducted with 288 health professionals. Most of the included publications focused on specific health care professions, with the highest number addressing barriers for physical therapists, speech and language therapists, and audiologists. The barriers were related to technology issues, practice issues, patient issues, environmental issues, attributions, interpersonal issues, policies and regulations, and administration issues. The most reported barriers included the lack of hands-on experience, unreliable network connection, the lack of technology access, diminished fidelity of observations and poor conditions for visual instructions, the lack of technology skills, and diminished client-practitioner interaction and communication. CONCLUSIONS This review identified key barriers to video call-based telehealth use by allied health professionals and nurses, which can foster the development of stable infrastructure, education, training, guidelines, policies, and support systems to improve telehealth services. Further research is necessary to identify potential solutions to the identified barriers.
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Affiliation(s)
- Lena Rettinger
- Health Assisting Engineering, FH Campus Wien, University of Applied Sciences, Vienna, Austria
- Institute of Digital Medicine, University Hospital of Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Sebastian Kuhn
- Institute of Digital Medicine, University Hospital of Giessen and Marburg, Philipps University Marburg, Marburg, Germany
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13
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Breeden LE, Tyger HT, Reckers AM, Johnson M, Morales AM, Ober L, Williams MA. An Examination of Occupational Therapy Telehealth Service Delivery Among Novice Users During the COVID-19 Pandemic. Int J Telerehabil 2023; 15:e6544. [PMID: 38046553 PMCID: PMC10687948 DOI: 10.5195/ijt.2023.6544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
The COVID-19 pandemic allowed for widespread implementation of telehealth as a delivery method for occupational therapy (OT) services. The purpose of this study was to investigate the perceptions of novice telehealth OT practitioners regarding telehealth as a delivery method for OT services. Quantitative data was collected through a modified version of the Telehealth Usability Questionnaire and analyzed via descriptive statistics. Qualitative data was collected by open-ended questions and analyzed via thematic analysis. OT practitioners' responses revealed four major themes: logistics of telehealth practice, role of client champions, capacity of the OT practitioner, and styles and approaches. The study revealed that OT sessions delivered via telehealth increased access to clients and continuity of services. Client champion engagement, effective coaching strategies, and practitioner flexibility supported the success of OT telehealth sessions.
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Affiliation(s)
- Lori E Breeden
- University of Indianapolis, School of Occupational Therapy, Indianapolis, Indiana, United States
| | - Hannah T Tyger
- University of Indianapolis, School of Occupational Therapy, Indianapolis, Indiana, United States
| | - Alexandra M Reckers
- University of Indianapolis, School of Occupational Therapy, Indianapolis, Indiana, United States
| | - Megan Johnson
- University of Indianapolis, School of Occupational Therapy, Indianapolis, Indiana, United States
| | - Analicia M Morales
- University of Indianapolis, School of Occupational Therapy, Indianapolis, Indiana, United States
| | - Lauren Ober
- University of Indianapolis, School of Occupational Therapy, Indianapolis, Indiana, United States
| | - Mackenzie A Williams
- University of Indianapolis, School of Occupational Therapy, Indianapolis, Indiana, United States
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14
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Anastasio AT, Tabarestani TQ, Bagheri K, Bethell MA, Prado I, Taylor JR, Adams SB. A New Trend in Social Media and Medicine: The Poor Quality of Videos Related to Ankle Sprain Exercises on TikTok. FOOT & ANKLE ORTHOPAEDICS 2023; 8:24730114231171117. [PMID: 37151477 PMCID: PMC10161314 DOI: 10.1177/24730114231171117] [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: 05/09/2023] Open
Abstract
Background Social media platforms, like TikTok, have become popular options for the distribution of health care information. Because of the lack of scientific oversight, the quality of health care-related videos has become a focus of the current literature. However, orthopaedic surgery has lagged behind other fields in acknowledging the widespread utilization of TikTok videos for medical information consumption. This study aims to assess the quality and educational benefits of ankle sprain-related TikTok videos. Methods TikTok was queried using the hashtag "#anklesprainexercises." One hundred videos were included after applying the exclusion criteria. The number of views, likes, shares, comments, and favorites was recorded. The content was graded using DISCERN (a well-validated informational analysis tool) and ASEES (a self-designed tool for exercise evaluation). We hypothesized that information on TikTok related to ankle sprain exercises would be poor in quality. Results The total number of views of the 100 videos was 6 483 412, with a median of 5377.5 (IQR = 1074-20 275). The videos collectively received 385 847 likes, 3642 comments, 55 574 favorites, and 14 918 shares with a median of 267.5 (IQR = 41.5-1678.0), 4.0 (IQR = 0.0-23.0), 42.0 (IQR = 4.8-264.5), and 13.0 (IQR = 1.8-67.8), respectively. General users had a higher percentage of their videos graded as "very poor" (61.8%) in comparison to the number of videos uploaded by health care professionals deemed "very poor" (34.4%). Neither general user nor health care professionals had videos graded as "good" or "excellent." There were significant differences between the 2 groups for DISCERN 1, 3, and ASSES scores. Conclusion Although TikTok is a powerful tool for information distribution, the educational value of the videos related to ankle sprain injury exercises was poor. With only 2% of videos receiving a grade of "fair," and no videos reaching a score of "good" or "excellent," health care professionals should be aware of the low-quality content easily accessible on TikTok. Level of Evidence Level III, cross-sectional study.
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Affiliation(s)
- Albert T. Anastasio
- Department of Orthopedic Surgery, Duke University Hospital, Durham, NC, USA
- Albert T. Anastasio, MD, Department of Orthopedic Surgery, Duke University Hospital, 200 Trent Drive, Durham, NC 27710, USA.
| | | | - Kian Bagheri
- Campbell University School of Osteopathic Medicine, Lillington, NC, USA
| | | | - Isabel Prado
- Duke University School of Medicine, Durham, NC, USA
| | | | - Samuel B. Adams
- Department of Orthopedic Surgery, Duke University Hospital, Durham, NC, USA
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15
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Kodjebacheva GD, Culinski T, Kawser B, Coffer K. Satisfaction with telehealth compared to non-telehealth services among pediatric patients and their caregivers: A systematic review of the literature. JMIR Pediatr Parent 2023; 6:e41554. [PMID: 37000504 PMCID: PMC10176140 DOI: 10.2196/41554] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/10/2022] [Accepted: 03/27/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Telehealth is the use of technology to deliver healthcare in a virtual format. The COVID-19 pandemic prompted an increase in the use of telehealth. OBJECTIVE To review satisfaction with pediatric care only in studies that have at least one group of pediatric patients and/or their caregivers receiving telehealth during the COVID-19 pandemic and at least one comparison group of those receiving non-telehealth services. METHODS We searched for peer-reviewed studies published in English that compared satisfaction with pediatric care between pediatric patients and/or their caregivers receiving telehealth services during the COVID-19 pandemic and those receiving non-telehealth services. Because of stay-at-home orders, studies with comparison groups for non-telehealth services that took place either before or during the pandemic were eligible. We conducted the search on January 5, 2023, in the PubMed, EMBASE, CINAHL, and PsycInfo databases. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two reviewers independently screened titles and abstracts prior to reviewing the full-text of remaining articles. The following information from each eligible study was extracted: country, participant characteristics by comparison group, study design, telehealth approach, measurement tools to assess satisfaction, and findings by comparison group. RESULTS All eligible 14 studies assessed satisfaction among caregivers and/or pediatric patients participating in video and/or telephone visits during the COVID-19 pandemic compared to those having in-person appointments either prior to or during the pandemic. In 5 of the 14 studies, comparison non-telehealth services took place before the pandemic, and in the remaining 9 investigations, non-telehealth services took place during the pandemic. Thirteen studies were observational investigations with different designs and one study was a quasi-experimental intervention with 3 comparison groups for video, in-person, and hybrid visits. In 9 out of the 14 studies, satisfaction with telehealth services was higher compared to that during in-person visits. Reasons caregivers were satisfied with video visits were the ease of use and the reduced need for transportation. Reasons caregivers were not satisfied with remote care included limited personal interaction with the provider and technological challenges. Caregivers participating in telehealth expressed concerns about the lack of a physical examination. Those participating in non-telehealth services expressed that in-person interactions promoted treatment adherence. Only 1 study assessed satisfaction among patients where adolescents completed their own surveys; a higher percentage of adolescents using telehealth reported effective communication with the provider compared to patients using in-person visits. CONCLUSIONS Telehealth services tended to receive more favorable or comparable satisfaction ratings than in-person visits in most studies. Needed improvements in telehealth included strategies to address technological challenges and develop better rapport between the patient/caregiver and medical provider. Interventions on the effectiveness of pediatric telehealth compared to pediatric non-telehealth services on improving satisfaction and health outcomes will be valuable. CLINICALTRIAL
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Affiliation(s)
- Gergana Damianova Kodjebacheva
- Department of Public Health and Health Sciences, College of Health Sciences, University of Michigan-Flint, 303 E. Kearsley St., Flint, US
- International Institute, University of Michigan, Ann Arbor, US
| | - Taylor Culinski
- Department of Behavioral Sciences, College of Arts and Sciences, University of Michigan-Flint, Fint, US
| | - Bushra Kawser
- Department of Public Health and Health Sciences, College of Health Sciences, University of Michigan-Flint, 303 E. Kearsley St., Flint, US
| | - Katelynn Coffer
- Department of Public Health and Health Sciences, College of Health Sciences, University of Michigan-Flint, 303 E. Kearsley St., Flint, US
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16
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Govender S, Vallabhjee AL, Charles CR, Roesch D, Balton S. Bridging the Access Gap: The Telepractice Experience of Speech Therapists and Audiologists at a Public Health Care Facility in South Africa. Int J Telerehabil 2022; 14:e6517. [PMID: 38026559 PMCID: PMC10681049 DOI: 10.5195/ijt.2022.6517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
South Africa is a low to middle income country (LMIC) with a population of 60 million people. The public health sector serves more than 80% of the population. Chris Hani Baragwanath Academic Hospital is a central level public health care facility situated in Gauteng. The Speech Therapy and Audiology Department provides insight into their telepractice services through a qualitative approach. The onset of the COVID-19 pandemic resulted in therapists exploring telepractice as a sustainable model of service delivery. Therapists and patients encountered many challenges to the implementation of telepractice, however, the commitment of therapists ensured that creative solutions were developed. A comprehensive needs analysis at public health institutions is required to ensure the sustainability of telepractice. A hybrid model (telepractice and in-person consults) holds the potential to reduce the financial burden on patients and increase access to quality patient-centered care.
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Affiliation(s)
- Shelissa Govender
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Annika L. Vallabhjee
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Chenay R. Charles
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Darike Roesch
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Sadna Balton
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
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17
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Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: Professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract 2022; 62:102684. [PMID: 36356408 PMCID: PMC9617680 DOI: 10.1016/j.msksp.2022.102684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Despite being the most prevalent physical therapy practice setting in the United States, no literature to date has examined the professional and ethical issues faced by outpatient physical therapists during the COVID-19 pandemic. The purpose of this study was to explore professional and ethical issues experienced by outpatient physical therapists in the United States during the COVID-19 pandemic. DESIGN An explorative semi-structured interview study using reflexive thematic analysis METHODS: Virtual semi-structured interviews explored physical therapists' experiences during COVID-19 in the OP setting. Data was analyzed using reflexive thematic analysis as described by Braun and Clarke. RESULTS Respondents worked predominantly with patients with orthopaedic impairments. Six primary themes and associated subthemes were identified: 1) Disruption of routine professional and personal life. 2) Negative impacts on health and wellbeing (physical, mental, and social). 3) Barriers to relationships, communication, and providing quality care. 4) Telehealth as a safe option to increase access with opportunities and challenges. 5) Discomfort practicing in an environment of misinformation, mistrust, and divisiveness. 6) New & pre-existing ethical issues in the COVID-19 context. CONCLUSIONS Results of this study indicate that physical therapists in the outpatient setting wrestled with critical questions regarding outpatient physical therapy practice during the COVID-19 pandemic: the role of touch in professional identity, challenges to the therapeutic alliance, effect of productivity and fiscal expectations and whether outpatient physical therapy is essential during public emergencies.
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Affiliation(s)
- Rebecca Edgeworth Ditwiler
- School of Physical Therapy and Rehabilitation Sciences, University of South Florida, USF Health Morsani College of Medicine, Tampa, FL, USA.
| | - Laura Lee Swisher
- School of Physical Therapy and Rehabilitation Sciences, University of South Florida, USF Health Morsani College of Medicine, Tampa, FL, USA
| | - Dustin Dean Hardwick
- School of Physical Therapy and Rehabilitation Sciences, University of South Florida, USF Health Morsani College of Medicine, Tampa, FL, USA,School of Physical Therapy, University of the Incarnate Word, San Antonio, TX, USA
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18
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Pediatric Physical Therapists' Perceptions of Telehealth Continuation Post-pandemic: A Thematic Analysis of Open-Ended Survey Responses. Pediatr Phys Ther 2022; 34:353-360. [PMID: 35639553 DOI: 10.1097/pep.0000000000000908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To explore pediatric physical therapists' (PTs) perceptions about continuing telehealth services post-pandemic. METHODS Two open-ended questions from a larger survey were analyzed using a pragmatic application of thematic analysis. RESULTS Two hundred two pediatric PTs in the United States responded. Themes included Telehealth During COVID-19, Benefits, Drawbacks , and Recommendations . Telehealth During COVID-19 acknowledged adopting and providing telehealth during a global pandemic was likely different than at other times. Benefits described perceived positive aspects of telehealth for children, families, and PTs, which support continuation of telehealth post-pandemic. Drawbacks described perceived negative aspects of telehealth for children, families, and PTs, which may dissuade continuation. Recommendations described respondents' recommendations for the continuation of telehealth. Ultimately respondents recommended a hybrid model of telehealth and in-person services going forward. CONCLUSIONS A hybrid model of telehealth and in-person services may have the benefits of increasing access, flexibility, efficiency, communication, and home programming across pediatric practice settings.
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19
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Commentary on "Using Telehealth to Conduct Family-Centered, Movement Intervention Research in Children With Autism Spectrum Disorder During the COVID-19 Pandemic". Pediatr Phys Ther 2022; 34:252. [PMID: 35385462 DOI: 10.1097/pep.0000000000000890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Jaramillo T, Scalise G, Nesbit KC. Learning activities without patient interactions can achieve pediatric curricular objectives for adult learners. Physiother Theory Pract 2022:1-14. [PMID: 35354360 DOI: 10.1080/09593985.2022.2057884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The literature is lacking in studies about what specific types of learning activities are most effective for adult learners. PURPOSE To examine the effectiveness of a learning activity with patient interactions as compared to a learning activity without patient interactions. METHODS A convenience sample of third year Doctor of Physical Therapy students participated in this retrospective cross-sectional study (n = 47). Data were a clinical reasoning assignment, the Andragogy in Practice Inventory (API) and Intent to Use Scale, and the Behavioral Engagement Related to Instruction (BERI) protocol. Data analysis included descriptive frequencies, paired t-tests, Wilcoxon Signed Rank Tests and Multivariate Analysis of Variance. RESULTS Significant differences were noted between the learning activity with and the learning activity without patient interaction on several API subscales: prepare the learner, climate setting, setting of objectives and learning activities as well as in the conceptual reasoning area of the clinical reasoning assignment (p = .005, p = .036, p = .002, p = .047, and p = .038, respectively). No other significant differences were noted in other outcome variables. No significant influence of age or gender was found. CONCLUSION This study demonstrated that, overall, both the with and without patient interaction learning activities were compatible with the preferences of the adult learner.
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Affiliation(s)
- Theresa Jaramillo
- UCSF/SFSU Graduate Program in Physical Therapy, San Francisco, CA, USA
| | | | - Kathryn C Nesbit
- UCSF/SFSU Graduate Program in Physical Therapy, San Francisco, CA, USA
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21
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Kaur M, Eddy EZ, Tiwari D. Exploring Practice Patterns of Pediatric Telerehabilitation During COVID-19: A Survey Study. Telemed J E Health 2022; 28:1505-1516. [PMID: 35263191 PMCID: PMC9618374 DOI: 10.1089/tmj.2021.0506] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background and Objective: Sudden transition to telerehabilitation during the coronavirus disease 2019 (COVID-19) pandemic was challenging for pediatric therapists, including physical therapists and occupational therapists, due to lack of prior experience and knowledge. The primary goal of the current study was to survey the pediatric therapists regarding the practice trends and specific challenges/strengths of delivering telerehabilitation during the pandemic. Materials and Methods: An electronic survey was developed by the research term and validated through cognitive interviews with three pediatric therapists. A total of 107 therapists completed the survey. Descriptive statistics were used to summarize the trends for the survey questions. Results: The majority of therapists (92.5%) reported no prior experience with telerehabilitation. When comparing telerehabilitation with standard-of-care, the therapists reported similar session durations and frequencies, but greater caregiver-initiated cancellations of telerehabilitation sessions. Furthermore, a greater percentage of therapists modified the intervention activities compared with assessments, which impacted therapists' perceptions about quality of telerehabilitation as a greater percentage of therapists expressed confidence in treating children compared with assessing children virtually. One of the commonly reported telerehabilitation challenges was reduced virtual engagement of children, and strength was better assessment of home environment. Lastly, a greater percentage of therapists relied on consultations and fewer therapists used empirical evidence to guide their delivery of virtual care. Conclusions: Telerehabilitation is a cost-effective health care model that offers remote accessibility and flexible scheduling. However, several limitations in the current pediatric telerehabilitation model, including lack of teleassessments and empirical evidence, could limit post-COVID use of telerehabilitation.
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Affiliation(s)
- Maninderjit Kaur
- Department of Physical Therapy, MGH Institute of Health Professions, Charlestown, Massachusetts, USA
| | - Emily Z Eddy
- Department of Occupational Therapy, MGH Institute of Health Professions, Charlestown, Massachusetts, USA
| | - Devashish Tiwari
- Department of Physical Therapy, Simmons University, Boston, Massachusetts, USA
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22
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Dostie R, Gaboury I, Cinar E, Camden C. Acceptability of Pediatric Telerehabilitation Interventions Provided by Physical Therapists and Occupational Therapists-A Scoping Review. Phys Occup Ther Pediatr 2022; 42:615-634. [PMID: 35440285 DOI: 10.1080/01942638.2022.2064203] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS The purpose of this scoping review was to explore the available literature and identify gaps regarding the acceptability of telerehabilitation interventions provided by pediatric physical therapists and occupational therapists. METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) framework to guide this scoping review. We systematically searched eight scholarly databases (CINAHL, Medline, SPORTDiscus, AMED, APA PsychInfo, SCOPUS, PEDro, OTseeker), five gray literature databases (MedlinePlus, Gray Literature Report, OpenGrey, National Institute for Health, ProQuest Dissertation & Theses Global [PQDT]), conducted a manual search of selected references and contacted international experts. We included articles published between 2000 and 2021. Acceptability was defined in accordance with the Theoretical Framework of Acceptability of Sekhon et al. RESULTS From a total of 1567 unique references, 123 were deemed eligible for full-text review. Eighteen studies published between 2011 and 2021 were included in this review. Even though every aspect of the Theoretical Framework of Acceptability was assessed from a variety of angles, a complete appreciation of the concept is still lacking for pediatric telerehabilitation. CONCLUSIONS This review highlights important gaps in our knowledge regarding the acceptability of pediatric telerehabilitation interventions and supports the need for further research focusing on the subject.
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Affiliation(s)
- Rosalie Dostie
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Quebec, Canada
| | - Eda Cinar
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Chantal Camden
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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23
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Pediatric rehabilitation services during COVID-19 pandemic in the United Arab Emirates. SRP ARK CELOK LEK 2022. [DOI: 10.2298/sarh220722105d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Introduction/Objective. COVID-19 pandemic has changed the rehabilitation practice across the globe. A sudden transition from in-person therapy at the center to remote therapy challenged the managers and multi-disciplinary team members providing pediatric rehabilitation. The main objective of this research was to assess the provision of services for children with disabilities during COVID-19 in the United Arab Emirates. Methods. Two surveys were developed by the research team, one for the managers and the others for multidisciplinary team members. Both surveys were validated through experts followed by a pilot study. The final versions of the survey were sent to all the pediatric rehabilitation centers within the United Arab Emirates in September 2020. A total of 44 managers and 434 multidisciplinary team members completed the survey. Results. The accessibility of the pediatric rehabilitation services was reported to be very high with 77%. Regarding the cost for running the services, almost half (46%) of managers reported them to be costlier than normal. Telerehabilitation was the most common approach utilized with synchronized live video calls (86%), YouTube video clips (88%), and created own videos (65%). Conclusion. Telerehabilitation appeared to be the most efficient model used for pediatric rehabilitation during the pandemic. The future investments for the continued use of telerehabilitation require planning, budgeting, investing, and creating supportive environments for parents, children, and multidisciplinary team members. There is a need for sharing platforms for educational and therapeutic resources created during the pandemic, with ongoing research on telerehabilitation.
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24
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Wittmeier KDM, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, Russell K, Pierce S, Costello C, Protudjer JLP. "Another Tool in Your Toolkit": Pediatric Occupational and Physical Therapists' Perspectives of Initiating Telehealth during the COVID-19 Pandemic. Phys Occup Ther Pediatr 2022; 42:465-481. [PMID: 35466859 DOI: 10.1080/01942638.2022.2065898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS Pediatric occupational and physical therapy service delivery via telehealth increased during the COVID-19 pandemic. Real-world experience can guide service improvement. This study explored experiences, barriers, and facilitators of initial telehealth implementation from the therapist's perspective. METHODS Qualitative descriptive approach. Semi-structured interviews were conducted with occupational therapists (n = 4) and physical therapists (n = 4) between May-June 2020. Interviews were recorded, and transcribed verbatim. Data were coded inductively to generate themes, then re-coded deductively to classify barriers and facilitators to telehealth acceptance and use using the Unified Technology Acceptance Theory. RESULTS Participants had 16.5 [(2-35); median (range)] years of experience (3 months with telehealth) and predominantly worked with preschool children. Three themes about telehealth were identified: a practical option; requires skill development and refinement; beneficial in perpetuity. Most frequently cited barriers were the lack of opportunity for 'hands-on' assessment/intervention and the learning curve required. Most frequently cited facilitators included seeing a child in their own environment, attendance may be easier for some families, and families' perception that telehealth was useful. CONCLUSION Despite rapid implementation, therapists largely described telehealth as a positive experience. Telehealth facilitated continued service provision and was perceived as relevant post-pandemic. Additional training and ensuring equitable access to services are priorities as telehealth delivery evolves.
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Affiliation(s)
- Kristy D M Wittmeier
- Rehabilitation Centre for Children, Winnipeg, Canada.,Rady Faculty of Health Sciences, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Elizabeth Hammond
- Rehabilitation Centre for Children, Winnipeg, Canada.,Rady Faculty of Health Sciences, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, Canada.,Rady Faculty of Health Sciences, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Kaitlyn Tymko
- Rady Faculty of Health Sciences, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Kristen Burnham
- Rady Faculty of Health Sciences, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Tamara Janssen
- Rady Faculty of Health Sciences, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Arnette J Pablo
- Rady Faculty of Health Sciences, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Kelly Russell
- Rady Faculty of Health Sciences, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Shayna Pierce
- Rehabilitation Centre for Children, Winnipeg, Canada
| | | | - Jennifer L P Protudjer
- Rady Faculty of Health Sciences, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, Canada.,George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Canada.,Department of Foods and Human Nutritional Sciences, University of Manitoba, Winnipeg, Canada.,Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
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Alonazi A. Effectiveness and Acceptability of Telerehabilitation in Physical Therapy during COVID-19 in Children: Findings of a Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2021; 8:1101. [PMID: 34943295 PMCID: PMC8700182 DOI: 10.3390/children8121101] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/09/2021] [Accepted: 11/24/2021] [Indexed: 01/30/2023]
Abstract
The goal of this systematic review was to determine the efficacy and acceptability of telerehabilitation in physical therapy (PT) and parental acceptance during the COVID-19 pandemic in children. In 2021, an electronic search of academic articles was performed using databases such as Embase, PubMed and Scopus. One-hundred and one articles did not satisfy the eligibility criteria after deleting duplicates and reviewing abstracts, while 16 papers did not meet eligibility after reviewing complete texts. Hence, full texts for 13 articles were retrieved, which were incorporated in the review. All these studies were observational studies assessing the effectiveness and acceptability of telerehabilitation in PT required for diverse conditions in children during the COVID-19 pandemic. All included studies revealed a positive effect of telerehabilitation in PT during the COVID-19 pandemic in children with different conditions. Moreover, the included studies revealed that both rehabilitation professionals and parents or caregivers of children were satisfied with the telerehabilitation services provided remotely. Thus, telerehabilitation appears to be a suitable and convenient strategy to offer remote services to children in need but cannot visit in person due to COVID-19. The existing evidence shows that telerehabilitation can be considered effective for children who need PT for any health condition mainly during the pandemic. However, due to the dearth of studies in this area, exploring this topic is recommended mostly in low-middle-income countries with poor access to health care services and limited resources.
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Affiliation(s)
- Asma Alonazi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Riyadh 11952, Saudi Arabia
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Sommese M, Corrado B. A Comprehensive Approach to Rehabilitation Interventions in Patients with Angelman Syndrome: A Systematic Review of the Literature. Neurol Int 2021; 13:359-370. [PMID: 34449677 PMCID: PMC8395863 DOI: 10.3390/neurolint13030036] [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: 06/07/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 11/24/2022] Open
Abstract
Angelman syndrome is a rare genetic disease affecting the central nervous system and neurobehavioral development causing severe mental, linguistic, and physical disabilities. The purpose of this review was to analyze the most recent evidence regarding the rehabilitation of subjects affected by this syndrome. The review was carried out in accordance with the preferred reporting items for systematic reviews and meta-analyses. A total of 3661 studies were identified in the databases. Once the inclusion/exclusion criteria were applied, 15 studies were considered for the paper's preparation. The level of evidence of the studies was established according to the criteria of the Oxford Center for Evidence-Based Medicine-Levels of Evidence. From the selected studies, five rehabilitative approaches emerged: physiotherapy, applied behavioral analysis, toilet training, microswitch-cluster technology, and augmentative and alternative communication. Although the studies did not have a high level of evidence, the reported results appear to be encouraging and pave the way for further studies. It seems that individualized and multidisciplinary rehabilitation interventions help to improve patients' autonomy and quality of life. In some studies, the caregivers' role was fundamental to identify preferences and long-term improvements. Further studies on larger populations and with better methodological quality are needed to confirm the results.
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Affiliation(s)
| | - Bruno Corrado
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy;
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