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Cooper K, Duncan E, Hart-Winks E, Cowie J, Shim J, Stage E, Tooman T, Alexander L, Love A, Morris JH, Ormerod J, Preston J, Swinton P. Exploring the perceptions and experiences of community rehabilitation for Long COVID from the perspectives of Scottish general practitioners' and people living with Long COVID: a qualitative study. BMJ Open 2024; 14:e082830. [PMID: 38749696 PMCID: PMC11097876 DOI: 10.1136/bmjopen-2023-082830] [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: 12/05/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVES To explore the experience of accessing Long COVID community rehabilitation from the perspectives of people with Long COVID and general practitioners (GPs). DESIGN Qualitative descriptive study employing one-to-one semistructured virtual interviews analysed using the framework method. SETTING Four National Health Service Scotland territorial health boards. PARTICIPANTS 11 people with Long COVID (1 male, 10 female; aged 40-65 (mean 53) and 13 GPs (5 male, 8 female). RESULTS Four key themes were identified: (1) The lived experience of Long COVID, describing the negative impact of Long COVID on participants' health and quality of life; (2) The challenges of an emergent and complex chronic condition, including uncertainties related to diagnosis and management; (3) Systemic challenges for Long COVID service delivery, including lack of clear pathways for access and referral, siloed services, limited resource and a perceived lack of holistic care, and (4) Perceptions and experiences of Long COVID and its management, including rehabilitation. In this theme, a lack of knowledge by GPs and people with Long COVID on the potential role of community rehabilitation for Long COVID was identified. Having prior knowledge of rehabilitation or being a healthcare professional appeared to facilitate access to community rehabilitation. Finally, people with Long COVID who had received rehabilitation had generally found it beneficial. CONCLUSIONS There are several patient, GP and service-level barriers to accessing community rehabilitation for Long COVID. There is a need for greater understanding by the public, GPs and other potential referrers of the role of community rehabilitation professionals in the management of Long COVID. There is also a need for community rehabilitation services to be well promoted and accessible to the people with Long COVID for whom they may be appropriate. The findings of this study can be used by those (re)designing community rehabilitation services for people with Long COVID.
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Affiliation(s)
- Kay Cooper
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Edward Duncan
- NMAHP Research Unit, University of Stirling, Stirling, UK
| | - Erin Hart-Winks
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Julie Cowie
- NMAHP Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Joanna Shim
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Emma Stage
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Tricia Tooman
- NMAHP Research Unit, University of Stirling, Stirling, UK
| | | | | | | | | | - Jenny Preston
- NMAHP Research Unit, University of Stirling, Stirling, UK
- Occupational Therapy, NHS Ayrshire and Arran, Irvine, UK
| | - Paul Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
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Maddocks M, Brighton LJ, Connell L, Cowley A, Laird B, Peryer G, Petrasso C, Ziegler L, Harwood R. Establishing a research partnership to investigate functional loss and rehabilitation towards the end of life. Health Technol Assess 2024:1-12. [PMID: 38676412 PMCID: PMC11070894 DOI: 10.3310/pthc7598] [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: 04/28/2024] Open
Abstract
Background Functional loss, the inability to perform necessary or desired tasks, is a common consequence of life-limiting illnesses and associated symptoms (pain, fatigue, breathlessness, etc.) and causes suffering for patients and families. Rehabilitation, a set of interventions designed to address functional loss, is recognised as essential within palliative care, as it can improve quality of life and reduce care costs. However, not everyone has equal access to rehabilitation. Despite limited life expectancy or uncertain ability to benefit from interventions, palliative rehabilitation services are often absent. This is partly due to a lack of high-quality research around optimal models of rehabilitation. Research in this area is methodologically challenging and requires multidisciplinary and cross-speciality collaboration. Aim and objectives We aimed to establish and grow a United Kingdom research partnership across diverse areas, commencing with partners from Edinburgh, East Anglia, Lancashire, Leeds, London and Nottingham, around the topic area of functional loss and rehabilitation in palliative and end-of-life care. The objectives were to (1) develop a multidisciplinary, cross-speciality research partnership, (2) generate high-priority unanswered research questions with stakeholders, (3) co-design and submit high-quality competitive research proposals, including (4) sharing topic and methodological expertise, and (5) to build capacity and capability to deliver nationally generalisable studies. Activities The partnership was established with professionals from across England and Scotland with complementary areas of expertise including complex palliative and geriatric research, physiotherapy, nursing, palliative medicine and psychology. Research questions were generated through a modified version of the Child Health and Nutrition Research Initiative, which allowed for the collation and refinement of research questions relating to functional loss and rehabilitation towards the end of life. Partnership members were supported through a series of workshops to transform research ideas into proposals for submission to stage one calls by the National Institute for Health and Care Research. The partnership not only supported students, clinicians and public members with training opportunities but also supported clinicians in securing protected time from clinical duties to allow them to focus on developing local research initiatives. Reflections Through our partnership we established a network that offered researchers, clinicians, students and public members the chance to develop novel skills and explore opportunities for personal and professional development around the topic area of functional loss and rehabilitation in palliative and end-of-life care. The partnership was crucial to foster collaboration and facilitate exchange of ideas, knowledge and experiences to build joint research study proposals. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) programme as award number NIHR135171. A plain language summary of this article is available on the NIHR Journals Library website https://doi.org/10.3310/PTHC7598.
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Affiliation(s)
- Matthew Maddocks
- King's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK
| | - Lisa Jane Brighton
- King's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Louise Connell
- University of Central Lancashire, Preston, Lancashire, UK
- East Lancashire Hospitals NHS Trust, Burnley, Lancashire, UK
| | - Alison Cowley
- Nottingham University Hospitals NHS, Research & Innovation, Nottingham, UK
- Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Barry Laird
- Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
- St Columba's Hospice Care, Edinburgh, UK
| | - Guy Peryer
- University of East Anglia, Faculty of Medicine and Health Sciences, Norwich Research Park, Norwich, UK
| | - Carmine Petrasso
- King's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK
| | - Lucy Ziegler
- University of Leeds, Academic Unit of Palliative Care, School of Medicine, Leeds, UK
| | - Rowan Harwood
- Faculty of Medicine and Health Sciences, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Óladóttir S, Pálmadóttir G, Óskarsson GK, Egilson ST. Psychometric properties of the client-centred rehabilitation questionnaire-is derived from a large and varied group of rehabilitation users. Disabil Rehabil 2024; 46:387-394. [PMID: 36587629 DOI: 10.1080/09638288.2022.2160835] [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: 05/23/2022] [Accepted: 12/16/2022] [Indexed: 01/03/2023]
Abstract
PURPOSE The purpose of this study was to inspect and establish the factor structure of the Icelandic Client-Centred Rehabilitation Questionnaire [CCRQ-is] and investigate the service experiences of a large and varied sample of rehabilitation users. MATERIALS AND METHODS Altogether 499 rehabilitation users completed the questionnaire. Confirmatory and exploratory factor analysis was conducted for analysis of items. Mann-Whitney's U and Kruskal-Wallis test was used to compare subscale responses based on participants' characteristics. RESULTS Four factors explained 53,2% of the variance: Respect and attentiveness, Interaction with significant others, Responsiveness to needs and preferences and Education and enablement. Subscales showed internal consistency from 0.72-0.91 and 0.92 for the whole instrument. The subscale Respect and attentiveness represented user centred rehabilitation the most and Interaction with significant others the least. Significant differences in relation to health conditions and age were obtained on all four subscales and differences by gender on one subscale. CONCLUSIONS Our results suggest the CCRQ-is is a reliable tool that can be used with rehabilitation users with a broad range of characteristics within the Icelandic context. The extent to which the intersection of age, gender and health issues influence users' perception of services needs to be further scrutinized.
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Affiliation(s)
- Sólrún Óladóttir
- Centre of Disability Studies, School of Social Sciences, University of Iceland, Reykjavik, Iceland
- Department of Occupational Therapy, School of Health Sciences, University of Akureyri, Akureyri, Iceland
| | - Guðrún Pálmadóttir
- Department of Occupational Therapy, School of Health Sciences, University of Akureyri, Akureyri, Iceland
| | | | - Snæfrídur Thóra Egilson
- Centre of Disability Studies, School of Social Sciences, University of Iceland, Reykjavik, Iceland
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Buckingham S, Anil K, Demain S, Gunn H, Jones RB, Kent B, Logan A, Marsden J, Playford ED, Freeman J. Telerehabilitation for people with physical disabilities and movement impairment: development and evaluation of an online toolkit for practitioners and patients. Disabil Rehabil 2023; 45:1885-1892. [PMID: 35603803 DOI: 10.1080/09638288.2022.2074549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/29/2022] [Accepted: 04/30/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Telerehabilitation has increasingly been used since the COVID-19 pandemic but with limited guidance available on undertaking physical assessments using remote methods. We aimed to provide such guidance by developing a Telerehab Toolkit, an online information and training resource for practitioners, patients, and carers on telerehabilitation for people with physical disabilities and movement impairment. MATERIALS AND METHODS Development and evaluation of the toolkit were informed by the Knowledge to Action framework and took place iteratively in two phases-knowledge creation and action. Information was collated from various sources including literature review, online survey, service evaluation, and focus group discussions. The toolkit has been evaluated using think-aloud interviews, e-mail and social media feedback from users, and analytics data on user engagement with the website. RESULTS The Telerehab Toolkit focuses on remote physical assessments, and contains information on technology, digital skills, remote assessment tools, information governance, and safety for telerehabilitation. Resources include top tips from practitioners and patients, how-to guides, checklists, videos, and links to evidence. CONCLUSIONS The Telerehab Toolkit has been well-received by practitioners, healthcare students, patients, and carers, is being disseminated widely, and is freely available (www.plymouth.ac.uk/research/telerehab). IMPLICATIONS FOR REHABILITATIONTelerehabilitation has been increasingly used since the COVID-19 pandemic, but with limited guidance and training for practitioners on undertaking safe and effective remote physical assessments.The Telerehab Toolkit has been developed iteratively using the Knowledge to Action framework; it is a free online resource for practitioners and patients with specific guidance on telerehabilitation for physical disabilities and movement impairment.It is anticipated that the resource will help to improve the knowledge, skills, and confidence of the current and future rehabilitation workforce.
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Affiliation(s)
- Sarah Buckingham
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Krithika Anil
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Sara Demain
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Hilary Gunn
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Ray B Jones
- Centre for Health Technology, University of Plymouth, Plymouth, UK
- School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
| | - Bridie Kent
- School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
| | - Angela Logan
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
- Stroke Rehabilitation, Royal Devon and Exeter NHS Foundation Trust, William Wright House, Wonford Hospital, Exeter, UK
| | - Jonathan Marsden
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | | | - Jenny Freeman
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
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Begazo Flores P, Supervía M, Gimeno González M, Morata Crespo AB. [Pandemic COVID-19 impact in Rehabilitation Services in Spain]. Rehabilitacion (Madr) 2023; 57:100736. [PMID: 35545483 PMCID: PMC8898680 DOI: 10.1016/j.rh.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/22/2021] [Accepted: 02/22/2022] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The COVID-19 pandemic situation has brought a considerable growth on the amount of patients requiring ICU admissions and long-term hospitalization. The present study is aimed at determining whether Rehabilitation Services has been able to reach a sufficient adaptation level, regarding the exponential increase on the demand of Rehab-related services from intensive care patients and inpatients. MATERIAL AND METHODS Through this cross-sectional research, an online survey was implemented in various Rehabilitation Departments across Spain from December the 22nd, 2020 to February the 12th, 2021. SORECAR (The Spanish Cardiopulmonary Rehabilitation Society) was the responsible entity for the design of the survey (ICU Rehabilitation Services Identification). Descriptive statistical analysis was conducted using SPSS. OBJECTIVE To address the specific needs and changes arising from the new COVID-19 pandemic situation within Spanish Rehabilitation Departments. RESULTS 38 hospitals from 18 cities (From a total of 49) participated in the study. The ICUs weekly demand scored 7.84 ± 6,8 Medical Consultation (MC) on average (range: 2-45). The hospitalization average was displayed as 9, 63 ± 6,2 MC/week (range: 2-55). The total worktime dedicated by physicians was 10.38 h/week, from which physiotherapists stood with 25.95 h/week. Only 7 hospitals (16.7%) counted with occupational therapists (OT) (average dedication of 5 h/week). Each Rehab-session lasted 30 min on average. 59.1% (n = 23) of the included hospitals had already implemented a specific post-covid follow-up rehab-consultation, whereas 9.1% (n = 4) of them were planning on implementing it. 64.3% (n = 24) of the surveyed centers implemented specific protocols for COVID-19 patients, while another 7.1% (n = 3) were in development progress. 48.5% (n = 18) of the surveyed centers did not owe its own specific training program within its ICUs and respiratory rehab-areas for the internal medical residents. CONCLUSIONS The pandemic situation has resulted in a substantial increase on the workload in the Spanish Rehabilitation Services. Most of the hospitals included in the present study had already implemented outpatient follow-up consultations. Rehabilitation in critical patients is an exponentially recurrent topic for this medical specialty that needs to be furtherly addressed in the nearby future.
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Affiliation(s)
- P Begazo Flores
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - M Supervía
- Servicio de Medicina Física y Rehabilitación, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, España; Mayo Clinic, Rochester, Minnesota, EE. UU
| | - M Gimeno González
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Miguel Servet, Zaragoza, España
| | - A B Morata Crespo
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Miguel Servet, Zaragoza, España
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Rehabilitation potential: A critical review of its meaning and validity. Clin Rehabil 2022; 37:869-875. [DOI: 10.1177/02692155221147606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background The concept of rehabilitation potential emerged in 1950 as a way to select people for rehabilitation; it is also used to limit access to services. Objective To elucidate the meaning(s) of rehabilitation potential and whether it is valid in selecting patients for rehabilitation, whether as an inpatient, outpatient, or in the community. Method A non-systematic review of how it has been used, a structured discussion of its potential meanings, an exploration of the evidence in support of selecting people who might benefit from rehabilitation, and a discussion of the concept of rehabilitation potential. Findings It has been used in several ways with two primary meanings: predicting a person's function at some later time; predicting who will gain additional improvement in outcome from being seen by a rehabilitation service. The concept is flawed because rehabilitation is a process, not a specific action; the effects anticipated after rehabilitation are not restricted to functional improvement; patient characteristics do not determine many essential outcomes. There is no evidence to guide the selection of patients for an assessment and formulation by a rehabilitation team. Conclusion Rehabilitation potential, defined as data that gives the likelihood of additional benefit from receiving input from an expert rehabilitation service, is an illusion lacking any coherent definition, description, or evidence. Its use to limit access to rehabilitation is invalid. The solution is to offer all people not recently seen by an expert multi-professional rehabilitation team a full rehabilitation assessment and formulation, which will reveal what rehabilitation might achieve.
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Buckingham SA, Anil K, Demain S, Gunn H, Jones RB, Kent B, Logan A, Marsden J, Playford ED, Freeman J. Telerehabilitation for People With Physical Disabilities and Movement Impairment: A Survey of United Kingdom Practitioners. JMIRX MED 2022; 3:e30516. [PMID: 37725532 PMCID: PMC10414449 DOI: 10.2196/30516] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/06/2021] [Accepted: 10/19/2021] [Indexed: 09/21/2023]
Abstract
BACKGROUND Telerehabilitation is a feasible and potentially effective alternative to face-to-face rehabilitation. However, specific guidance, training, and support for practitioners who undertake remote assessments in people with physical disabilities and movement impairment are limited. OBJECTIVE The aims of this survey of United Kingdom-based health and social care practitioners were to explore experiences, assess training needs, and collate ideas on best practices in telerehabilitation for physical disabilities and movement impairment. The aim will be to use the findings to inform a practical tool kit and training package for telerehabilitation use. METHODS UK rehabilitation practitioners were invited to complete an online questionnaire from November to December 2020. Opportunity and snowball sampling were used to recruit participants from professional and educational networks, special interest groups, and via social media. Closed questionnaire items were analyzed using descriptive statistics. Qualitative inductive analysis using NVivo was used for open responses. RESULTS There were 247 respondents, of which 177 (72%) were physiotherapists and occupational therapists. Most (n=207, 84%) had used video-based consultations (typically supported by telephone and email), and the use of this method had increased in frequency since the COVID-19 pandemic. Practitioners perceived telerehabilitation positively overall and recognized benefits for patients including a reduced infection risk, convenience and flexibility, and reduced travel and fatigue. Common obstacles were technology related (eg, internet connection), practical (eg, difficulty positioning the camera), patient related (eg, health status), practitioner related (eg, lack of technical skills), and organizational (eg, lack of access to technology). Support from family members or carers was a major facilitator for successful remote consultations. Of the 207 respondents who had used video-based consultations, 103 (50%) had assessed physical impairments using this method, 107 (52%) had assessed physical function, and 121 (59%) had used patient-reported outcome measures. Although practitioners generally felt confident in delivering video-based consultations, they felt less proficient in undertaking remote physical assessments, expressing concerns about validity, reliability, and safety. Only 46 of the 247 (19%) respondents had received any training in telerehabilitation or video consultations, and some felt they were "feeling their way in the dark." Practitioners desired training and guidance on physical assessment tools suitable for remote use, when to use video-based consultations or alternative methods, governance issues, digital platforms, and signposting to digital skills training for themselves and their patients. CONCLUSIONS In response to the COVID-19 pandemic, practitioners rapidly adopted telerehabilitation for people with physical disabilities and movement impairment. However, there are technical, practical, and organizational obstacles to overcome, and a clear need for improved guidance and training in remote physical assessments. The findings of this survey will inform the development of a tool kit of resources and a training package for the current and future workforce in telerehabilitation.
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Affiliation(s)
- Sarah A Buckingham
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom
| | - Krithika Anil
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom
| | - Sara Demain
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Hilary Gunn
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom
| | - Ray B Jones
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Bridie Kent
- School of Nursing and Midwifery, University of Plymouth, Plymouth, United Kingdom
| | - Angela Logan
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom
- Stroke Rehabilitation, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | - Jonathan Marsden
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom
| | - E Diane Playford
- Warwick Medical School, University of Warwick, Warwick, United Kingdom
- Central England Rehabilitation Unit, Royal Leamington Spa Rehabilitation Hospital, Warwick, United Kingdom
| | - Jennifer Freeman
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom
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Beare B, Doogan CE, Douglass-Kirk P, Leff AP, Ward N. Neuro-Rehabilitation OnLine (N-ROL): description and evaluation of a group-based telerehabilitation programme for acquired brain injury. J Neurol Neurosurg Psychiatry 2021; 92:1354-1355. [PMID: 34162729 DOI: 10.1136/jnnp-2021-326809] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/02/2021] [Indexed: 12/16/2022]
Affiliation(s)
- Ben Beare
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,The National Hospital for Neurology and Neurosurgery, London, UK
| | - Catherine E Doogan
- The National Hospital for Neurology and Neurosurgery, London, UK.,Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, London, UK
| | | | - Alexander P Leff
- The National Hospital for Neurology and Neurosurgery, London, UK.,Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, London, UK
| | - Nick Ward
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK .,The National Hospital for Neurology and Neurosurgery, London, UK
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Anil K, Freeman JA, Buckingham S, Demain S, Gunn H, Jones RB, Logan A, Marsden J, Playford D, Sein K, Kent B. Scope, context and quality of telerehabilitation guidelines for physical disabilities: a scoping review. BMJ Open 2021; 11:e049603. [PMID: 34385253 PMCID: PMC8361705 DOI: 10.1136/bmjopen-2021-049603] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To identify the available guidance and training to implement telerehabilitation movement assessments for people (adults and children) with a physical disability, including those recovering from COVID-19. DESIGN Rapid scoping review. INCLUDED SOURCES AND ARTICLES PubMed, CINAHL, PsychInfo, Cochrane, Embase, Web of Science, PEDro, UK Health Forum, WHO, National Archives and NHS England were searched using the participant-concept-context framework from 2015 to August 2020. Primary studies that recruited individuals with physical disabilities and guidance documents aimed at providers to implement movement-related telerehabilitation were included. RESULTS 23 articles (11 primary research studies, 3 systematic reviews and 9 guidance documents) were included out of 7857 that were identified from the literature search. Two main issues were found: (1) telerehabilitation guidance (from both research studies and guidance documents) was not specific to movement-related assessment and (2) most primary research studies provided neither guidance nor training of movement-specific assessment to practitioners. Of the COVID-19 related guidance, two articles reported COVID-19 management that only referred to identifying COVID-19 status without references to specific movement-related guidance. CONCLUSIONS Telerehabilitation guidance and training have existed pre-COVID-19, yet the lack of specific movement-related information and provider support is surprising. This gap must be addressed to optimise effective implementation of remote assessments for those with physical disabilities. REVIEW REGISTRATION Open Science Framework: osf.io/vm6sp.
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Affiliation(s)
- Krithika Anil
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Jennifer A Freeman
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Sarah Buckingham
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Sara Demain
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Hilary Gunn
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Ray B Jones
- School of Nursing and Midwifery, Plymouth University, Plymouth, UK
| | - Angela Logan
- Stroke Rehabilitation, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Jonathan Marsden
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Diane Playford
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Kim Sein
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Bridie Kent
- School of Nursing and Midwifery, Plymouth University, Plymouth, UK
- Innovations in Health and Social Care: A JBI Centre of Excellence, Plymouth University, Plymouth, UK
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