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Devlin J, Reid B. Heart failure patients' experiences of telerehabilitation. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:572-576. [PMID: 38900655 DOI: 10.12968/bjon.2024.0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
In the UK, almost 1 million people are living with heart failure, with heart and circulatory diseases accounting for 27% of all deaths, according to the British Heart Foundation. Current heart failure guidelines support cardiac rehabilitation as an intervention to reduce cardiovascular events, increase exercise tolerance and enhance patients' quality of life. Research indicates that telerehabilitation is an effective component of heart failure management, which helps overcome perceived barriers to cardiac rehabilitation including travel to appointments, long waiting times and accessibility. Understanding patient experiences and increasing telerehabilitation among heart failure patients is pertinent to implementing person-centred care, reducing risk and optimising quality of life.
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Affiliation(s)
- Julie Devlin
- Trainee Advanced Nurse Practitioner, School of Nursing and Paramedic Science, University of Ulster, Belfast
| | - Bernie Reid
- Lecturer of Nursing, School of Nursing and Paramedic Science, University of Ulster, Derry
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Pritwani S, Pandey S, Shrivastava P, Kumar A, Malhotra R, Maddison R, Devasenapathy N. Challenges in rehabilitation and continuum of care provision after knee replacement: a mixed-methods study from a low- and middle-income country. Disabil Rehabil 2024; 46:2890-2900. [PMID: 37461195 DOI: 10.1080/09638288.2023.2236012] [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: 02/22/2023] [Accepted: 07/07/2023] [Indexed: 06/20/2024]
Abstract
PURPOSE Continuum-of-care is crucial following knee replacement. This is an understudied area in the context of low- and middle-income countries. We report findings of a mixed-methods study conducted to understand patient's postoperative experiences in following unsupervised home-based physiotherapy protocols and healthcare provider's experiences in providing rehabilitation care. METHODS Consecutive adults (n = 79) scheduled or had undergone knee replacement, attending an urban tertiary care hospital in India completed a 22-item questionnaire to gauge attitude towards physical rehabilitation. We conducted in-depth interviews with nine patients, ten physiotherapists, and three surgeons using a phenomenology approach. Data were interpreted using the capability, opportunity, and motivation-behaviour (COM-B) framework. RESULTS Patients were motivated to do exercises and valued family support during the recovery period. However, they desired physiotherapy support, especially during the early recovery period due to post-operative pain. Healthcare providers reported poor adherence with the exercise regimen and desired a mechanism to monitor patient progress after discharge. Patients and health care providers identified accessibility to rehabilitation centre as a major barrier in availing affordable and reliable physiotherapy services. CONCLUSION There is a need for a continuum of care to improve patient experience during recovery and for health care providers to monitor progress and provide personalised progressive exercise therapy.
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Affiliation(s)
| | - Shruti Pandey
- The George Institute for Global Health India, Delhi, India
| | | | - Ajit Kumar
- Department of Orthopaedics, All India Institute of Medical Sciences, Delhi, India
| | - Rajesh Malhotra
- Department of Orthopaedics, All India Institute of Medical Sciences, Delhi, India
| | - Ralph Maddison
- Department of School of Exercise & Nutrition, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
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Chen Q, Wu X, Huang Y, Chen L. Internet of Things-Based Home Respiratory Muscle Training for Patients with Chronic Obstructive Pulmonary Disease: A Randomized Clinical Trial. Int J Chron Obstruct Pulmon Dis 2024; 19:1093-1103. [PMID: 38800522 PMCID: PMC11128236 DOI: 10.2147/copd.s454804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/14/2024] [Indexed: 05/29/2024] Open
Abstract
Purpose Whether Internet of Things (IoT)-based home respiratory muscle training (RMT) benefits patients with comorbid chronic obstructive pulmonary disease (COPD) remains unclear. Therefore, this study aims to evaluate the effectiveness of IoT-based home RMT for patients with COPD. Patients and Methods Seventy-eight patients with stable COPD were randomly divided into two groups. The control group received routine health education, while the intervention group received IoT-based home RMT (30 inspiratory muscle training [IMT] and 30 expiratory muscle training [EMT] in different respiratory cycles twice daily for 12 consecutive weeks). Assessments took place pre-intervention and 12 weeks post-intervention, including lung function tests, respiratory muscle strength tests, the mMRC dyspnea scale, CAT questionnaires, the HAMA scale, and 6-month COPD-related readmission after intervention. Results Seventy-four patients with COPD were analyzed (intervention group = 38, control group = 36), and the mean age and FEV1 of the patients were 68.65 ± 7.40 years, 1.21 ± 0.54 L. Compared to those of the control population, the intervention group exhibited higher FEV1/FVC (48.23 ± 10.97 vs 54.32 ± 10.31, p = 0.016), MIP (41.72 ± 7.70 vs 47.82 ± 10.99, p = 0.008), and MEP (42.94 ± 7.85 vs 50.29 ± 15.74, p = 0.013); lower mMRC (2.00 [2.00-3.00] vs 1.50 [1.00-2.00], p < 0.001), CAT (17.00 [12.00-21.75] vs 11.00 [9.00-13.25], p < 0.001), and HAMA (7.00 [5.00-9.00] vs 2.00 [1.00-3.00], p < 0.001) scores; and a lower incidence rate of 6-month readmission (22% vs 5%, p = 0.033). Conclusion Compared with no intervention, IoT-based home RMT may be a more beneficial intervention for patients with COPD.
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Affiliation(s)
- Qiong Chen
- Respiratory Medicine Department, Xiamen Haicang Hospital, Xiamen, Fujian, People’s Republic of China
| | - Xuejuan Wu
- Respiratory Medicine Department, Xiamen Haicang Hospital, Xiamen, Fujian, People’s Republic of China
| | - Yanjin Huang
- Nursing Department, Xiamen Haicang Hospital, Xiamen, Fujian, People’s Republic of China
| | - Lingling Chen
- Respiratory Medicine Department, Xiamen Haicang Hospital, Xiamen, Fujian, People’s Republic of China
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Mora-Traverso M, Prieto-Moreno R, Molina-Garcia P, Salas-Fariña Z, Martín-Martín L, Martín-Matillas M, Ariza-Vega P. Effects of the @ctivehip telerehabilitation program on the quality of life, psychological factors and fitness level of patients with hip fracture. J Telemed Telecare 2024; 30:549-558. [PMID: 35060784 DOI: 10.1177/1357633x211073256] [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] [Indexed: 02/21/2024]
Abstract
INTRODUCTION Telerehabilitation has emerged in the last decade as a promising alternative to conduct the rehabilitation process at home. However, there are no studies testing the effects of telerehabilitation interventions for patients with hip fracture on quality of life nor psychological factors, whereas the evidence on fitness level is scarce. Thus, the aim of this study is to test the effects of the @ctivehip telerehabilitation program on the quality of life, psychological factors and fitness level of patients who had suffered a hip fracture. METHODS The present study is a non-randomized clinical trial that includes patients older than 65 years old with a hip fracture and their family caregivers (ClinicalTrials.gov; Identifier: NCT02968589). Per-protocol (64 participants) and intention-to-treat (71 participants) analyses were performed, the first being the main analysis. The intervention group received a home-based multidisciplinary telerehabilitation intervention, called @ctivehip, that lasted 12 weeks. The control group received the traditional care and rehabilitation provided by the Andalusian Public Health Care System. The outcomes measured were the patients' quality of life through the EuroQol Quality of Life Questionnaire (EQ-5D), physiological factors (anxiety and depression) using the Hospital Anxiety and Depression Scale (HADS) and the fitness level, assessed with the International Fitness Scale. RESULTS The quality of life of the telerehabilitation group increased, while the control group scored worsened at the 3-month follow-up (medium effect size: 0.66 SDs; p = 0.006). The telerehabilitation group demonstrated a greater decrease than the control group in the total HADS score (medium effect size: -0.50 SDs; p = 0.015). Lastly, the telerehabilitation group recovered a fitness level close to the pre-hip fracture in comparison with the control group (small effect size: 0.49 SDs; p = 0.022). DISCUSSION The @ctivehip telerehabilitation program seems to be a promising treatment to improve the quality of life and psychological factors (i.e. anxiety and depression) of older adults after a hip fracture, as well as to recover their previous fitness level.
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Affiliation(s)
- Marta Mora-Traverso
- Biohealth Research Institute (ibs.Granada) Physical Medicine and Rehabilitation Service, Virgen de las Nieves University Hospital, Granada, Spain
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain
| | - Rafael Prieto-Moreno
- Biohealth Research Institute (ibs.Granada) Physical Medicine and Rehabilitation Service, Virgen de las Nieves University Hospital, Granada, Spain
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain
| | - Pablo Molina-Garcia
- Biohealth Research Institute (ibs.Granada) Physical Medicine and Rehabilitation Service, Virgen de las Nieves University Hospital, Granada, Spain
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Zeus Salas-Fariña
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Lydia Martín-Martín
- Department of Physiotherapy, Faculty of Health Science, University of Granada, Granada, Spain
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain
- Sport and Health University Research Institute (iMUDS), Universtity of Granada, Granada, Spain
| | - Miguel Martín-Matillas
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Patrocinio Ariza-Vega
- Biohealth Research Institute (ibs.Granada) Physical Medicine and Rehabilitation Service, Virgen de las Nieves University Hospital, Granada, Spain
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain
- Department of Physiotherapy, Faculty of Health Science, University of Granada, Granada, Spain
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Zampolini M, Oral A, Barotsis N, Aguiar Branco C, Burger H, Capodaglio P, Dincer F, Giustini A, Hu X, Irgens I, Negrini S, Tederko P, Treger I, Kiekens C. Evidence-based position paper on Physical and Rehabilitation Medicine (PRM) professional practice on telerehabilitation. The European PRM position (UEMS PRM Section). Eur J Phys Rehabil Med 2024; 60:165-181. [PMID: 38477069 PMCID: PMC11135123 DOI: 10.23736/s1973-9087.24.08396-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 01/29/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION The evidence on the utility and effectiveness of rehabilitation interventions delivered via telerehabilitation is growing rapidly. Telerehabilitation is expected to have a key role in rehabilitation in the future. AIM The aim of this evidence-based position paper (EBPP) is to improve PRM physicians' professional practice in telerehabilitation to be delivered to improve functioning and to reduce activity limitations and/or participation restrictions in individuals with a variety of disabling health conditions. METHODS To produce recommendations for PRM physicians on telerehabilitation, a systematic review of the literature and a consensus procedure by means of a Delphi process have been performed involving the delegates of all European countries represented in the UEMS PRM Section. RESULTS The systematic literature review is reported together with the 32 recommendations resulting from the Delphi procedure. CONCLUSIONS It is recommended that PRM physicians deliver rehabilitation services remotely, via digital means or using communication technologies to eligible individuals, whenever required and feasible in a variety of health conditions in favor of the patient and his/her family, based on evidence of effectiveness and in compliance with relevant regulations. This EBPP represents the official position of the European Union through the UEMS PRM Section and designates the professional role of PRM physicians in telerehabilitation.
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Affiliation(s)
| | - Aydan Oral
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye -
| | | | - Catarina Aguiar Branco
- Department of Physical and Rehabilitation Medicine, Hospital of Entre o Douro e Vouga E.P.E., Porto, Portugal
- Faculty of Dentistry, University of Porto, Porto, Portugal
| | - Helena Burger
- University Rehabilitation Institute of the Republic of Slovenia, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Paolo Capodaglio
- Orthopedic Rehabilitation Unit and Research Lab in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, Istituto Auxologico Italiano, IRCCS, Verbania, Italy
- Department of Surgical Sciences, Physical and Rehabilitation Medicine, University of Turin, Turin, Italy
| | - Fitnat Dincer
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | | | - Xiaolei Hu
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Ingebjorg Irgens
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Piotr Tederko
- Department of Rehabilitation, Center of Postgraduate Medical Education, Otwock, Poland
| | - Iuly Treger
- Department of Rehabilitation, Soroka University Medical Center, Beer-Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Cockburn L, Baer G, Rhodes J. Level of diagnostic agreement in musculoskeletal shoulder diagnosis between remote and face-to-face consultations: A retrospective service evaluation. Health Sci Rep 2024; 7:e2060. [PMID: 38650721 PMCID: PMC11033340 DOI: 10.1002/hsr2.2060] [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] [Received: 11/28/2023] [Revised: 03/22/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024] Open
Abstract
Background and Aims To determine the level of diagnostic agreement between remote and face-to-face consultation in assessing shoulder complaints. Methods A retrospective service evaluation with three groups of patient data; those assessed only face-to-face (group 1), remotely then face-to-face (group 2), remotely only (group 3). Patient data were extracted from 6 secondary care shoulder Advanced Physiotherapy Practitioner's (APPs) records, covering six sites. Three-hundred-and-fifty-nine sets of patient data were included in the final evaluation. The main outcome measure was the percentage of agreement between diagnosis at initial and follow-up consultation, when assessed by APPs across the three groups. A Pearson χ 2 test was used to assess the relationship between the method of consultation and the level of diagnostic agreement. Diagnoses were categorized as either the same, similar, or different by an independent APP. Secondary outcome measures investigated whether age or the length of time between appointments had any effect in determining the level of diagnostic concordance. Results There was exact agreement of 77.05% and 85.52% for groups 1 and 3, respectively, compared with 34.93% for patient data in group 2. Similar clinical impressions across both initial and follow-up were seen 16.39% of the time in group 1, 7.24% of the time in group 3, and 36.99% in group 2. Lastly, the percentage of times a diagnosis was changed between initial and review appointments occurred in only 6.56% of group 1 contacts, 7.24% of group 3 contacts, but 28.08% of the time in group 2. Conclusion There was a large mismatch in the diagnosis of musculoskeletal shoulder complaints, when patients are initially assessed remotely and then followed-up in-person. This has implications for the future provision of shoulder assessment in physiotherapy.
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Affiliation(s)
- Louise Cockburn
- Division of Dietetics Nutrition Biological Sciences Physiotherapy Podiatry and RadiographyQueen Margaret UniversityMusselburghUK
| | - Gill Baer
- Division of Dietetics Nutrition Biological Sciences Physiotherapy Podiatry and RadiographyQueen Margaret UniversityMusselburghUK
| | - Jenna Rhodes
- Division of Dietetics Nutrition Biological Sciences Physiotherapy Podiatry and RadiographyQueen Margaret UniversityMusselburghUK
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Molina-Garcia P, Mora-Traverso M, Prieto-Moreno R, Díaz-Vásquez A, Antony B, Ariza-Vega P. Effectiveness and cost-effectiveness of telerehabilitation for musculoskeletal disorders: A systematic review and meta-analysis. Ann Phys Rehabil Med 2024; 67:101791. [PMID: 38128150 DOI: 10.1016/j.rehab.2023.101791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 07/25/2023] [Accepted: 08/21/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Internet-based telerehabilitation could be a valuable option for the treatment of musculoskeletal disorders, with the advantage of providing rehabilitation from anywhere. However, there is no solid and updated evidence demonstrating its effectiveness on relevant clinical and cost outcomes. OBJECTIVE This systematic review aims to determine the clinical and cost-effectiveness of internet-based telerehabilitation during the recovery of musculoskeletal disorders. METHODS Medline, Web of Science, Scopus and Cochrane databases were systematically searched from inception to June 2023. Trials investigating the effects of internet-based telerehabilitation in any musculoskeletal disorder were selected. Nonoriginal articles and grey literature were excluded. Two independent reviewers conducted the study selection and data extraction. Random effect meta-analyses (standardized mean difference) and further sensitivity analyses were performed. RESULTS We selected 37 clinical trials (33 randomized and 4 non-randomized) and 5 health economics studies, which included a total of 4,288 participants. Telerehabilitation was more favourable than control treatments in improving all studied clinical outcomes, although the effectiveness varied depending on the type of musculoskeletal disorder. The standard mean differences (SMD) ranged from 0.24 to 0.91. For physical function, the primary outcome, superior effectiveness was found only in people with hip fractures (SMD, 0.87; 95 % CI, 0.34 to 1.41). The effects for joint replacement, osteoarthritis, and spine pain were similar to those of control treatments. However, the favourable outcomes for telerehabilitation became insignificant when compared specifically to face-to-face rehabilitation. Some results displayed publication bias and a lack of robustness, necessitating cautious interpretation. In terms of health economics studies, telerehabilitation was 89.55$ (95 % CI 4.6 to 174.5) cheaper per individual than conventional treatments. CONCLUSIONS Telerehabilitation should be considered in the recovery process of musculoskeletal disorders when optimal face-to-face rehabilitation is not feasible. Moreover, telerehabilitation reduces costs and time. PROSPERO NUMBER CRD42022322425.
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Affiliation(s)
| | - Marta Mora-Traverso
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain
| | - Rafael Prieto-Moreno
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain; Biomedical Research Unit, Torrecárdenas University Hospital, 04009 Almería, Spain; Department of Education, Faculty of Education Sciences, SPORT Research Group (CTS-1024) and CERNEP Research Center, University of Almería, Almería, Spain
| | | | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania 7000, Australia
| | - Patrocinio Ariza-Vega
- Instituto de Investigación Biosanitaria ibs.GRANDA, Granada, Spain; PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain; Department of Physiotherapy, Faculty of Health Science, University of Granada, Granada, Spain
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Barzegar Khanghah A, Fernie G, Roshan Fekr A. Joint angle estimation during shoulder abduction exercise using contactless technology. Biomed Eng Online 2024; 23:11. [PMID: 38281988 PMCID: PMC10822169 DOI: 10.1186/s12938-024-01203-5] [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: 09/02/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Tele-rehabilitation, also known as tele-rehab, uses communication technologies to provide rehabilitation services from a distance. The COVID-19 pandemic has highlighted the importance of tele-rehab, where the in-person visits declined and the demand for remote healthcare rises. Tele-rehab offers enhanced accessibility, convenience, cost-effectiveness, flexibility, care quality, continuity, and communication. However, the current systems are often not able to perform a comprehensive movement analysis. To address this, we propose and validate a novel approach using depth technology and skeleton tracking algorithms. METHODS Our data involved 14 participants (8 females, 6 males) performing shoulder abduction exercises. We collected depth videos from an LiDAR camera and motion data from a Motion Capture (Mocap) system as our ground truth. The data were collected at distances of 2 m, 2.5 m, and 3.5 m from the LiDAR sensor for both arms. Our innovative approach integrates LiDAR with the Cubemos and Mediapipe skeleton tracking frameworks, enabling the assessment of 3D joint angles. We validated the system by comparing the estimated joint angles versus Mocap outputs. Personalized calibration was applied using various regression models to enhance the accuracy of the joint angle calculations. RESULTS The Cubemos skeleton tracking system outperformed Mediapipe in joint angle estimation with higher accuracy and fewer errors. The proposed system showed a strong correlation with Mocap results, although some deviations were present due to noise. Precision decreased as the distance from the camera increased. Calibration significantly improved performance. Linear regression models consistently outperformed nonlinear models, especially at shorter distances. CONCLUSION This study showcases the potential of a marker-less system, to proficiently track body joints and upper-limb angles. Signals from the proposed system and the Mocap system exhibited robust correlation, with Mean Absolute Errors (MAEs) consistently below [Formula: see text]. LiDAR's depth feature enabled accurate computation of in-depth angles beyond the reach of traditional RGB cameras. Altogether, this emphasizes the depth-based system's potential for precise joint tracking and angle calculation in tele-rehab applications.
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Affiliation(s)
- Ali Barzegar Khanghah
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Ave, Toronto, M5G 2A2, ON, Canada.
- Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, M5S 3G9, ON, Canada.
| | - Geoff Fernie
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Ave, Toronto, M5G 2A2, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, M5S 3G9, ON, Canada
- Department of Surgery, University of Toronto, 149 College St., Toronto, M5T 1P5, ON, Canada
| | - Atena Roshan Fekr
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Ave, Toronto, M5G 2A2, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, M5S 3G9, ON, Canada
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Hakam HT, Mühlensiepen F, Salzmann M, Lettner J, Becker R, Kopf S, Prill R. Development of the INpaTiEnt Rehabilitation App Compliance QuesTionnaire [INTERACT]. J Pers Med 2023; 13:1638. [PMID: 38138865 PMCID: PMC10744598 DOI: 10.3390/jpm13121638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND The elements of previously designed questionnaires do not take into consideration the burdens encountered in an inpatient hospital setting. The purpose of this study is to validate elements of a non-compliance survey in an in-hospital setting and discuss aspects of compliance with telerehabilitative physiotherapy in the early postoperative period. METHODS A literature search was conducted to identify elements that prevent patients from performing their prescribed physical therapy exercises. These items were then evaluated by the expert review technique as described by Ikart. Afterwards, the synthesized survey was handed out to patients for the assessment of the quality of its items. RESULTS The results of the expert review technique identified some conceptual and grammatical problems. This led to the adjustment of some of the elements. The quality of the resulting questionnaire was deemed to be good, as patients were able to fully understand the concepts and answer accordingly. A statistical analysis was conducted to evaluate the responses. CONCLUSIONS The items of this second questionnaire have proven to be reliable to assess the compliance of patients in an in-hospital setting. These items will be added to the cross-culturally adapted items of a previous questionnaire.
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Affiliation(s)
- Hassan Tarek Hakam
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstr. 29, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
- Center of Evidence Based Practice in Brandenburg (EBB), A JBI Affiliated Group, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
| | - Felix Mühlensiepen
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
- Center of Evidence Based Practice in Brandenburg (EBB), A JBI Affiliated Group, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
- Center for Health Services Research, Brandenburg Medical School, 15562 Rüdersdorf, Germany
| | - Mikhail Salzmann
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstr. 29, 14770 Brandenburg an der Havel, Germany
| | - Jonathan Lettner
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstr. 29, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
- Center of Evidence Based Practice in Brandenburg (EBB), A JBI Affiliated Group, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstr. 29, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
| | - Sebastian Kopf
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstr. 29, 14770 Brandenburg an der Havel, Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstr. 29, 14770 Brandenburg an der Havel, Germany
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
- Center of Evidence Based Practice in Brandenburg (EBB), A JBI Affiliated Group, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
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Zhou Z, Zhou X, Cui N, Huang H, Yang F, Yang G, Liu D, Liu K, Zhang X, Wang J. Effectiveness of tele-rehabilitation after total hip replacement: a systematic review and meta-analysis of randomized controlled trials. Disabil Rehabil 2023:1-6. [PMID: 37990882 DOI: 10.1080/09638288.2023.2280070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/01/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE To identify articles that evaluated the efficacy of tele-rehabilitation after total hip replacement and to provide a reference for clinical decision-making and continuous improvement of rehabilitation exercise intervention strategies for clinical medical staff. METHODS Embase, PubMed, Web of Science, Medline, China National Knowledge Network and Google Scholar databases were searched for randomized controlled trials of tele-rehabilitation after total hip replacement from inception to March 4, 2023. The two researchers used the PEDro scale to assess the methodological quality of the included studies. Two researchers used the PEDro scale to assess the methodological quality of the included studies. RESULTS Ten studies with 632 participants were analysed.Compared to face-to-face rehabilitation, Internet-based telerehabilitation showed better outcomes in Get-up and go test (SMD -0.54, 95% CI -0.79 to -0.29). telerehabilitation showed no significant difference in outcomes of other functional tests and functional questionnaires. CONCLUSION In this systematic review and meta-analysis, internet-based tele-rehabilitation and face-to-face rehabilitation had the same effect on patients after total hip replacement, and compliance was higher in the tele-rehabilitation group, but attention should be devoted to standardizing this form of rehabilitation to avoid adverse events. In addition, the number and quality of included studies in this study are limited, and the outcome indicators and intervention means have not been unified. More high-quality studies are needed to verify these conclusions to better evaluate the effectiveness and advantages of telerehabilitation.Implications for rehabilitationWith the development of science and technology, remote rehabilitation technology will be applied to various fields of rehabilitation, providing personalized and extensive rehabilitation services.The application of tele-rehabilitation technology to postoperative rehabilitation after total hip arthroplasty is feasible and can reduce the workload of healthcare professionals to a certain extent.This review evaluated the randomized controlled trials of telerehabilitation after total hip arthroplasty, and the results showed that the clinical efficacy of telerehabilitation after total hip arthroplasty was not inferior to that of traditional rehabilitation.
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Affiliation(s)
- Zheng Zhou
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Institute of Sport, Exercise & Health, Tianjin University of Sport, Tianjin, China
| | - Xiang Zhou
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Na Cui
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Institute of Sport, Exercise & Health, Tianjin University of Sport, Tianjin, China
| | - Hongjie Huang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Fan Yang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Gang Yang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Dingge Liu
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Kaiping Liu
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Xin Zhang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Jianquan Wang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
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11
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Duncan RP, Earhart GM. Remote Delivery of Allied Health Therapies in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2023:JPD230214. [PMID: 38007673 PMCID: PMC11234339 DOI: 10.3233/jpd-230214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
Remote delivery of allied health therapies has long been possible, but adoption has been limited in some disciplines until relatively recently. The COVID-19 pandemic drove dramatic increases in use of remote delivery within allied health. This review summarizes the latest evidence on remotely-delivered physical therapy, occupational therapy, and speech therapy and discusses associated challenges and opportunities.
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Affiliation(s)
- Ryan P Duncan
- Washington University in St. Louis, School of Medicine, Program in Physical Therapy, St. Louis, MO, USA
- Washington University in St. Louis, School of Medicine, Department of Neurology, St. Louis, MO, USA
| | - Gammon M Earhart
- Washington University in St. Louis, School of Medicine, Program in Physical Therapy, St. Louis, MO, USA
- Washington University in St. Louis, School of Medicine, Department of Neurology, St. Louis, MO, USA
- Washington University in St. Louis, Department of Neuroscience, St. Louis, MO, USA
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12
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Valle C, Schmitt-Sody M. [Digitalization in rehabilitation]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023; 52:869-875. [PMID: 37318535 DOI: 10.1007/s00132-023-04402-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The term digitalization is in trend. In addition to modernizing existing structures and converting analogue to digital processes, there are now a large number of digital applications available in the medical field. This is also increasingly influencing prehabilitation and rehabilitation. OBJECTIVE The aim of this article is to provide an overview of digitalization options in the field of rehabilitation, taking the current literature into account. MATERIAL AND METHODS A systematic literature search was carried out on the topic of digitalization in rehabilitation, especially in relation to interventions and diseases of the knee joint, using among others PubMed and PEDro. RESULTS AND CONCLUSION Having arrived in "Rehabilitation 4.0", the networking of all infrastructures as well as the increasing use of artificial intelligence, the individualization of offers for healthcare companies and patients are playing an increasing role and are experiencing a real hype due to the supposedly infinite possibilities; however, the data situation on various digital offers in rehabilitation is inconsistent. The digital transformation provides many opportunities and challenges for rehabilitation, but despite all the euphoria it has to be critically questioned.
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Affiliation(s)
- Christina Valle
- Medical Park Chiemsee, Birkenallee 41, 83233, Bernau am Chiemsee, Deutschland.
- Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum Rechts der Isar, München, Deutschland.
| | - Markus Schmitt-Sody
- Medical Park Chiemsee, Birkenallee 41, 83233, Bernau am Chiemsee, Deutschland.
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13
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Sara LK, Lewis CL. Rehabilitation Phases, Precautions, and Mobility Goals Following Total Hip Arthroplasty. HSS J 2023; 19:494-500. [PMID: 37937096 PMCID: PMC10626929 DOI: 10.1177/15563316231192980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/13/2023] [Indexed: 11/09/2023]
Abstract
The prevalence of total hip arthroplasty (THA) for advanced hip osteoarthritis (OA) is both increasing and shifting toward a younger average age. However, THA alone does not typically normalize function in these patients. Postoperative rehabilitation is often recommended to optimize joint motion, strength, and function. To date, there are no peer-reviewed clinical practice guidelines for postoperative rehabilitation following THA. Thus, optimal postoperative rehabilitation requires consideration of the existing literature and clinical expertise. This review article summarizes current recommendations for postoperative management of THA, including phases of rehabilitation, postoperative hip precautions, the effect of rehabilitation setting and mode of delivery on postoperative outcomes, and gait mechanics.
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Affiliation(s)
- Lauren K Sara
- Department of Physical Therapy, Boston University, Boston, MA, USA
| | - Cara L Lewis
- Department of Physical Therapy, Boston University, Boston, MA, USA
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14
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Venosa M, Romanini E, Ciminello E, Cerciello S, Angelozzi M, Calvisi V. Telerehabilitation Is a Valid Option for Total Knee Arthroplasty Patients: A Retrospective Pilot Study Based on Our Experience during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:2489. [PMID: 37761686 PMCID: PMC10530780 DOI: 10.3390/healthcare11182489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/03/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION Total knee arthroplasty is an effective operation. Post-surgery rehabilitation, based on early and intensive progressive exercise programs, plays a substantial role and telerehabilitation can be an effective safe option. This retrospective study aimed to compare traditional in-presence rehabilitation and telerehabilitation for total knee arthroplasty, based on our experience during the Italian COVID-19 lockdown. MATERIALS AND METHODS We retrospectively analyzed 164 patients (94 females and 70 males) enrolled in 2020 within 2 weeks after total knee replacement to perform post-operative outpatient rehabilitation. The clinical results of 82 patients (mean age 66.8 ± 10.2 years) performing telerehabilitation with those obtained from a similar cohort of 82 patients (mean age 65.4 ± 11.8 years) performing traditional in-presence outpatient rehabilitation were compared. Clinical outcomes were examined by comparing the gait speed (Time Up and Go-TUG test), the range of motion, the pain intensity (VAS), the functional status (Oxford Knee Score-OKS and Knee injury and Osteoarthritis Outcome Score-KOOS) and the overall satisfaction (Self-administered patient satisfaction scale) 12 weeks after the beginning of the physiotherapeutic protocol. RESULTS Telerehabilitation was non-inferior to traditional in-presence rehabilitation in all of the investigated areas and no statistical difference in terms of effectiveness was detected at 12 weeks, as confirmed by the respective patient-reported outcome scores such as TUG test (reduced from 20 ± 2 s to 12 ± 1.5 s for the telerehab cohort and from 18 ± 1.5 s to 13.1 ± 2 s for the in-presence rehabilitation one), pain VAS, OKS (improved from 22 ± 1.3 to 36 ± 2.7 for the telerehab cohort and from 23 ± 2.1 to 35.1 ± 4.2 for the in-presence group), KOOS (improved from 46.2 ± 10.2 to 67.4 ± 3.8 for the telerehabilitation cohort and from 48.4 ± 8.4 to 68.3 ± 6.6 for the other group), and the Self-administered patient satisfaction scale (more than two-thirds of patients globally satisfied with the results of their surgery in both groups). CONCLUSION The telerehabilitation program was effective after total knee replacement and yielded clinical outcomes that were not inferior to conventional outpatient protocols.
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Affiliation(s)
- Michele Venosa
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Vetoio, Coppito 2, 67100 L’Aquila, Italy; (M.A.); (V.C.)
- RomaPro, Polo Sanitario San Feliciano, Via Mattia Battistini 44, 00167 Rome, Italy;
| | - Emilio Romanini
- RomaPro, Polo Sanitario San Feliciano, Via Mattia Battistini 44, 00167 Rome, Italy;
- GLOBE, Italian Working Group on Evidence-Based Orthopaedics, Via Nicola Martelli 3, 00197 Rome, Italy
| | - Enrico Ciminello
- Italian Implantable Prostheses Registry (RIPI), Italian National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy;
| | - Simone Cerciello
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy;
- Orthopaedic Department, Casa di Cura Villa Betania, Via Pio IV 42, 00165 Rome, Italy
| | - Massimo Angelozzi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Vetoio, Coppito 2, 67100 L’Aquila, Italy; (M.A.); (V.C.)
| | - Vittorio Calvisi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Vetoio, Coppito 2, 67100 L’Aquila, Italy; (M.A.); (V.C.)
- UOSD, Department of Mini-Invasive and Computer-Assisting Orthopedic Surgery, San Salvatore Hospital, Via L. Natali 1, 67100 L’Aquila, Italy
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15
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Baffert S, Hadouiri N, Fabron C, Burgy F, Cassany A, Kemoun G. Economic Evaluation of Telerehabilitation: Systematic Literature Review of Cost-Utility Studies. JMIR Rehabil Assist Technol 2023; 10:e47172. [PMID: 37669089 PMCID: PMC10509745 DOI: 10.2196/47172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/07/2023] [Accepted: 07/26/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Telerehabilitation could benefit a large population by increasing adherence to rehabilitation protocols. OBJECTIVE Our objective was to review and discuss the use of cost-utility approaches in economic evaluations of telerehabilitation interventions. METHODS A review of the literature on PubMed, Scopus, Centres for Review and Dissemination databases (including the HTA database, the Database of Abstracts of Reviews of Effects, and the NHS Economic Evaluation Database), Cochrane Library, and ClinicalTrials.gov (last search on February 8, 2021) was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The inclusion criteria were defined in accordance with the PICOS (population, intervention, comparison, outcomes, and study design) system: the included studies had to evaluate patients in rehabilitation therapy for all diseases and disorders (population) through exercise-based telerehabilitation (intervention) and had to have a control group that received face-to-face rehabilitation (comparison), and these studies had to evaluate effectiveness through gain in quality of life (outcome) and used the design of randomized and controlled clinical studies (study). RESULTS We included 11 economic evaluations, of which 6 concerned cardiovascular diseases. Several types of interventions were assessed as telerehabilitation, consisting in monitoring of rehabilitation at home (monitored by physicians) or a rehabilitation program with exercise and an educational intervention at home alone. All studies were based on randomized clinical trials and used a validated health-related quality of life instrument to describe patients' health states. Four evaluations used the EQ-5D, 1 used the EQ-5D-5L, 2 used the EQ-5D-3L, 3 used the Short-Form Six-Dimension questionnaire, and 1 used the 36-item Short Form survey. The mean quality-adjusted life years gained using telerehabilitation services varied from -0.09 to 0.89. These results were reported in terms of the probability that the intervention was cost-effective at different thresholds for willingness-to-pay values. Most studies showed results about telerehabilitation as dominant (ie, more effective and less costly) together with superiority or noninferiority in outcomes. CONCLUSIONS There is evidence to support telerehabilitation as a cost-effective intervention for a large population among different disease areas. There is a need for conducting cost-effectiveness studies in countries because the available evidence has limited generalizability in such countries. TRIAL REGISTRATION PROSPERO CRD42021248785; https://tinyurl.com/4xurdvwf.
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Affiliation(s)
| | - Nawale Hadouiri
- Pôle Rééducation et de Réadaptation, CHU de Dijon, Dijon, France
- InterSyndicale Nationale des Internes, Paris, France
| | | | - Floriane Burgy
- Pôle Rééducation et de Réadaptation, CHU de Dijon, Dijon, France
| | | | - Gilles Kemoun
- Centre Clinical, Department of Médecine Physique et de Réadaptation Fonctionnelle, ELSAN, Soyaux, France
- Laboratoire Mobilité, Mouvement et Exercice (MOVE) - EA 6314, Université de Poitiers, Poitiers, France
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16
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Roitenberg N, Ben-Ami N. Qualitative exploration of physical therapists' experiences providing telehealth physical therapy during COVID-19. Musculoskelet Sci Pract 2023; 66:102789. [PMID: 37343401 PMCID: PMC10257945 DOI: 10.1016/j.msksp.2023.102789] [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: 04/02/2023] [Revised: 05/24/2023] [Accepted: 06/05/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Physical therapists are trained to provide treatment to patients through a mixture of strategies. The coronavirus (COVID-19) pandemic resulted in social distancing restrictions, and physical therapists, some without previous experience, adopted telehealth physical therapy modalities to treat their patients. OBJECTIVES The objective of this study was to explore physical therapists' experiences of providing telehealth physical therapy during the COVID-19 pandemic. DESIGN AND METHODS A multisite qualitative semi-structured interview study was conducted. Seventeen physical therapists were interviewed by videoconference or by phone, and the interviews were transcribed and analyzed thematically. RESULTS Three main themes emerged from the study. Firstly, physical therapists experienced professional challenges with diagnosing and treating patients hands-off and becoming more verbal. Secondly, telehealth physical therapy was perceived as not feasible or effective for certain patients, attesting to the digital care divide. Lastly, participants' perceptions of patient-therapist communication varied, expressing both communicative advantages and challenges. CONCLUSIONS Physical therapists who practiced telehealth physical therapy during the COVID-19 period experienced information and communication technology as professionally challenging. Physical therapists adapted positively to the use of telehealth physical therapy but perceived that not every patient could benefit from it. The study emphasized the need for a better understanding of physical therapists' hands-off skills for practicing telehealth physical therapy and considers the need to establish a patient classification for telehealth physical therapy.
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Affiliation(s)
- Neta Roitenberg
- Sociology and Anthropology Department, Bar-Ilan University, Ramat-Gan, Israel.
| | - Noa Ben-Ami
- Physical-Therapy Department, Ariel University, Ariel, Israel
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17
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Jaswal S, Lo J, Sithamparanathan G, Nowrouzi-Kia B. The era of technology in healthcare: an evaluation of telerehabilitation on patient outcomes-a systematic review and meta-analysis protocol. Syst Rev 2023; 12:76. [PMID: 37143097 PMCID: PMC10157558 DOI: 10.1186/s13643-023-02248-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 04/25/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND The World Health Organization announced the outbreak of the Coronavirus disease as a global pandemic on March 11, 2020. Since then, rapid implementation of telehealth approaches into the healthcare system have been evident. The pandemic has drastically impacted the lives of many around the globe and has detrimentally affected our healthcare systems, specifically with the delivery of healthcare. This has had many implications on rehabilitation services such as, occupational therapy, physiotherapy, and speech therapy. The delivery of mental health services remotely may be referred to as teletherapy, telemental health, telepsychiatry, and telepsychology. Telerehabilitation has become a necessity over the course of the pandemic due to safety concerns with COVID-19 transmission. The primary aim of this systematic review protocol is to evaluate the literature on the effect of telerehabilitation on patient outcomes and propose directives for future research based on the evidence reviewed. METHODS A systematic review and meta-analysis will be conducted to examine the literature on the effect of telerehabilitation on patient outcomes following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PRISMA, 2015). The systematic review will use the following databases to examine the literature on telerehabilitation and patient outcomes: APA PsychINFO, Embase (Ovid), MEDLINE (Ovid), CINAHL, and Scopus. DISCUSSION The utilization of telerehabilitation and similar telehealth treatments has increased throughout the COVID-19 pandemic. However, much is still unclear regarding the effectiveness of these methods in the delivery and service of healthcare, and their effect on health outcomes. This review will identify and address the knowledge gaps in the literature, which will provide further directions for future research. TRIAL REGISTRATION This systematic review has been registered with PROSPERO under registration number CRD42022297849.
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Affiliation(s)
- Sharan Jaswal
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Joyce Lo
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Gobika Sithamparanathan
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Centre for Research in Occupational Safety and Health, School of Rural and Northern Health, Laurentian University, Sudbury, ON, Canada.
- Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
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Khan N, Gilliar W, Bamrah JS, Dave S. Post-COVID-19: can digital solutions lead to a more equitable global healthcare workforce? BJPsych Int 2023; 20:18-23. [PMID: 36812032 PMCID: PMC9909439 DOI: 10.1192/bji.2022.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 04/07/2022] [Indexed: 11/23/2022] Open
Abstract
An unintended consequence of the COVID-19 pandemic has been the exponential growth of telemedicine, with automation of healthcare becoming more common. Face-to-face meetings and training events have been replaced relatively seamlessly with online versions, taking clinical or academic expertise to distant parts of the world and making them more accessible and affordable. The wide reach of digital platforms offering remote healthcare offers the opportunity of democratising access to high-quality healthcare, However, certain challenges remain: (a) clinical guidance developed in one geographical area may need adaptation for use in others; (b) regulatory mechanisms from one jurisdiction need to offer patient safety across other jurisdictions; (c) barriers created by disparity in technology infrastructure and the variation in pay for services across different economies, leading to brain drain and an inequitable workforce. The World Health Organization's Global Code of Practice on the International Recruitment of Health Personnel could offer the preliminary framework on which solutions to these challenges could be built.
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Affiliation(s)
- Nagina Khan
- BHSc, PGCert, PhD, Senior Research Associate, College of Osteopathic Medicine, Touro University Nevada, Henderson, Nevada, USA.
| | - Wolfgang Gilliar
- DO, FAAPMR, Dean, College of Osteopathic Medicine, Touro University Nevada, Henderson, Nevada, USA
| | - J. S. Bamrah
- FRCPSYCH, MHSM, FIIOPM, Consultant Psychiatrist, Greater Manchester Mental Health NHS Foundation Trust, Park House, North Manchester General Hospital, UK
| | - Subodh Dave
- FRCPsych, MMed, Consultant Psychiatrist and Deputy Director of Undergraduate Medical Education, Derbyshire Healthcare Foundation Trust, University of Bolton, UK.
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19
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de Rezende DRB, Neto IA, Iunes DH, Carvalho LC. Analysis of the effectiveness of remote intervention of patients affected by chronic diseases: A systematic review and meta-analysis. THE JOURNAL OF MEDICINE ACCESS 2023; 7:27550834231197316. [PMID: 37781504 PMCID: PMC10540568 DOI: 10.1177/27550834231197316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/04/2023] [Indexed: 10/03/2023]
Abstract
Objectives The aim of the study was to verify the effectiveness of telemedicine in randomized controlled trials (RCTs) in terms of its influence on physical conditioning, quality of life, and health conditions in adults/elderly people affected by chronic diseases. Design This was a systematic review and meta-analysis. Methods The search covered RCTs published from 2011 to 2021 and was conducted using the PubMed, Embase, PEDro, Lilacs, and Cochrane Library databases, on volunteers of both sexes, that were rehabilitated, and/or monitored, and/or evaluated, specifically, via remote care. The extraction, quality of studies, and risk of bias were assessed using the RoB2 (risk of bias) tool, for analysis of the strength of evidence, the GRADE (Grading of Recommendations Assessment, Developing, and Evaluation) method was used, and for the preparation of meta-analysis was used at RevMan 5.4 (Review Manager) was used. Results The database search identified 3949 potential articles for screening, 13 of which were eligible for the present systematic review, involving 1469 participants with chronic diseases (chronic obstructive pulmonary disease (COPD), asthma, heart failure, diabetes mellitus, and fibromyalgia). Through the meta-analysis, an advantage was identified for the remote intervention on physical conditioning (p = 0.001), with an estimated effect of 0.29 (0.11, 0.46) and on health conditions (p = 0.0004), -0.30 (-0.47, -0.14), while for quality of life, no significant difference was identified (p = 0.90), 0.01 (-0.13, 0.14). Conclusion Telemedicine has clinical effectiveness for the outcome of physical conditioning and general health conditions in adults with chronic diseases when compared to usual care without face-to-face intervention.
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Affiliation(s)
| | | | - Denise Hollanda Iunes
- Physiotherapy Course at the Federal University of Alfenas, Alfenas, Brazil
- Department of Postgraduate Program in Rehabilitation Sciences, Federal University of Alfenas, Alfenas, Brazil
| | - Leonardo César Carvalho
- Department of Postgraduate Program in Applied Health Biosciences, Federal University of Alfenas, Alfenas, Brazil
- Physiotherapy Course at the Federal University of Alfenas, Alfenas, Brazil
- Department of Postgraduate Program in Rehabilitation Sciences, Federal University of Alfenas, Alfenas, Brazil
- Institute of Motricity Sciences, Federal University of Alfenas, Alfenas, Brazil
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20
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Therapeutic Exercise Interventions through Telerehabilitation in Patients with Post COVID-19 Symptoms: A Systematic Review. J Clin Med 2022; 11:jcm11247521. [PMID: 36556137 PMCID: PMC9785416 DOI: 10.3390/jcm11247521] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/06/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
The worldwide incidence of COVID-19 has generated a pandemic of sequelae. These sequelae require multidisciplinary rehabilitative work to address the multisystemic symptoms that patients will present with now and in the future. The aim of the present systematic review is to analyze the current situation of telerehabilitation in patients with COVID-19 sequelae and its effectiveness. Searches were conducted on the following databases: PubMed, Scopus, PEDro, and Web of Science (WOS). There was no complete homogeneity among the five selected articles, so we differentiated two clinical subgroups for the clustering of outcome measures: (group one) patients with post-discharge symptoms and (group two) patients with permanent symptoms or “long COVID-19” defined as persistent symptoms > 2 months. For group one, post-discharge sequelae, improvements were obtained in cardiovascular parameters, and physical test studies in group two presented very favorable results in all the cardiorespiratory measures and physical tests evaluated. Telerehabilitation through therapeutic exercise based on mixed protocols of aerobic, respiratory, and low-load strength exercises appear to be an effective and safe strategy for the recovery of short- and long-term post-COVID-19 sequelae.
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21
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Grigorovich A, Xi M, Lam N, Pakosh M, Chan BCF. A systematic review of economic analyses of home-based telerehabilitation. Disabil Rehabil 2022; 44:8188-8200. [PMID: 34965827 DOI: 10.1080/09638288.2021.2019327] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE Telerehabilitation, or the delivery of rehabilitation using information and communication technologies, may improve timely and equitable access to rehabilitation services at home. A systematic literature review was conducted of studies that formally documented the costs and effects of home-based telerehabilitation versus in-person rehabilitation across all health conditions. MATERIALS AND METHODS Six electronic databases were searched from inception to 13 July 2021 (APA, PsycInfo, CINAHL, Embase, EmCare, Medline (Ovid), and PubMed) using a protocol developed by a medical librarian. A quality appraisal of full economic evaluation studies was conducted using the Drummond 10-point quality checklist. RESULTS Thirty-five studies were included in this review covering various rehabilitation types and diverse populations. The majority were published in the last six years. Available evidence suggests that telerehabilitation may result in similar or lower costs as compared to in-person rehabilitation for the health care system and for patients. However, the impact of telerehabilitation on long-term clinical outcomes and health-related quality of life remains unclear. CONCLUSIONS More high quality and robust economic evaluations exploring the short- and long-term costs and other impacts of telerehabilitation on patients, caregivers, and health care systems across all types of patient populations are still required.Implications for rehabilitationHome-based telerehabilitation may reduce barriers in access to care for individuals living in the community.Economic analyses can inform health care system decision-making by evaluating the costs and effects associated with telerehabilitation.This study found that telerehabilitation may result in similar or lower costs as in-person rehabilitation; however, its impact on health-related quality of life is unclear.
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Affiliation(s)
- Alisa Grigorovich
- Department of Recreation and Leisure Studies, Brock University, St. Catharines, Canada.,KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
| | - Min Xi
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Natascha Lam
- School of Kinesiology, University of British Columbia, Vancouver, Canada
| | - Maureen Pakosh
- Library & Information Services, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Brian C F Chan
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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22
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Nertinger S, Kirschner RJ, Naceri A, Haddadin S. Acceptance of Remote Assistive Robots with and without Human-in-the-Loop for Healthcare Applications. Int J Soc Robot 2022. [DOI: 10.1007/s12369-022-00931-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractAssistive social robots aim to facilitate outpatient-care including required safety critical measures. Accepting a robot to perform such measures, e.g., operate in close physical interaction for medical examinations, requires human trust towards the robot. Human-in-the-loop (HIL) applications where the robot is teleoperated by a human expert can help the person to accept even risky tasks performed by a robot. Therefore, the assistive humanoid GARMI was designed to enable HIL applications with varying autonomy. In this study, we use GARMI to understand which tasks in the framework of care may be accepted depending on human socio-demographics and user beliefs as well as the level of robot autonomy. Firstly, we seek to understand the general acceptance of GARMI using the Almere questionnaire. Secondly, we ask adults to rate their willingness to use several functionalities of GARMI. Lastly, we investigate the effect of the introduction method of GARMI on user acceptance. We assemble all relevant factors on acceptance to provide direction in the user-centered design process of assistive robots. The results of 166 participants show that alongside others, trust towards the robot and utilitarian variables such as perceived usefulness are the most influencing factors on the acceptance of GARMI and should be considered for the design of robotic semi-autonomous outpatient-services.
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23
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Kamecka K, Foti C, Gawiński Ł, Matejun M, Rybarczyk-Szwajkowska A, Kiljański M, Krochmalski M, Kozłowski R, Marczak M. Telemedicine Technologies Selection for the Posthospital Patient Care Process after Total Hip Arthroplasty. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11521. [PMID: 36141791 PMCID: PMC9517262 DOI: 10.3390/ijerph191811521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
For many years, the importance of using telematic technologies in medicine has been growing, especially in the period of the coronavirus pandemic, when direct contact and supervision of medical personnel over the patient is difficult. The existing possibilities of modern information and communication technologies (ICTs) are not fully used. The aim of the study is to identify the telemedicine technologies that can be used in future implementation projects of the posthospital patient care process after total hip arthroplasty (THA). The literature search is reported according to PRISMA 2020. The search strategy included databases and gray literature. In total, 28 articles (EMBASE, PubMed, PEDro) and 24 records from gray literature (Google Search and Technology presentations) were included in the research. This multi-source study analyzes the possibilities of using different technologies useful in the patient care process. The conducted research resulted in defining visual and wearable types of telemedicine technologies for the original posthospital patient care process after THA. As the needs of stakeholders in the posthospital patient care process after THA differ, the awareness of appropriate technologies selection, information flow, and its management importance are prerequisites for effective posthospital patient care with the use of telemedicine technologies.
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Affiliation(s)
- Karolina Kamecka
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland
| | - Calogero Foti
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, 00133 Rome, Italy
| | - Łukasz Gawiński
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland
| | - Marek Matejun
- Department of Entrepreneurship and Industrial Policy, Faculty of Management, University of Lodz, 90-237 Lodz, Poland
| | | | - Marek Kiljański
- Polish Association of Physiotherapy Specialists, 95-200 Pabianice, Poland
- Medical Magnus Clinic, 90-552 Lodz, Poland
| | - Marek Krochmalski
- Medical Magnus Clinic, 90-552 Lodz, Poland
- Polish Muscles, Ligaments and Tendons Society, 90-552 Lodz, Poland
| | - Remigiusz Kozłowski
- Center of Security Technologies in Logistics, Faculty of Management, University of Lodz, 90-237 Lodz, Poland
| | - Michał Marczak
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland
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24
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Early Virtual-Reality-Based Home Rehabilitation after Total Hip Arthroplasty: A Randomized Controlled Trial. J Clin Med 2022; 11:jcm11071766. [PMID: 35407373 PMCID: PMC8999553 DOI: 10.3390/jcm11071766] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 11/16/2022] Open
Abstract
The benefits of early virtual-reality-based home rehabilitation following total hip arthroplasty (THA) have not yet been assessed. The aim of this randomized controlled study was to compare the efficacy of early rehabilitation via the Virtual Reality Rehabilitation System (VRRS) versus traditional rehabilitation in improving functional outcomes after THA. Subjects were randomized either to an experimental (VRRS; n = 21) or a control group (control; n = 22). All participants were invited to perform a daily home exercise program for rehabilitation after THA with different administration methods—namely, an illustrated booklet for the control group and a tablet with wearable sensors for the VRRS group. The primary outcome was the hip disability (HOOS JR). Secondary outcomes were the level of independence and the degree of global perceived effect of the rehabilitation program (GPE). Outcomes were measured before surgery (T0) and at the 4th (T1), 7th (T2), and 15th (T3) day after surgery. Mixed-model ANOVA showed no significant group effect but a significant effect of time for all variables (p < 0.001); no differences were observed in HOOS JR between VRRS and the control at T0, T1, T2, or T3. Further, no differences in the level of independence were found between VRRS and the control, whereas the GPE was higher at T3 in VRSS compared to the control (4.76 ± 0.43 vs. 3.96 ± 0.65; p < 0.001). Virtual-reality-based home rehabilitation resulted in similar improvements in functional outcomes with a better GPE compared to the traditional rehabilitation program following THA. The application of new technologies could offer novel possibilities for service delivery in rehabilitation.
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25
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Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2021; 396:2006-2017. [PMID: 33275908 PMCID: PMC7811204 DOI: 10.1016/s0140-6736(20)32340-0] [Citation(s) in RCA: 911] [Impact Index Per Article: 303.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 10/04/2020] [Accepted: 10/27/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Rehabilitation has often been seen as a disability-specific service needed by only few of the population. Despite its individual and societal benefits, rehabilitation has not been prioritised in countries and is under-resourced. We present global, regional, and country data for the number of people who would benefit from rehabilitation at least once during the course of their disabling illness or injury. METHODS To estimate the need for rehabilitation, data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 were used to calculate the prevalence and years of life lived with disability (YLDs) of 25 diseases, impairments, or bespoke aggregations of sequelae that were selected as amenable to rehabilitation. All analyses were done at the country level and then aggregated to seven regions: World Bank high-income countries and the six WHO regions (ie, Africa, the Americas, Southeast Asia, Europe, Eastern Mediterranean, and Western Pacific). FINDINGS Globally, in 2019, 2·41 billion (95% uncertainty interval 2·34-2·50) individuals had conditions that would benefit from rehabilitation, contributing to 310 million [235-392] YLDs. This number had increased by 63% from 1990 to 2019. Regionally, the Western Pacific had the highest need of rehabilitation services (610 million people [588-636] and 83 million YLDs [62-106]). The disease area that contributed most to prevalence was musculoskeletal disorders (1·71 billion people [1·68-1·80]), with low back pain being the most prevalent condition in 134 of the 204 countries analysed. INTERPRETATION To our knowledge, this is the first study to produce a global estimate of the need for rehabilitation services and to show that at least one in every three people in the world needs rehabilitation at some point in the course of their illness or injury. This number counters the common view of rehabilitation as a service required by only few people. We argue that rehabilitation needs to be brought close to communities as an integral part of primary health care to reach more people in need. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Alarcos Cieza
- Sensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, World Health Organization, Geneva, Switzerland.
| | - Kate Causey
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Kaloyan Kamenov
- Sensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Sarah Wulf Hanson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Somnath Chatterji
- Data and Analytics Department, World Health Organization, Geneva, Switzerland
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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26
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Ariza-Vega P, Prieto-Moreno R, Castillo-Pérez H, Martínez-Ruiz V, Romero-Ayuso D, Ashe MC. Family Caregivers' Experiences with Tele-Rehabilitation for Older Adults with Hip Fracture. J Clin Med 2021; 10:jcm10245850. [PMID: 34945145 PMCID: PMC8708159 DOI: 10.3390/jcm10245850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/02/2021] [Accepted: 12/08/2021] [Indexed: 01/17/2023] Open
Abstract
Background: There is a knowledge gap for implementing tele-rehabilitation (telerehab) after hip fracture. We recently conducted a clinical trial (ClinicalTrials.gov Identifier: NCT02968589) to test a novel online family caregiver-supported rehabilitation program for older adults with hip fracture, called @ctivehip. In this qualitative substudy, our objective was to use semi-structured interviews to explore family caregivers experience with the telerehab program. Methods: Twenty-one family caregivers were interviewed between three and six months after the older adults completed @ctivehip. One occupational therapist with research and clinical experience, but not involved in the main trial, conducted and transcribed the interviews. We conducted a multi-step content analysis, and two authors completed one coding cycle and two recoding cycles. Results: Family caregivers who enrolled in @ctivehip were satisfied with the program, stated it was manageable to use, and perceived benefits for older adults’ functional recovery after hip fracture. They also suggested improvements for the program content, such as more variety with exercises, and increased monitoring by health professionals. Conclusions: This work extends existing literature and generates research hypotheses for future studies to test telerehab content and program implementation.
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Affiliation(s)
- Patrocinio Ariza-Vega
- Department of Physiotherapy, University of Granada, 18016 Granada, Spain; (P.A.-V.); (D.R.-A.)
- Physical Medicine and Rehabilitation Service, Biohealth Research Institute, Virgen de las Nieves University Hospital, 18012 Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, 18071 Granada, Spain
| | - Rafael Prieto-Moreno
- Physical Medicine and Rehabilitation Service, Biohealth Research Institute, Virgen de las Nieves University Hospital, 18012 Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, 18071 Granada, Spain
- Correspondence:
| | | | - Virginia Martínez-Ruiz
- Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, 18016 Granada, Spain;
- Center for Biomedical Research in Network of Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18014 Granada, Spain
| | - Dulce Romero-Ayuso
- Department of Physiotherapy, University of Granada, 18016 Granada, Spain; (P.A.-V.); (D.R.-A.)
| | - Maureen C. Ashe
- Centre for Hip Health and Mobility, Department of Family Practice, University of British Columbia, Vancouver, BC V5Z 1M9, Canada;
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Process of Posthospital Care Involving Telemedicine Solutions for Patients after Total Hip Arthroplasty. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910135. [PMID: 34639436 PMCID: PMC8508342 DOI: 10.3390/ijerph181910135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/31/2021] [Accepted: 09/22/2021] [Indexed: 12/18/2022]
Abstract
The importance of telemedicine technologies around the world has been growing for many years, and it turned out to be a particularly important issue for conducting some medical procedures during the SARS-CoV-2 pandemic. It is necessary to create interdisciplinary teams to design and implement improved procedures using telemedicine tools. The aim of the article is to develop original, improved posthospital patient care process after total hip arthroplasty (THA) with the use of telemedicine technologies. In the study, a literature review and empirical research were used. The conducted research resulted in the designing an original posthospital patient care process after THA that uses telematics technologies. Due to the use of analyzed telemedicine technologies, the designed patient care process brings a possibility to increase the patient's safety by monitoring life parameters, allowing for regular, remote contact with specialists and to be supervised remotely. All this may contribute to shortening the convalescence time, reducing the risk of complications, as well as reducing treatment costs. The designed model is ready for further clinical research with the participation of medical staff, patients after THA and patient caregivers.
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28
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Xiang G, Zhu X, Ma L, Huang H, Wu X, Zhang W, Li S. Clinical guidelines on the application of Internet of Things (IOT) medical technology in the rehabilitation of chronic obstructive pulmonary disease. J Thorac Dis 2021; 13:4629-4637. [PMID: 34527304 PMCID: PMC8411163 DOI: 10.21037/jtd-21-670] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/22/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Guiling Xiang
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaodan Zhu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lin Ma
- Department of Pulmonary Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Huai Huang
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaodan Wu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wei Zhang
- Department of Pulmonary Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shanqun Li
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
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29
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Tully L, Sorensen J, O'Malley G. Pediatric Weight Management Through mHealth Compared to Face-to-Face Care: Cost Analysis of a Randomized Control Trial. JMIR Mhealth Uhealth 2021; 9:e31621. [PMID: 34519665 PMCID: PMC8479601 DOI: 10.2196/31621] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/26/2021] [Accepted: 08/01/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) may improve pediatric weight management capacity and the geographical reach of services, and overcome barriers to attending physical appointments using ubiquitous devices such as smartphones and tablets. This field remains an emerging research area with some evidence of its effectiveness; however, there is a scarcity of literature describing economic evaluations of mHealth interventions. OBJECTIVE We aimed to assess the economic viability of using an mHealth approach as an alternative to standard multidisciplinary care by evaluating the direct costs incurred within treatment arms during a noninferiority randomized controlled trial (RCT). METHODS A digitally delivered (via a smartphone app) maintenance phase of a pediatric weight management program was developed iteratively with patients and families using evidence-based approaches. We undertook a microcosting exercise and budget impact analysis to assess the costs of delivery from the perspective of the publicly funded health care system. Resource use was analyzed alongside the RCT, and we estimated the costs associated with the staff time and resources for service delivery per participant. RESULTS In total, 109 adolescents participated in the trial, and 84 participants completed the trial (25 withdrew from the trial). We estimated the mean direct cost per adolescent attending usual care at €142 (SD 23.7), whereas the cost per adolescent in the mHealth group was €722 (SD 221.1), with variations depending on the number of weeks of treatment completion. The conversion rate for the reference year 2013 was $1=€0.7525. The costs incurred for those who withdrew from the study ranged from €35 to €681, depending on the point of dropout and study arm. The main driver of the costs in the mHealth arm was the need for health professional monitoring and support for patients on a weekly basis. The budget impact for offering the mHealth intervention to all newly referred patients in a 1-year period was estimated at €59,046 using the assessed approach. CONCLUSIONS This mHealth approach was substantially more expensive than usual care, although modifications to the intervention may offer opportunities to reduce the mHealth costs. The need for monitoring and support from health care professionals (HCPs) was not eliminated using this delivery model. Further research is needed to explore the cost-effectiveness and economic impact on families and from a wider societal perspective. TRIAL REGISTRATION ClinicalTrials.gov NCT01804855; https://clinicaltrials.gov/ct2/show/NCT01804855.
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Affiliation(s)
- Louise Tully
- Obesity Research and Care Group, Division of Population Health Sciences, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Jan Sorensen
- Healthcare Outcomes Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Grace O'Malley
- Obesity Research and Care Group, Division of Population Health Sciences, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland.,W82GO Child and Adolescent Weight Management Service, Children's Health Ireland at Temple Street, Dublin, Ireland
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30
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Mohammadi S, Miller WC, Wu J, Pawliuk C, Robillard JM. Effectiveness of eHealth Tools for Hip and Knee Arthroplasty: A Systematic Review. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:696019. [PMID: 36188859 PMCID: PMC9397702 DOI: 10.3389/fresc.2021.696019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022]
Abstract
Objective: This study aimed to compare the effectiveness and costs of eHealth tools with usual care in delivering health-related education to patients' undergoing total hip or knee arthroplasty due to osteoarthritis.Data Sources: Six electronic databases were searched to identify randomized controlled trials and experimental designs (randomized or not) examining the effect of eHealth tools on pre- or post-operative care. Only manuscripts written in English were included. In the current study, no specific primary or secondary outcomes were selected. Any study that investigated the impacts of eHealth tools on hip or knee arthroplasty outcomes were included.Review Methods: Two researchers reviewed all titles and abstracts independently and in duplicate. Two researchers also conducted full-text screening and data extraction from the 26 selected articles.Results: The data were descriptively reported, and themes could emerge from each outcome. Two researchers separately assessed the Risk of Bias for each paper using the Cochrane risk of bias assessment tool. The majority of studies evaluated the impact of eHealth tools on physical (n = 23) and psychosocial outcomes (n = 19). Cost-related outcomes were measured in 7 studies. eHealth tools were found to be equivocal to usual care, with few studies reporting statistically significant differences in physical or psychosocial outcome measures. However, cost-related outcomes showed that using eHealth tools is more cost-effective than usual care.Conclusions: This review demonstrated that eHealth tools might be as effective as usual care, and possibly more cost-effective, a crucial implication for many overly burdened health care systems.
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Affiliation(s)
- Somayyeh Mohammadi
- GF Strong Rehabilitation Research Program, Vancouver, BC, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - William C. Miller
- GF Strong Rehabilitation Research Program, Vancouver, BC, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Julia Wu
- BC Children's and Women's Hospitals and Health Centres, Vancouver, BC, Canada
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Colleen Pawliuk
- BC Children Hospital Research Institute, Vancouver, BC, Canada
| | - Julie M. Robillard
- BC Children's and Women's Hospitals and Health Centres, Vancouver, BC, Canada
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
- *Correspondence: Julie M. Robillard
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31
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Malik IV, Devasenapathy N, Kumar A, Dogra H, Ray S, Gautam D, Malhotra R. Estimation of Expenditure and Challenges Related to Rehabilitation After Knee Arthroplasty: A Hospital-Based Cross-Sectional Study. Indian J Orthop 2021; 55:1317-1325. [PMID: 34824731 PMCID: PMC8586390 DOI: 10.1007/s43465-021-00405-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/08/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Expenditure for rehabilitation following knee arthroplasty for osteoarthritis- and rehabilitation-related challenges following discharge to home after surgery is not available in the Indian context. OBJECTIVES To estimate cost of rehabilitation and document challenges in following rehabilitation advices, from a patient perspective. METHODS We conducted a hospital-based cross-sectional study of patients visiting the orthopedic department at a tertiary care public-funded hospital in New Delhi and included those who recently (less than 4 months) underwent primary knee arthroplasty for osteoarthritis. A trained physiotherapist not involved in clinical care collected information on expenditures incurred after discharge from hospital, patient's ability to recall the advices given by the physician and challenges they experienced using a semi-structured questionnaire. We report median costs by category of direct and indirect cost and used linear regression to explore determinants of cost. RESULTS We interviewed 82 consecutive patients (mean age 60.8 years and 68% females) with median time since surgery of 28 days. More than half (52%) sought some support for physiotherapy. The median cost of rehabilitation was INR 18,395 (Interquartile-range 11,325-27,775). Direct medical cost contributed to 74% of total cost (32% fee for services, 21% medications and lab investigations, 21% assistive devices). Twenty percent higher costs were incurred among those undergoing bilateral knee surgery after adjusting for age, sex, income, and type of physiotherapy support sought. Challenges were related to recall of advices, not understanding the recovery process and pain management. CONCLUSION About half patients undergoing knee arthroplasty seek support for rehabilitation after discharge to home contributing to a major portion of expenses incurred during rehabilitation. Cost-effective support mechanism for home-based rehabilitation is required for improving patient rehabilitation experiences. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s43465-021-00405-6.
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Affiliation(s)
- Isha V. Malik
- grid.415361.40000 0004 1761 0198Indian Institute of Public Health-Delhi, Public Health Foundation of India, Plot 47, Sec 44, Institutional Area, Gurgaon, 122002 India
| | - Niveditha Devasenapathy
- grid.415361.40000 0004 1761 0198Indian Institute of Public Health-Delhi, Public Health Foundation of India, Plot 47, Sec 44, Institutional Area, Gurgaon, 122002 India
| | - Ajit Kumar
- grid.413618.90000 0004 1767 6103Department of Orthopedics, All India Institute of Medical Sciences, Ansari Nagar (East), New Delhi, 110029 India
| | - Hardik Dogra
- grid.415361.40000 0004 1761 0198Indian Institute of Public Health-Delhi, Public Health Foundation of India, Plot 47, Sec 44, Institutional Area, Gurgaon, 122002 India
| | - Shomik Ray
- grid.415361.40000 0004 1761 0198Indian Institute of Public Health-Delhi, Public Health Foundation of India, Plot 47, Sec 44, Institutional Area, Gurgaon, 122002 India
| | - Deepak Gautam
- grid.413618.90000 0004 1767 6103Department of Orthopedics, All India Institute of Medical Sciences, Ansari Nagar (East), New Delhi, 110029 India
| | - Rajesh Malhotra
- grid.413618.90000 0004 1767 6103Department of Orthopedics, All India Institute of Medical Sciences, Ansari Nagar (East), New Delhi, 110029 India
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32
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Fontalis A, Epinette JA, Thaler M, Zagra L, Khanduja V, Haddad FS. Advances and innovations in total hip arthroplasty. SICOT J 2021; 7:26. [PMID: 33843582 PMCID: PMC8040589 DOI: 10.1051/sicotj/2021025] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/20/2021] [Indexed: 12/12/2022] Open
Abstract
Total hip arthroplasty (THA) has been quoted as one of the most successful and cost-effective procedures in Orthopaedics. The last decade has seen an exponential rise in the number of THAs performed globally and a sharp increase in the percentage of young patients hoping to improve their quality of life and return to physically demanding activities. Hence, it is imperative to review the various applications of technology in total hip arthroplasty for improving outcomes. The development of state-of-the-art robotic technology has enabled more reproducible and accurate acetabular positioning, while long-term data are needed to assess its cost-effectiveness. This opinion piece aims to outline and present the advances and innovations in total hip arthroplasty, from virtual reality and three-dimensional printing to patient-specific instrumentation and dual mobility bearings. This illustrates and reflects the debate that will be at the centre of hip surgery for the next decade.
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Affiliation(s)
- Andreas Fontalis
- Department of Trauma and Orthopaedic Surgery, University College London Hospitals, London NW1 2BU, UK
| | | | - Martin Thaler
- Department of Orthopaedics and Traumatology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Luigi Zagra
- IRCCS Istituto Ortopedico Galeazzi, Hip Department, Milan 20161, Italy
| | - Vikas Khanduja
- Young Adult Hip Service, Department of Trauma and Orthopaedics, Box 37, Addenbrookes Hospital, Cambridge CB2 0QQ, UK
| | - Fares S Haddad
- Department of Trauma and Orthopaedic Surgery, University College London Hospitals, London NW1 2BU, UK
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33
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Phuphanich ME, Sinha KR, Truong M, Pham QG. Telemedicine for Musculoskeletal Rehabilitation and Orthopedic Postoperative Rehabilitation. Phys Med Rehabil Clin N Am 2021; 32:319-353. [PMID: 33814061 DOI: 10.1016/j.pmr.2020.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Telehealth visits result in high-quality care, with high patient and provider satisfaction. Strong evidence suggests that virtual physical therapy is noninferior to conventional face-to-face physical therapy for a variety of musculoskeletal disorders. Postoperative telerehabilitation has a strong positive effect on clinical outcomes, and the increased intensity telerehabilitation programs offer is a promising option for patients. Studies demonstrate effective virtual postoperative management. The novel coronavirus disease 2019 pandemic has led to improved reimbursement for telehealth visits and accelerated widespread implementation of telemedicine. This article establishes experience and evidence-based practice guidelines for conducting telemedicine visits, with emphasis on the virtual physical examination.
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Affiliation(s)
- Melissa E Phuphanich
- Department of Physical Medicine and Rehabilitation, Greater Los Angeles VA Healthcare System, (117), 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA
| | - Kunal R Sinha
- Department of Physical Medicine and Rehabilitation, Greater Los Angeles VA Healthcare System, (117), 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA
| | - Michael Truong
- University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Quynh Giao Pham
- Pain Medicine Fellowship Training Program, Department of Medicine, Division of Physical Medicine and Rehabilitation, Greater Los Angeles VA Healthcare System, David Geffen School of Medicine at UCLA, (117), 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA.
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Windsor EN, Sharma AK, Gkiatas I, Elbuluk AM, Sculco PK, Vigdorchik JM. An Overview of Telehealth in Total Joint Arthroplasty. HSS J 2021; 17:51-58. [PMID: 33967642 PMCID: PMC8077983 DOI: 10.1177/1556331620972629] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 12/13/2022]
Abstract
With the increase in technological advances over the years, telehealth services in orthopedic surgery have gained in popularity, yet adoption among surgeons has been slow. With the onset of the COVID-19 pandemic, however, orthopedic surgery practices nationwide have accelerated adaptation to telemedicine. Telehealth can be effectively applied to total joint arthroplasty, with the ability to perform preoperative consultations, postoperative follow-up, and telerehabilitation in a virtual, remote manner with similar outcomes to in-person visits. New technologies that have emerged, such as virtual goniometers, wearable sensors, and app-based patient questionnaires, have improved clinicians' ability to conduct telehealth visits. Benefits of using telehealth include high patient satisfaction, cost-savings, increased access to care, and more efficiency. Notably, some challenges still exist, including widespread accessibility and adaptation of new technologies, inability to conduct an in-person orthopedic physical examination, and regulatory barriers, such as insurance reimbursement, increased medicolegal risk, and privacy and confidentiality concerns. Despite these hurdles, telehealth is here to stay and can be successfully incorporated in any total joint arthroplasty practice with the appropriate adjustments.
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Affiliation(s)
- Eric N. Windsor
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY, USA
| | - Abhinav K. Sharma
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY, USA
| | - Ioannis Gkiatas
- Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA
| | - Ameer M. Elbuluk
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Peter K. Sculco
- Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA
| | - Jonathan M. Vigdorchik
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY, USA
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Mukaino M, Tatemoto T, Kumazawa N, Tanabe S, Katoh M, Saitoh E, Otaka Y. An Affordable, User-friendly Telerehabilitation System Assembled Using Existing Technologies for Individuals Isolated With COVID-19: Development and Feasibility Study. JMIR Rehabil Assist Technol 2020; 7:e24960. [PMID: 33279877 PMCID: PMC7732353 DOI: 10.2196/24960] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/17/2020] [Accepted: 12/05/2020] [Indexed: 12/14/2022] Open
Abstract
Background Isolation due to a COVID-19 infection can limit activities and cause physical and mental decline, especially in older adults and people with disabilities. However, due to limited contact, adequate rehabilitation is difficult to provide for quarantined patients. Telerehabilitation technology could be a solution; however, issues specific to COVID-19 should be taken into consideration, such as strict quarantine and respiratory symptoms, as well as accessibility to deal with rapid increases in need due to the pandemic. Objective This study aims to develop and to investigate the feasibility of a telerehabilitation system for patients who are quarantined due to COVID-19 by combining existing commercial devices and computer applications. Methods A multidisciplinary team has identified the requirements for a telerehabilitation system for COVID-19 and developed the system to satisfy those requirements. In the subsequent feasibility study, patients diagnosed with COVID-19 (N=10; mean age 60 years, SD 18 years) were included. A single session of telerehabilitation consisted of stretching exercises, a 15-minute exercise program, and a video exercise program conducted under real-time guidance by a physical therapist through a video call. The system included a tablet computer, a pulse oximeter, videoconferencing software, and remote control software. The feasibility of the system was evaluated using the Telemedicine Satisfaction Questionnaire (TSQ; 14 items) and an additional questionnaire on the telerehabilitation system (5 items). Each item was rated from “1 = strongly disagree” to “5 = strongly agree.” Results The telerehabilitation system was developed by combining existing devices and applications, including a pulse oximeter and remote control mechanism, to achieve user-friendliness, affordability, and safety, which were determined as the system requirements. In the feasibility study, 9 out of 10 patients were able to use the telerehabilitation system without any on-site help. On the TSQ, the mean score for each item was 4.7 (SD 0.7), and in the additional items regarding telerehabilitation, the mean score for each item was 4.3 (SD 1.0). Conclusions These findings support the feasibility of this simple telerehabilitation system in quarantined patients with COVID-19, encouraging further investigation on the merit of the system’s use in clinical practice.
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Affiliation(s)
- Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Tsuyoshi Tatemoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Nobuhiro Kumazawa
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Shigeo Tanabe
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Masaki Katoh
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
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Mehta SP, Kendall KM, Reasor CM. Virtual assessments of knee and wrist joint range motion have comparable reliability with face-to-face assessments. Musculoskeletal Care 2020; 19:208-216. [PMID: 33107154 DOI: 10.1002/msc.1525] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND There has been increased usage of virtual telerehabilitation approach during the COVID-19 pandemic. It is crucial to establish reliability of conducting virtual assessments for musculoskeletal conditions. OBJECTIVES This research determined the intra- and interrater reliability of measuring knee and wrist range of motion (ROM) assessed virtually and obtained face-to-face (F2F) using a goniometer (UG) for a student and an experienced examiner. METHOD Knee and wrist joint ROM for 54 healthy participants was assessed virtually and F2F by a student examiner and an experienced physical therapist. Intra- (virtual vs. UG assessment) and inter-rater (virtual or UG assessment between examiners) reliabilities were examined for all ROM using Intraclass correlation coefficient (ICC). The ICC values were considered good (>0.75) or excellent (>0.90). Bland and Altman plots determined the limits of agreement (LOA) in assessing joint ROM. RESULTS/FINDINGS Student examiner had good reliability in virtually estimating knee extension (ICC = 0.79), wrist flexion (ICC = 0.82) and wrist extension (ICC = 0.78), whereas the experienced examiner had excellent reliability in virtually estimating all knee and wrist ROM (ICC > 0.90). The LOA in assessing knee and wrist ROM for the student examiner were wider indicating higher disagreement between virtual and UG-obtained ROM in some cases. CONCLUSIONS Virtual estimation of knee and wrist ROM is a reliable technique, however experience level impacts the precision of measurement. It is suggested that the same examiner conducts all the ROM assessments throughout the clinical course of a patient receiving virtual interventions for knee or wrist pathologies.
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Affiliation(s)
- Saurabh P Mehta
- School of Physical Therapy, Marshall University, Huntington, West Virginia, USA.,Dept. of Orthopedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, USA
| | - Kaitlyn M Kendall
- School of Physical Therapy, Marshall University, Huntington, West Virginia, USA
| | - Charlotte M Reasor
- School of Physical Therapy, Marshall University, Huntington, West Virginia, USA
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Wong B, Ward D, Gemmell K, Bright R, Blackman R, Sole G, Ward S. How is telehealth being utilized in the context of rehabilitation for lower limb musculoskeletal disorders: a scoping review. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1832712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Berenice Wong
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Declan Ward
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Kirsty Gemmell
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Reuben Bright
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Roman Blackman
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Gisela Sole
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
- Centre for Health, Activity and Rehabilitation Research, University of Otago, Dunedin, New Zealand
| | - Sarah Ward
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
- Centre for Health, Activity and Rehabilitation Research, University of Otago, Dunedin, New Zealand
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Cottrell MA, Russell TG. Telehealth for musculoskeletal physiotherapy. Musculoskelet Sci Pract 2020; 48:102193. [PMID: 32560876 PMCID: PMC7261082 DOI: 10.1016/j.msksp.2020.102193] [Citation(s) in RCA: 127] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/14/2020] [Accepted: 05/17/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Musculoskeletal conditions are a leading cause of global morbidity. Access to traditional in-person healthcare can be difficult for some under usual conditions and has become a ubiquitous barrier throughout the COVID-19 pandemic. Telehealth, defined as the 'delivery of healthcare at a distance using information and communication technology' is a solution to many access barriers and has been rapidly adopted by many healthcare professions throughout the crisis. While significant advancements in technology has made the widespread adoption of telehealth feasible, there are many factors to be considered when implementing a telehealth service. PURPOSE The aims of this masterclass are to (i) introduce telehealth and outline the current research within the context of musculoskeletal physiotherapy; (ii) provide insights into some of the broader challenges in the wide-scale adoption of telehealth; and (iii) to describe a systematic approach to implementing telehealth into existing healthcare settings, along with some practical considerations. IMPLICATIONS Telehealth is a broad concept and should be implemented to meet the specific needs of a healthcare service. This masterclass offers a structured approach to the implementation of a musculoskeletal physiotherapy telehealth service, and highlights practical considerations required by both clinicians and healthcare organisations throughout all stages of the implementation process.
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Affiliation(s)
- Michelle A. Cottrell
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, 4029, Australia,Corresponding author. Physiotherapy Department, Royal Brisbane and Women's Hospital, Physiotherapy Department, Level 2 Ned Hanlon Building, Royal Brisbane and Women's Hospital, Herston, QLD, 4029, Australia.
| | - Trevor G. Russell
- RECOVER Injury Research Centre, Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, 4072, Australia,School of Health & Rehabilitation Sciences, University of Queensland, St Lucia, 4072, Australia
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