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Marwaa MN, Guidetti S, Ytterberg C, Kristensen HK. Acceptability of two mobile applications to support cross-sectoral, person-centred and empowering stroke rehabilitation - a process evaluation. Ann Med 2024; 56:2302979. [PMID: 38466794 DOI: 10.1080/07853890.2024.2302979] [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: 09/27/2023] [Accepted: 12/04/2023] [Indexed: 03/13/2024] Open
Abstract
AIM To evaluate the acceptability of two co-designed mobile applications Mit Sygehus [a knowledge-based solution] and Genoptræn.dk [a self-training solution] to support a cross-sectoral, person-centred and empowering stroke rehabilitation. SETTING The applications were implemented and tested throughout two stroke rehabilitation trajectories in Southern Denmark, comprising two acute, two sub-acute and two municipal stroke rehabilitation settings. METHODS, PARTICIPANTS AND ANALYSIS A process evaluation focusing on acceptability was conducted. Individual and dyadic interviews were performed with ten stroke survivors (three women and seven men, aged 50-84) with moderate stroke and seven significant others (five women and two men, aged 50-78) post-rehabilitation. A constructivist Grounded Theory analysis was used to explore what, why, when, and how the apps worked or did not work throughout the stroke rehabilitation trajectory and if adaptions were needed. RESULTS Participants found that Mit Sygehus provided adequate and sufficient knowledge and was easy to use, however, acceptability of Mit Sygehus declined throughout the rehabilitation process. Also, knowledge on 'return-to-work' and 're-gaining driver's license/permission to drive' needed to be developed. The content in Genoptræn.dk was perceived as acceptable, through content being person-centred, motivating and meaningful. Genoptræn.dk furthermore, supported the transfer between rehabilitation settings, provided a sense of progress throughout the rehabilitation process, facilitated positive habits regarding self-training, and relieved the burden on significant others. Genoptræn.dk was perceived most acceptable in the sub-acute rehabilitation setting and declined when rehabilitation continued in the municipal setting. CONCLUSION Stroke survivors and their significant others found Mit Sygehus and Genoptræn.dk acceptable to support cross-sectoral, person-centred and empowering stroke rehabilitation, however acceptability declined throughout the rehabilitation process. Further investigations are required to determine how cognitive rehabilitation can play a greater role in app-supported stroke rehabilitation and how the need for more long-term follow-up can be supported.
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Affiliation(s)
- Mille Nabsen Marwaa
- Department of Physiotherapy Education, University College Southern Denmark, Esbjerg, Denmark
- Department of Clinical Research, Center for Innovative Medical Technologies, University of Southern Denmark, Odense, Denmark
| | - Susanne Guidetti
- Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Charlotte Ytterberg
- Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
- Geriatric Research Unit, Department of Clinical Research, University Hospital Odense, University of Southern Denmark, Odense, Denmark
| | - Hanne Kaae Kristensen
- Department of Clinical Research, Center for Innovative Medical Technologies, University of Southern Denmark, Odense, Denmark
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Cui J. Measuring the adoption of internet and communication technologies among practitioners in routine disability services: a stepped inclusive approach. Disabil Rehabil Assist Technol 2024:1-9. [PMID: 38949182 DOI: 10.1080/17483107.2024.2367080] [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: 10/04/2023] [Accepted: 06/06/2024] [Indexed: 07/02/2024]
Abstract
PURPOSE Existing measurements of the use of information and communication technologies (ICTs) among practitioners in disability services often treat ICT adoption as a monolithic concept, overlooking its multifaceted nature within the disability field. This study introduces a stepped, inclusive approach to capturing this complexity, elucidating disparities in the utilization of various ICT dimensions, the present vs. anticipated use, and variations among different clinical-demographic groups. MATERIALS AND METHODS A cross-sectional survey was conducted in Hong Kong, gathering valid data from 324 practitioners spanning diverse disciplines and disability services. RESULTS Data analysis produced a three-factor model categorizing ICT tools into (1) information and communication tools, (2) screening and monitoring tools, and (3) treatment and rehabilitation tools. The first category was identified as the predominant ICT utilized currently, with significant projected growth in the latter two categories' usage. Variances in current ICT adoption were influenced by practitioners' roles, clientele, positions, affiliating agencies, and educational attainments. CONCLUSIONS This research provides a deeper understanding of the key dimensions of ICT adoption within disability services. It underscores the importance of devising specific and customized strategies for the effective integration of ICTs, ensuring a more tailored approach to meeting the unique demands of the disability field.
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Affiliation(s)
- Jialiang Cui
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
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Moulaee Conradsson D, Leavy B, Hagströmer M, Franzén E. Predictors of Sustained Physical Activity During the COVID-19 Pandemic in People With Parkinson Disease in Sweden. J Neurol Phys Ther 2024; 48:75-82. [PMID: 37436217 DOI: 10.1097/npt.0000000000000455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
BACKGROUND AND PURPOSE During the first wave of the COVID-19 pandemic, people with Parkinson disease (PwPD) reported deterioration in health and physical activity. The aim of this study was to describe 1-year changes in physical activity and perceived health in PwPD during the COVID-19 pandemic and to identify predictors of sustained physical activity. METHODS This study compared perceived health and sensor-derived physical activity (Actigraph GT3x) in PwPD between the first (June to July 2020) and third waves (June to July 2021) of the pandemic. Multiple logistic regression analyses were used to predict sustained physical activity across the study period using personal factors, disease severity, and functioning as independent variables. RESULTS Sixty-three PwPD (mean age 71.0 years, 41% females) completed both baseline and 1-year follow-up (26 lost to follow-up). PwPD showed a decrease in average number of steps per day (Δ415 steps, P = 0.048), moderate-to-vigorous-physical activity (Δ7 minutes, P = 0.007) and increase in sedentary time (Δ36 minutes, P <.001) between baseline and 1-year follow-up. While self-perceived walking impairments and depressive symptoms increased significantly, balance confidence decreased between baseline and 1-year follow-up, no significant changes occurred for self-rated health, quality of life, or anxiety. Significant predictors of sustained physical activity levels were 15 years or more of education (odds ratio [OR] = 7.38, P = 0.013) and higher perceived walking ability (OR = 0.18, P = 0.041). DISCUSSION AND CONCLUSION Among PwPD with mild to moderate disease severity living in Sweden, factors associated with reduced physical activity levels during the COVID-19 pandemic included older age, lower education levels, and greater perceived walking difficulties.
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Affiliation(s)
- David Moulaee Conradsson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden (D.M.C., B.L., M.H., E.F.); Medical Unit Occupational Therapy & Physiotherapy, Theme Women's Health and Allied Health Professional, Karolinska University Hospital, Stockholm, Sweden (D.M.C., E.F.); Research and Development Department, Stockholm Sjukhem's Foundation, Stockholm, Sweden (B.L, E.F); and Academic Primary Care Centre, Region Stockholm, Stockholm, Sweden (M.H)
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Seebacher B, Bergmann E, Geimer C, Kahraman T, Reindl M, Diermayr G. Factors influencing the willingness to adopt telerehabilitation among rehabilitation professionals in Austria and Germany: a survey comparing data before and during COVID-19. Disabil Rehabil 2024; 46:1149-1157. [PMID: 36970941 DOI: 10.1080/09638288.2023.2193428] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 03/16/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE To investigate determinants of willingness to adopt telerehabilitation, willingness of technology use, core affect regarding using telerehabilitation, and digital competencies in rehabilitation professionals in Austria and Germany before and during the COVID-19 pandemic. MATERIALS AND METHODS A cross-sectional paper-based and online survey was conducted before and during COVID-19, respectively, with three cohorts of rehabilitation professionals. Outcomes were the willingness to adopt telerehabilitation evaluated using the extended Unified Theory of Acceptance and Use of Technology; willingness of technology use using the short scale for assessing the willingness of technology use; digital competencies and core affect using the Digital Competence Framework and semantic differential, respectively. Multivariate ordinal regression analysis was performed to determine predictors. RESULTS Included were 603 rehabilitation professionals. Analysis revealed differences between Austria and Germany and before and during the pandemic for most outcomes. German residency, the pandemic, and a higher educational level were most important predictors of higher willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. The pandemic increased most aspects of willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. Results confirm that rehabilitation professionals with higher degrees are more prone to adopt innovations in healthcare.Registration: German Clinical Trials Register (DRKS00021464)IMPLICATIONS FOR REHABILITATIONThe willingness to adopt telerehabilitation is associated with external factors increasing the need for alternative rehabilitation delivery, such as COVID-19, and with financial facilitators, such as reimbursement.As the willingness to adopt telerehabilitation is higher among speech and language therapists and dietitians, efforts are necessary to enhance its use in physiotherapists and occupational therapists.As a higher willingness to adopt telerehabilitation was observed in younger rehabilitation professionals and those with higher education, increasing the importance of telerehabilitation in education curricula and further knowledge transfer into practice for those already working in the field seems necessary.
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Affiliation(s)
- Barbara Seebacher
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- VASCage, Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
| | - Elena Bergmann
- School of Therapeutic Sciences, SRH Hochschule Heidelberg, Heidelberg, Germany
| | - Carole Geimer
- School of Therapeutic Sciences, SRH Hochschule Heidelberg, Heidelberg, Germany
| | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Markus Reindl
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gudrun Diermayr
- School of Therapeutic Sciences, SRH Hochschule Heidelberg, Heidelberg, Germany
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Assylbek MI, Kocyigit BF, Yessirkepov M, Zimba O. Post-stroke rehabilitation in the peri-pandemic COVID-19 era. Rheumatol Int 2024; 44:399-411. [PMID: 38253904 DOI: 10.1007/s00296-023-05520-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024]
Abstract
The coronavirus disease 2019 (COVID-19), which arose in late 2019, caused extensive destruction, impacting a substantial proportion of the worldwide population and leading to millions of deaths. Although COVID-19 is mainly linked to respiratory and pulmonary complications, it has the potential to affect neurologic structures as well. Neurological involvement may manifest as minimal and reversible; however, a notable proportion of cases have exhibited pronounced neurological consequences, such as strokes. Endothelial inflammation, hypercoagulation, renin-angiotensin-aldosterone system alterations, and cardiogenic embolism are the pathophysiological mechanisms of stroke under COVID-19 circumstances. Physical activity and exercise have improved several aspects of post-stroke recovery, including cardiovascular health, walking capacity, and upper limb strength. They are commonly used to assist stroke survivors in overcoming their motor restrictions. Furthermore, stroke rehabilitation can incorporate a range of specific techniques, including body-weight-supported treadmill applications, constraint-induced movement therapy, robotic rehabilitation interventions, transcranial direct current stimulation, transcranial magnetic stimulation, and prism adaptation training. Under pandemic conditions, there were several barriers to neurological rehabilitation. The most significant of these were individual's fear of infection, which caused them to postpone their rehabilitation applications and rehabilitation areas being converted into COVID-19 units. The primary emphasis had turned to COVID-19 treatment. Several valuable data and views were gained in reorganizing rehabilitation during the pandemic, contributing to establishing future views in this regard.
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Affiliation(s)
- Meirgul I Assylbek
- Department of Neurology, Psychiatry, Neurosurgery and Rehabilitation, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
- Department of Social Health Insurance and Public Health, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
- Medical Center ''Mediker'', Shymkent, Kazakhstan
| | - Burhan Fatih Kocyigit
- Department of Physical Medicine and Rehabilitation, Adana Health Practice and Research Center, University of Health Sciences, Adana, Turkey.
| | - Marlen Yessirkepov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Olena Zimba
- Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
- Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
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Zdziechowski A, Zdziechowska M, Rysz J, Woldańska-Okońska M. The Effectiveness of Preoperative Outpatient and Home Rehabilitation and the Impact on the Results of Hip Arthroplasty: Introductory Report. Healthcare (Basel) 2024; 12:327. [PMID: 38338212 PMCID: PMC10855594 DOI: 10.3390/healthcare12030327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
A total hip replacement is the treatment of choice for end-stage hip osteoarthritis. Rehabilitation performed before surgery (called prehabilitation) is used to improve the results of surgical treatment. However, the results of studies have not unquestionably confirmed the effectiveness of preoperative rehabilitation and its impact on the outcome of surgery. The aim of this study is to assess the effectiveness of preoperative outpatient and home rehabilitation in relation to a control group not subject to these forms of influence. A total of 61 patients qualified for primary hip arthroplasty were randomly assigned to a group with outpatient rehabilitation before surgery, exercises performed at home, or a group without any intervention before surgery. Three weeks after surgery, the patients were re-qualified and underwent three weeks of outpatient rehabilitation in the day rehabilitation department. The patients from all three groups were evaluated in terms of functionality and pain using point scales upon enrolment in the study, on admission to the day rehabilitation department, and after 3 weeks of rehabilitation in the department. A total of 50 subjects completed the study. The study results did not reveal statistically significant differences between preoperative rehabilitation and no intervention. Patients rehabilitated at home gave up self-therapy more often than those undergoing outpatient rehabilitation.
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Affiliation(s)
- Adam Zdziechowski
- Department of Internal Diseases, Rehabilitation and Physical Medicine, Medical University of Łódź, 90-419 Łódź, Poland;
| | - Magdalena Zdziechowska
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Łódź, 90-419 Łódź, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Łódź, 90-419 Łódź, Poland
| | - Marta Woldańska-Okońska
- Department of Internal Diseases, Rehabilitation and Physical Medicine, Medical University of Łódź, 90-419 Łódź, Poland;
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Ahmed AN, Nuri RP, Xu X, Balakrishna V, Sebeh A, Maholo C, Aldersey HM. Community-based rehabilitation/community based inclusive development functioning during the COVID-19 pandemic: A secondary analysis of qualitative data. PLoS One 2024; 19:e0296274. [PMID: 38180965 PMCID: PMC10769068 DOI: 10.1371/journal.pone.0296274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 12/01/2023] [Indexed: 01/07/2024] Open
Abstract
INTRODUCTION The coronavirus (COVID-19) became a global pandemic in March 2020 and impacted nations worldwide not only because of the disease but also because the containment measures-imposed created ripple effects for the populations in each country. The COVID-19 pandemic disproportionately affected vulnerable groups, such as persons with disabilities. This study aimed to understand the impact of COVID-19 on the function of Community-Based Rehabilitation (CBR)/Community-Based Inclusive Development (CBID) across nations and for their target communities-persons with disabilities. The current article also described some measures CBR/CBID programs took in light of service closure to facilitate access to needed services for persons with disabilities. METHODS We conducted a secondary analysis of qualitative data to understand the impact of COVID-19 on the functioning of CBR/CBID programs and their target communities. The original qualitative data were collected through online dialogues among CBR/CBID partners across five regions of the world, facilitated for understanding of their practices on five other topics. FINDINGS COVID-19 significantly impacted the function of CBR/CBID programs across the world. Many services were halted due to public health measures, such as maintaining social distancing or lockdowns. The COVID-19 pandemic also had a negative impact on access to health, education and livelihood support for persons with disabilities. Additionally, many people with disabilities did not have access to COVID-19 related information and services like vaccines. However, we found that technology played a significant role in revitalizing CBR/CBID programs during COVID-19. CBR/CBID service providers across five regions used online platforms to disseminate information about COVID-19. Professionals also used technology to provide rehabilitation and educational services to people with disabilities through online platforms. CONCLUSION Our findings suggest that technology can play a vital role in continuing many services (e.g., CBR/CBID) that cannot be offered in person during crises like COVID-19. However, it is important to remember that technology may not be accessible to many individuals with disabilities, specifically those who reside in rural areas and who experience adverse situations like financial constraints. Additionally, many persons with disabilities may not have the necessary knowledge and skills to use technology. CBR personnel must consider that before adopting technology to provide services under CBR programs.
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Affiliation(s)
- Ansha Nega Ahmed
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Reshma Parvin Nuri
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Xiaolin Xu
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Venkatesh Balakrishna
- Community Based Rehabilitation (CBR) Global Network, Anantapur, Andhra Pradesh, India
| | - Alaa Sebeh
- Disability Institution, United Nations Economic and Social Commission for Western Asia, Beirut, Lebanon
| | - Carolyne Maholo
- Department of Community and Disability Studies, Kyambogo University, Kampala, Uganda
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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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Thurston C, Bezuidenhout L, Humphries S, Johansson S, von Koch L, Häger CK, Holmlund L, Sundberg CJ, Garcia-Ptacek S, Kwak L, Nilsson M, English C, Conradsson DM. Mobile health to promote physical activity in people post stroke or transient ischemic attack - study protocol for a feasibility randomised controlled trial. BMC Neurol 2023; 23:124. [PMID: 36978045 PMCID: PMC10043533 DOI: 10.1186/s12883-023-03163-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Physical activity is essential to improve health and reduce the risk of recurrence of stroke or transient ischemic attack (TIA). Still, people post stroke or TIA are often physically inactive and the availability of physical activity promotion services are often limited. This study builds on an existing Australian telehealth-delivered programme (i-REBOUND- Let's get moving) which provides support for home-based physical activity for people post stroke or TIA. The aim of this study is to test the feasibility, acceptability, and preliminary effects of a mobile Health (mHealth) version of the i-REBOUND programme for the promotion of physical activity in people post stroke or TIA living in Sweden. METHODS One hundred and twenty participants with stroke or TIA will be recruited via advertisement. A parallel-group feasibility randomised controlled trial design with a 1:1 allocation ratio to 1) i-REBOUND programme receiving physical exercise and support for sustained engagement in physical activity through behavioural change techniques, or 2) behavioural change techniques for physical activity. Both interventions will proceed for six months and be delivered digitally through a mobile app. The feasibility outcomes (i.e., reach, adherence, safety and fidelity) will be monitored throughout the study. Acceptability will be assessed using the Telehealth Usability Questionnaire and further explored through qualitative interviews with a subset of both study participants and the physiotherapists delivering the intervention. Clinical outcomes on preliminary effects of the intervention will include blood pressure, engagement in physical activity, self-perceived exercise self-efficacy, fatigue, depression, anxiety, stress and health-related quality of life and will be measured at baseline and at 3, 6 and 12 months after the baseline assessments. DISCUSSION We hypothesise that the mHealth delivery of the i-REBOUND programme will be feasible and acceptable in people post stroke/TIA living in rural and urban regions of Sweden. The results of this feasibility trial will inform the development of full-scale and appropriately powered trial to test the effects and costs of mHealth delivered physical activity for people after stroke or TIA. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05111951. Registered November 8, 2021.
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Affiliation(s)
- Charlotte Thurston
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23100, Stockholm, Sweden
| | - Lucian Bezuidenhout
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23100, Stockholm, Sweden
| | - Sophia Humphries
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23100, Stockholm, Sweden
| | - Sverker Johansson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23100, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Lena von Koch
- Department of Neurobiology, Care Science and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden
- Theme Heart & Vascular and Neuro, Karolinska University Hospital, Stockholm, Sweden
| | - Charlotte K Häger
- Department of Community Medicine and Rehabilitation - Physiotherapy Section, Umeå University, Umeå, Sweden
| | - Lisa Holmlund
- Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Carl Johan Sundberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Sara Garcia-Ptacek
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Lydia Kwak
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Michael Nilsson
- Heart and Stroke Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia
- Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
- The Centre for Rehab Innovations (CRI), College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Coralie English
- Heart and Stroke Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia
- Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
- The Centre for Rehab Innovations (CRI), College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - David Moulaee Conradsson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23100, Stockholm, Sweden.
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
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Willcocks C, Joy DLA, Seward J, Mills S, Heywood M, Price C. Patient experiences of remote care in a pain service during a pandemic. Br J Pain 2023; 17:36-45. [PMID: 36820058 PMCID: PMC9396734 DOI: 10.1177/20494637221121708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background In March 2020, Pain Management Services were obliged to cease face-to-face consultations. This abrupt change, in line with recommendations from the British Pain Society, aimed to protect patients and staff and allowed resource re-allocation. Pain services were obliged to switch to remote consultations using Video Tele-Conferencing Technology (VTC) and Remote Consultations (RC) either through telephone or video calls using a variety of media and software applications. Little is known about the patient experience of remotely delivered pain care especially when alternatives are removed. The aim of this work was to understand the patient experience of this necessary switch regarding pain self-management interventions during the initial stages of the COVID-19 pandemic. Methods A mixed-methods evaluation of the patient experience from three pain self-management interventions, taking place in a large community-based pain rehabilitation service along the South Coast of England, was performed. Experience-Based Design (EBD) methods were used to map patient experience at touch points through two interventions that were delivered in a structured format. Semi-structured recorded interviews were transcribed and analysed using thematic analysis for the third. Findings Fifty-eight patients took part covering the scope of the service. In general, educational and psychological sessions were well received, with physical rehabilitation components being less easy to convey remotely. Attrition rates were high for the pain management programme. Group pain education worked particularly well in an online format with hope being the predominant emotion experienced. Clear limitations were technical failures and the lack of ability to form relationships in a virtual world. Conclusions Remote digitalised interventions were acceptable to most patients. Attention should be paid to access and improving social aspects of delivery when considering such interventions. Physiotherapy may require more face-to-face necessitating a hybrid model and needs further investigation. EBD proved a highly suitable approach.
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Affiliation(s)
| | | | - Joseph Seward
- University of Southampton Faculty of Medicine, Southampton, UK
| | - Samantha Mills
- University of Southampton Faculty of Medicine, Southampton, UK
| | - Mark Heywood
- University of Southampton Faculty of Medicine, Southampton, UK
| | - Cathy Price
- Pain Clinic, Solent NHS Trust, Southampton, UK,Cathy Price, Pain Clinic, Solent NHS Trust, Western Community Campus, Southampton SO16, UK.
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Jonsdottir J, Santoyo-Medina C, Kahraman T, Kalron A, Rasova K, Moumdjian L, Coote S, Tacchino A, Grange E, Smedal T, Arntzen EC, Learmonth Y, Pedulla L, Quinn G, Kos D. Changes in physiotherapy services and use of technology for people with multiple sclerosis during the COVID-19 pandemic. Mult Scler Relat Disord 2023; 71:104520. [PMID: 36724646 DOI: 10.1016/j.msard.2023.104520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/04/2023] [Accepted: 01/13/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND The COVID-19 pandemic has led to reorganization or reduction of neurorehabilitation services for people with multiple sclerosis (PwMS). The aim of this study was to explore the changes in the organizational framework and technology usage in physiotherapy services for PwMS during the COVID-19 pandemic. METHODS This international cross-sectional survey study was designed, developed, and disseminated by RIMS European Network for Best Practice and Research in Multiple Sclerosis Rehabilitation. Physiotherapists from nine countries (Australia, Belgium, Czech Republic, Ireland, Israel, Italy, Norway, Spain, Turkey) who provided physiotherapy services to PwMS, were invited to complete an online survey to compare physiotherapy delivery to PwMS prior to and during the pandemic period. RESULTS The survey was completed by 215 physiotherapists. Accessibility, the average number, length and perceived effectiveness of physiotherapy sessions provided to PwMS were significantly reduced during the COVID-19 pandemic (p=0.001). Physiotherapists increased the advice of mobile apps, recorded videos for rehabilitation and exercise websites during the pandemic (p<0.001) while the use of telerehabilitation and virtual reality technology did not change. CONCLUSION There was of a reduction in the number, duration and perceived effectiveness of rehabilitation sessions for people with multiple sclerosis during the COVID-19 pandemic while use of remote technologies for physiotherapy did not change. To ensure the continuity of physiotherapy for PwMS with complex healthcare needs also during pandemics, the provision of guidelines and training in telehealth technologies in professional education becomes crucial.
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Affiliation(s)
| | - Carme Santoyo-Medina
- Neurology-Neuroimmunology Department & Neurorehabilitation Unit, Multiple Sclerosis Centre of Catalonia (Cemcat), Barcelona, Spain; Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, C/ Josep Trueta sn, 08195 Sant Cugat del Vallès, Barcelona, Spain.
| | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
| | - Alon Kalron
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel-Aviv University, Israel; Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Kamila Rasova
- Department of Rehabilitation, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lousin Moumdjian
- UMSC Hasselt, Pelt, Belgium; REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; IPEM Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, Ghent University, Ghent, Belgium.
| | - Susan Coote
- Centre of Physical Activity for Health, Health Research Institute, University of Limerick, Limerick, Ireland; Multiple Sclerosis Society of Ireland and Physical Activity for Health Research Centre, Ireland.
| | - Andrea Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genova, Italy.
| | - Erica Grange
- CRRF "Mons. L. Novarese", Moncrivello (VC), Italy
| | - Tori Smedal
- Department of Physiotherapy, Haukeland University Hospital, Helse Bergen, Bergen, Norway,; Department of Neurology, Multiple Sclerosis Competence Centre, Haukeland University Hospital, Helse Bergen, Bergen, Norway.
| | | | - Yvonne Learmonth
- Discipline of Exercise Science, Murdoch University, Murdoch, Australia; Centre for Molecular Medicine and Innovative Therapeutics, Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Australia; Perron Institute for Neurological and Translational Science, Nedlands, Australia.
| | - Ludovico Pedulla
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy.
| | - Gillian Quinn
- Physiotherapy Department, St. James's Hospital, Dublin, Ireland
| | - Daphne Kos
- Department of Rehabilitation Sciences, KU Leuven, Leuven 1501-3001, Belgium; National MS Center, Melsbroek, Belgium.
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Stark AL, Krayter S, Dockweiler C. Competencies required by patients and health professionals regarding telerehabilitation: A scoping review. Digit Health 2023; 9:20552076231218841. [PMID: 38107985 PMCID: PMC10722929 DOI: 10.1177/20552076231218841] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023] Open
Abstract
Background Telerehabilitation offers patients alternative access to therapy and has become more prominent during the COVID-19 pandemic. Despite the increasing attractiveness of such programs, there are research gaps regarding the required competencies in the demand-oriented technology use in rehabilitative care. Objective The study aims at collecting evidence on competencies required by patients and health professionals for using telerehabilitation. We analyse tasks and requirements associated with telerehabilitation and derive and systematise relevant competencies. Methods We conducted a scoping review and analysed MEDLINE, Psyndex, EMBASE, Cochrane Library, and Web of Science for empirical studies and grey literature from 2017 to May 2022. Articles had to be in English/German and refer to medical rehabilitation accompanied by health professionals taking place in the patient's home. Results One hundred ten articles were included, covering video conferencing systems, applications with video, audio, or visual therapy content, or wearables. Depending on the program, tasks before, during, and after therapy sessions differ, as do whether these are performed by health professionals, patients, or the technology. Users need digital, health-related, social, personal, and health professionals also professional competencies. This comprises telerehabilitation, technical, health-related, and clinical knowledge, a range of physical, cognitive, social-interactive, technical, and clinical skills, a positive attitude towards telerehabilitation and experience. Whether sociodemographic factors promote successful use is unclear. Conclusions Telerehabilitation requires a variety of different competencies from patients and health professionals - going beyond the sphere of technical skills. This highlights the need for an evaluation of existing programs for promoting competencies in the use of telerehabilitation and refinement of the programs in line with demands.
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Affiliation(s)
- Anna Lea Stark
- Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, Siegen, Germany
| | - Stephan Krayter
- Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, Siegen, Germany
| | - Christoph Dockweiler
- Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, Siegen, Germany
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Ghosh R, Healy A, Prabhune A, Mallavaram A, Raju S, Chockalingam N. Provision of rehabilitation and assistive technology services in a low resource setting during the COVID-19 pandemic and introduction of telehealth: service users' and providers' perspectives. Assist Technol 2022:1-7. [PMID: 35857654 DOI: 10.1080/10400435.2022.2095582] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 10/17/2022] Open
Abstract
The COVID-19 pandemic created a challenge for providing assistive technology (AT) and rehabilitation services, with many service providers implementing telehealth service provision for the first time. The objective of this study was to explore the experiences of people accessing and providing AT and rehabilitation services during the pandemic and to assess the implementation of telehealth service delivery at an assistive technology and rehabilitation center in India. A mixed-methods design, combining analysis of clinical data and semi-structured interviews, was utilized. A descriptive analysis of demographics and clinical characteristics of service users accessing services through telehealth, or in-person mode was completed. In addition, service users were interviewed to explore their experiences of accessing services during the pandemic. Service providers were also interviewed to gather their opinions on telehealth service delivery during the pandemic. Findings showed that telehealth was an alternative tool in the pandemic for continuing to deliver services in a low-resource setting. However, not all types of services could be successfully delivered via telehealth. There are barriers to the delivery of telehealth services that need to be considered and addressed to allow successful implementation, and it is important to consider that telehealth consultations are not suitable for all service users.
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Affiliation(s)
- Ritu Ghosh
- Mobility India Rehabilitation Research & Training Centre, Bangalore, Karnataka, India
| | - Aoife Healy
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent, UK
| | - Akash Prabhune
- Institute of Health Management Research Bangalore, Bengaluru, Karnataka, India
| | | | - Sama Raju
- Mobility India Rehabilitation Research & Training Centre, Bangalore, Karnataka, India
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent, UK
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