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Deodato M, Fornasaro M, Martini M, Zelesnich F, Sartori A, Galmonte A, Buoite Stella A, Manganotti P. Comparison of different telerehabilitation protocols for urogenital symptoms in females with multiple sclerosis: a randomized controlled trial. Neurol Sci 2024; 45:5501-5509. [PMID: 39223424 DOI: 10.1007/s10072-024-07742-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
Telerehabilitation has been suggested to be equally effective than in-person rehabilitation, and could be helpful to increase participation and reduce barriers. People with multiple sclerosis (MS) often present urogenital dysfunctions, impairing independence and quality of life (QoL). Since the different available telerehabilitation protocols, the present study aimed to compare a live video urogenital rehabilitation intervention protocol (REMOTE) with a home-based pre-recorded video protocol (SELF). A randomized-controlled trial was performed, with 14 females with MS being allocated in the REMOTE group (36 ± 9 y) and 14 females in the SELF group (37 ± 7 y). Both telerehabilitation protocols were identical in terms of contents (including pelvic floor training and relaxation exercises), frequency and duration, consisting of 10 sessions of 45 min each, every 5 days. Questionnaires were administered at the beginning and the end of the study: Short Form Health Survey 36 (SF-36), Beck Depression Inventory (BDI), Female Sexual Function Index (FSFI), International Consultation on Incontinence Questionnaire (ICIQ) symptoms and related QoL, the main outcome being ICIQ incontinence score. Despite most of the outcomes improved in both groups, REMOTE was found to be more effective than SELF in most of the SF-36 domains (from p < 0.001 pη2 0.555 to p = 0.044 pη2 0.147), FSFI (p = 0.001 pη2 0.373), ICIQ (p = 0.003 pη2 0.291). Despite the home-based pre-recorded videos could be effective in improving urogenital symptoms, live video urogenital rehabilitation results in larger improvements. Telerehabilitation should be encouraged for urogenital dysfunctions in females with MS, and pre-recorded videos could represent an alternative when live sessions are not available. Clinical trial registration This randomized controlled trial was registered on ClinicalTrials.gov with the number NCT05984095.
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Affiliation(s)
- Manuela Deodato
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, via Pascoli 31, 34100, Trieste, Italy
| | - Mia Fornasaro
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, via Pascoli 31, 34100, Trieste, Italy
| | - Miriam Martini
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, via Pascoli 31, 34100, Trieste, Italy
- PhD program in Personalized Medicine and Innovative Therapies, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
| | - Francesca Zelesnich
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, via Pascoli 31, 34100, Trieste, Italy
| | - Arianna Sartori
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital (ASUGI), University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
| | - Alessandra Galmonte
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, via Pascoli 31, 34100, Trieste, Italy
| | - Alex Buoite Stella
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, via Pascoli 31, 34100, Trieste, Italy.
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital (ASUGI), University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy.
| | - Paolo Manganotti
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, via Pascoli 31, 34100, Trieste, Italy
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital (ASUGI), University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
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Bonet-Collantes M, Niño-Pinzón DM, Chaustre-Porras AD, Salas-Poloche YA, Angarita-Fonseca A. Enhancing physiotherapists' knowledge and perceptions of telerehabilitation: A before-after educational intervention study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2120. [PMID: 39192801 DOI: 10.1002/pri.2120] [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: 03/18/2024] [Revised: 07/10/2024] [Accepted: 08/08/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND AND PURPOSE In the evolving landscape of healthcare, telerehabilitation is emerging as a pivotal modality, especially in delivering services to vulnerable populations. With the increasing reliance on digital health solutions, there is a pressing need for physiotherapists to be adequately trained in telerehabilitation. This training is essential for them to adapt to new technologies and methodologies, ensuring effective and efficient patient care. The aim of this study was to evaluate the effect of a telerehabilitation educational intervention on physiotherapists' knowledge and perceptions in Bucaramanga and its metropolitan area. METHODS A group of 27 physiotherapists underwent an educational intervention focused on telerehabilitation. Before- and after-intervention assessments were conducted to gauge their perceptions and knowledge. RESULTS Participants generally held a positive perception of telerehabilitation both before and after the intervention [Before Median (Md) and interquartile range (IQR): Md = 2.5 (IQR = 2.1-3); after: Md = 2.7 (IQR = 2.4-3.1), p = 0.256]. A significant increase in their knowledge after-intervention was observed [Before: Md = 55.5 (IQR = 33.3-66.6)]; after: Md = 77.7 (IQR = 66.6-88.8), p = <0.001, emphasizing the potential benefits of targeted educational interventions. CONCLUSIONS The educational intervention significantly improved physiotherapists' knowledge of telerehabilitation, underscoring the importance of professional training in this domain. While perceptions remained consistently positive, the notable increase in knowledge suggests that such educational programs are crucial for enhancing the adoption and effective use of telerehabilitation in physiotherapy practice.
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Affiliation(s)
- Milena Bonet-Collantes
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga, Colombia
| | | | | | | | - Adriana Angarita-Fonseca
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga, Colombia
- Research Institute of the McGill University Health Centre, Montréal, Quebec, Canada
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Lam SKY, Chau JPC, Lo SHS, Choi KC, Siow EKC, Shum EWC, Lee VWY, Hung SS, Mok VCT, Ching JYL, Lau AYL. Evaluation of Cost-Effectiveness of a Virtual Multidisciplinary Stroke Care Clinic for Community-Dwelling Survivors of Stroke. J Am Heart Assoc 2024; 13:e035367. [PMID: 39189616 DOI: 10.1161/jaha.124.035367] [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: 05/29/2024] [Accepted: 07/25/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND A technologically integrated, multidisciplinary approach to stroke rehabilitation service was delivered and embedded into conventional health care practice. This article reports an evaluation of cost-effectiveness analysis of a new Virtual Multidisciplinary Stroke Care Clinic (VMSCC) service for community-dwelling survivors of stroke. METHODS AND RESULTS A randomized controlled trial was conducted. Adults with a first/recurrent ischemic/hemorrhagic stroke were recruited from 10 hospitals. Eligible participants were randomly assigned to receive the VMSCC service (individual virtual consultations with a registered nurse, home blood pressure telemonitoring, and unlimited access to an online resource platform) plus usual care or usual care alone. Cost-effectiveness analyses were performed based on incremental cost-effectiveness ratios expressed as incremental cost per emergency admission reduced, and day of hospitalization reduced over the study period. A total of 256 participants (intervention group n=141 versus control group n=115) with complete cost and health care use data were included in the cost-effectiveness analyses. The VMSCC service, on average, resulted in a greater reduction in the number of emergency admission (-0.06 [95% bootstrapped CI, -0.14 to 0.01]) and fewer days of hospitalization (-0.08, [95% bootstrapped CI -0.40 to 0.24]) but incurred a higher total cost of HK$375 (95% bootstrapped CI, -2103 to 2743) compared with the usual care. The incremental cost-effectiveness ratios of the VMSCC service compared with the usual care were HK$6070 and HK$4826 per an emergency admission and a day of hospital stay reduced respectively. CONCLUSIONS The study provides preliminary but not confirmative evidence that the VMSCC service could be more effective but more costly than usual care in reducing health service use. REGISTRATION URL: https://www.chictr.org.cn. Unique identifier: ChiCTR1800016101.
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Affiliation(s)
- Simon Kwun Yu Lam
- Nethersole School of Nursing, Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China
| | - Janita Pak Chun Chau
- Nethersole School of Nursing, Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China
| | - Suzanne Hoi Shan Lo
- Nethersole School of Nursing, Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China
| | - Kai Chow Choi
- Nethersole School of Nursing, Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China
| | - Elaine Kee Chen Siow
- Health and Social Sciences Singapore Institute of Technology Singapore City Singapore
| | | | - Vivian Wing Yan Lee
- Centre for Learning Enhancement And Research The Chinese University of Hong Kong Hong Kong SAR China
| | - Sheung Sheung Hung
- School of Chinese Medicine, Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China
| | - Vincent Chung Tong Mok
- Department of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong SAR China
| | - Jessica Yuet Ling Ching
- Department of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong SAR China
| | - Alexander Yuk Lun Lau
- Department of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong SAR China
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Lavorgna L, Maida E, Reinhard C, Cras P, Reetz K, Molnar MJ, Nonnekes J, Medijainen K, Summa S, Diserens K, Petrarca M, Albanese A, Leocani L, Delussi M, Vinciguerra C, Pagliano E, Kubica J, Lallemant P, Wenning G, Sival D, Groleger Srsen K, Bertini ES, Lopane G, Boesch S, Bonavita S, Crosiers D, Muresanu D, Timmann D, Federico A. The Growing Role of Telerehabilitation and Teleassessment in the Management of Movement Disorders in Rare Neurological Diseases: A Scoping Review. Telemed J E Health 2024; 30:2419-2430. [PMID: 38946606 DOI: 10.1089/tmj.2023.0702] [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] [Indexed: 07/02/2024] Open
Abstract
Background: People with rare neurological diseases (RNDs) often experience symptoms related to movement disorders, requiring a multidisciplinary approach, including rehabilitation. Telemedicine applied to rehabilitation and symptom monitoring may be suitable to ensure treatment consistency and personalized intervention. The objective of this scoping review aimed to emphasize the potential role of telerehabilitation and teleassessment in managing movement disorders within RNDs. By providing a systematic overview of the available literature, we sought to highlight potential interventions, outcomes, and critical issues. Methods: A literature search was conducted on PubMed, Google Scholar, IEEE, and Scopus up to March 2024. Two inclusion criteria were followed: (1) papers focusing on telerehabilitation and teleassessment and (2) papers dealing with movement disorders in RNDs. Results: Eighteen papers fulfilled the inclusion criteria. The main interventions were home-based software and training programs, exergames, wearable sensors, smartphone applications, virtual reality and digital music players for telerehabilitation; wearable sensors, mobile applications, and patient home video for teleassessment. Key findings revealed positive outcomes in gait, balance, limb disability, and in remote monitoring. Limitations include small sample sizes, short intervention durations, and the lack of standardized protocols. Conclusion: This review highlighted the potential of telerehabilitation and teleassessment in addressing movement disorders within RNDs. Data indicate that these modalities may play a major role in supporting conventional programs. Addressing limitations through multicenter studies, longer-term follow-ups, and standardized protocols is essential. These measures are essential for improving remote rehabilitation and assessment, contributing to an improved quality of life for people with RNDs.
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Affiliation(s)
- Luigi Lavorgna
- Department of Advanced Medical and Surgical Sciences Napoli, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Elisabetta Maida
- Department of Advanced Medical and Surgical Sciences Napoli, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Carola Reinhard
- Centre for Rare Diseases and Institute of Medical Genetics and Applied Genomics, University Hospitals Tubingen, Tubingen, Germany
| | - Patrick Cras
- Department of Neurology, University Hospital Antwerp, Edegem, Belgium
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University Hospital Antwerp, Edegem, Belgium
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- Forschungszentrum Julich GmbH, JARA Institute Molecular Neuroscience and Neuroimaging, Julich, Germany
| | - Maria Judit Molnar
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University, Budapest, Hungary
| | - Jorik Nonnekes
- Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, The Netherlands
| | | | - Susanna Summa
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), Bambino Gesu Pediatric Hospital, Roma, Italy
| | | | - Maurizio Petrarca
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), Bambino Gesu Pediatric Hospital, Roma, Italy
| | | | - Letizia Leocani
- Institute of Experimental Neurology and Neurological Department, San Raffaele Hospital, Milano, Italy
| | - Marianna Delussi
- Department of translational biomedicine and neuroscience "DiBraiN", University of Bari Aldo Moro, Bari, Italy
| | | | | | - Jadwiga Kubica
- Institute of Physiotherapy, Faculty of Health Science, Jagiellonian University Medical College, Krakow, Poland
| | - Pauline Lallemant
- Paris Brain Institute (ICM Institut du Cerveau), INSERM, CNRS, Assistance Publique-Hôpitaux de Paris (APHP), University Hospital Pitié-Salpêtrière, Sorbonne Université, Paris, France
- Pediatric Physical Medicine and Rehabilitation Department, Sorbonne Université, Paris, France
| | - Gregor Wenning
- Department of Neurology and Neurosurgery, Medical University Innsbruck, Innsbruck, Austria
| | - Deborah Sival
- Department of Pediatrics, University of Groningen, Beatrix Children's Hospital, Groningen, The Netherlands
| | - Katja Groleger Srsen
- Rehabilitation Institute of Republic Slovenia, University of Ljubljana, Ljubljana, Slovenia
- Medical faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Enrico Silvio Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, IRCCS, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Giovanna Lopane
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Sylvia Boesch
- Department of Neurology and Neurosurgery, Center for rare movement disorders, Innsbruck Medical University, Innsbruck, Austria
| | - Simona Bonavita
- Department of Advanced Medical and Surgical Sciences Napoli, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - David Crosiers
- Department of Neurology, University Hospital Antwerp, Edegem, Belgium
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University Hospital Antwerp, Edegem, Belgium
| | - Dafin Muresanu
- Department of Neuroscience, Iuliu Hagieganu University of Medicine and Pharmacy Faculty of Medicine, Cluj Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Dagmar Timmann
- Department of Neurology, Center for Translational Neuro, and Behavioral Sciences (C-TNBS), University Hospital Essen, Essen, Germnany
| | - Antonio Federico
- Dept. Medicine, Surgery and Neurosciences, Siena University Hospital, Siena, Italy
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Casalini C, Pecini C. Telerehabilitation of Developmental Dyslexia: Critical Considerations on Intervention Methods and Their Effectiveness. Brain Sci 2024; 14:793. [PMID: 39199485 PMCID: PMC11352316 DOI: 10.3390/brainsci14080793] [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: 06/10/2024] [Revised: 07/26/2024] [Accepted: 07/26/2024] [Indexed: 09/01/2024] Open
Abstract
Paper-based or IT tools can be used in telerehabilitation mode to improve the skills of children with developmental dyslexia (DD), seeking to increase reading speed and reduce errors. Telerehabilitation is the provision of remote treatments in which the patient works autonomously in a familiar environment under the remote monitoring, through telecommunication means, of an expert operator. Through telerehabilitation, children with DD can receive treatments outside the specialist clinic, at home or school, via internet connections, and through advanced technological platforms. These procedures allow adequate communication with the family, intensity of treatment, self-adaptivity of exercises, and child engagement; these factors are crucial for a high intervention efficacy. Recent studies have supported the effectiveness of the telerehabilitation of reading in children with DD, with some studies reporting no differences in efficacy between remote and in-person methods. Nevertheless, many points remain to be clarified about the procedures and methods required by telerehabilitation, the variables linked to its effectiveness (e.g., the impact of the intensity of the training and the neuropsychological profile of the child), and the comparative validity of different tele-treatment paths. These aspects are discussed in the present paper.
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Affiliation(s)
- Claudia Casalini
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy;
| | - Chiara Pecini
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, 50121 Firenze, Italy
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Garofano M, Vecchione C, Calabrese M, Rusciano MR, Visco V, Granata G, Carrizzo A, Galasso G, Bramanti P, Corallo F, Izzo C, Ciccarelli M, Bramanti A. Technological Developments, Exercise Training Programs, and Clinical Outcomes in Cardiac Telerehabilitation in the Last Ten Years: A Systematic Review. Healthcare (Basel) 2024; 12:1534. [PMID: 39120237 PMCID: PMC11311841 DOI: 10.3390/healthcare12151534] [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: 07/01/2024] [Revised: 07/24/2024] [Accepted: 07/31/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are associated with very high rates of re-hospitalization and mortality worldwide, so the complexity of these pathologies requires frequent access to hospital facilities. The guidelines also emphasize the importance of cardiac rehabilitation (CR) programs, which have demonstrated a favorable effect on outcomes, and cardiac telerehabilitation (CTR) could represent an innovative healthcare delivery model. The aim of our review is to study how technologies used in rehabilitation have changed over time and also to understand what types of rehabilitation programs have been used in telerehabilitation. METHODS We searched randomized controlled trials (RCTs) in three electronic databases, PubMed, Web of Science, and Scopus, from January 2015 to January 2024, using relevant keywords. Initially, 502 articles were found, and 79 duplicates were identified and eliminated with EndNote. RESULTS In total, 16 RCTs fulfilled the pre-defined criteria, which were analyzed in our systematic review. The results showed that after CTR, there was a significant improvement in main outcome measures, as well as in relation to technological advances. CONCLUSIONS Moreover, compared to center-based rehabilitation, CTR can offer further advantages, with better cost-effectiveness, the breakdown of geographical barriers, and the improvement of access to treatment for the female population, which is traditionally more socially committed.
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Affiliation(s)
- Marina Garofano
- Department of Medicine, Surgery and Dentistry, University of Cagliari, 09124 Cagliari, Italy
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy; (C.V.); (M.C.); (M.R.R.); (V.V.); (G.G.); (A.C.); (G.G.); (C.I.); (M.C.); (A.B.)
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy; (C.V.); (M.C.); (M.R.R.); (V.V.); (G.G.); (A.C.); (G.G.); (C.I.); (M.C.); (A.B.)
| | - Mariaconsiglia Calabrese
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy; (C.V.); (M.C.); (M.R.R.); (V.V.); (G.G.); (A.C.); (G.G.); (C.I.); (M.C.); (A.B.)
| | - Maria Rosaria Rusciano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy; (C.V.); (M.C.); (M.R.R.); (V.V.); (G.G.); (A.C.); (G.G.); (C.I.); (M.C.); (A.B.)
| | - Valeria Visco
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy; (C.V.); (M.C.); (M.R.R.); (V.V.); (G.G.); (A.C.); (G.G.); (C.I.); (M.C.); (A.B.)
| | - Giovanni Granata
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy; (C.V.); (M.C.); (M.R.R.); (V.V.); (G.G.); (A.C.); (G.G.); (C.I.); (M.C.); (A.B.)
| | - Albino Carrizzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy; (C.V.); (M.C.); (M.R.R.); (V.V.); (G.G.); (A.C.); (G.G.); (C.I.); (M.C.); (A.B.)
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy; (C.V.); (M.C.); (M.R.R.); (V.V.); (G.G.); (A.C.); (G.G.); (C.I.); (M.C.); (A.B.)
| | - Placido Bramanti
- Faculty of Psychology, University eCampus, 22060 Novedrate, Italy;
| | | | - Carmine Izzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy; (C.V.); (M.C.); (M.R.R.); (V.V.); (G.G.); (A.C.); (G.G.); (C.I.); (M.C.); (A.B.)
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy; (C.V.); (M.C.); (M.R.R.); (V.V.); (G.G.); (A.C.); (G.G.); (C.I.); (M.C.); (A.B.)
| | - Alessia Bramanti
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy; (C.V.); (M.C.); (M.R.R.); (V.V.); (G.G.); (A.C.); (G.G.); (C.I.); (M.C.); (A.B.)
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Amin R, Suvarna V, Neelapala YVR, Parmar ST, Vaishali K. Use of telerehabilitation platforms for delivering patient education among patients with asthma: a scoping review. Curr Med Res Opin 2024; 40:1421-1430. [PMID: 38994747 DOI: 10.1080/03007995.2024.2380006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 07/04/2024] [Accepted: 07/10/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVE Use of tele-technology for monitoring symptoms, functional parameters, and quality-of-life of people with asthma is essential. Delivering this information among patients is mandated for a better outcome and made possible via patient education (PE). This review aims to summarize the types of telerehabilitation modalities, dosage, and outcome measures used to assess the effectiveness of PE among people with asthma. METHODS We adopted a scoping review methodology. Thematic analysis was used to synthesize the data. The Preferred Reporting System for Meta-Analysis for Scoping Reviews (PRISMA-ScR) was followed during the review process. RESULTS PubMed, Embase, and Scopus were searched, with 34 studies meeting inclusion criteria. Results are presented in three themes: telerehabilitation platforms used to deliver PE among patients with asthma; content, duration, and frequency of the PE administered; and patient-reported outcome measures used to evaluate the effectiveness of PE. CONCLUSION This scoping study detailed the types of telerehabilitation modalities, dosage, and outcome measures used to assess the effectiveness of PE in people with asthma. This review will be especially beneficial to those considering where additional research or implementation of telerehabilitation for asthma patients is required. The studies emphasized the involvement of several healthcare experts, emphasizing the significance of a multidisciplinary approach to efficient PE delivery and possible improvements in asthma management through telerehabilitation. Although a range of telerehabilitation platforms were generally accepted, hybrid models that integrate online and in-person sessions could further enhance patient satisfaction and quality-of-life. Comprehensive economic analyses are also required, and solving technology issues is essential to maximizing the efficacy of these initiatives.
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Affiliation(s)
- Revati Amin
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Vaishnavi Suvarna
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | | | | | - K Vaishali
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
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Sanchez-Ramirez DC, Pol M, Loewen H, Choukou MA. Effect of telemonitoring and telerehabilitation on physical activity, exercise capacity, health-related quality of life and healthcare use in patients with chronic lung diseases or COVID-19: A scoping review. J Telemed Telecare 2024; 30:1097-1115. [PMID: 36045633 PMCID: PMC9434200 DOI: 10.1177/1357633x221122124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Telemonitoring and telerehabilitation can support home-based pulmonary rehabilitation (PR) and benefit patients with lung diseases or COVID-19. This study aimed to (1) identify which telemonitoring and telerehabilitation interventions (e.g. videoconferencing) are used to provide telehealth care for people with chronic respiratory conditions or COVID-19, and (2) provide an overview of the effects of telemonitoring and telerehabilitation on exercise capacity, physical activity, health-related QoL (HRQoL), and healthcare use in patients with lung diseases or COVID-19. METHODS A search was performed in the electronic databases of Ovid MEDLINE, EMBASE, and Cinahl through 15 June 2021. Subject heading and keywords were used to reflect the concepts of telemonitoring, telerehabilitation, chronic lung diseases, and COVID-19. Studies that explored the effect of a telerehabilitation and/or telemonitoring intervention, in patients with a chronic lung disease such as asthma, chronic obstructive pulmonary diseases (COPD), or COVID-19, and reported the effect of the intervention in one or more of our outcomes of interest were included. Excluding criteria included evaluation of new technological components, teleconsultation or one-time patient assessment. RESULTS This scoping review included 44 publications reporting the effect of telemonitoring (25 studies), telerehabilitation (8 studies) or both (11 studies) on patients with COPD (35 studies), asthma (5 studies), COPD and asthma (1 study), and COVID-19 (2 studies). Patients who received telemonitoring and/or telerehabilitation had improvements in exercise capacity in 9 out of 11 (82%) articles, better HRQoL in 21 out of 25 (84%), and fewer health care use in 3 out of 3 (100%) articles compared to pre-intervention. Compared to controls, no statistically significant differences were found in the intervention groups' exercise capacity in 5 out 6 (83%) articles, physical activity in 3 out of 3 (100%) articles, HRQoL in 21 out of 25 (84%) articles, and healthcare use in 15 out of 20 (75%) articles. The main limitation of the study was the high variability between the characteristics of the studies, such as the number and age of the patients, the outcome measures, the duration of the intervention, the technological components involved, and the additional elements included in the interventions that may influence the generalization of the results. CONCLUSION Telemonitoring and telerehabilitation interventions had a positive effect on patient outcomes and appeared to be as effective as standard care. Therefore, they are promising alternatives to support remote home-based rehabilitation in patients with chronic lung diseases or COVID-19.
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Affiliation(s)
- Diana C Sanchez-Ramirez
- Department of Respiratory Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Margriet Pol
- Department of Occupational Therapy, Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, The Netherlands
| | - Hal Loewen
- Neil John Maclean Health Sciences Library, University of Manitoba, Canada
| | - Mohamed-Amine Choukou
- Department of Occupational Therapy, Rady Faculty of Health Science, University of Manitoba, Canada
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9
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Denti M, Pecorari A, Accogli MA, Costi S, Mainini C, Pellegrini M, Boni C, Barbara B, Braglia L, Fugazzaro S. Facing the COVID-19 pandemic: An Italian feasibility study of a mixed in-person/telerehabilitation intervention for cancer patients. Cancer Med 2024; 13:e70022. [PMID: 39095954 PMCID: PMC11296954 DOI: 10.1002/cam4.70022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 06/23/2024] [Accepted: 07/04/2024] [Indexed: 08/04/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic impacted healthcare organizations, necessitating a rapid transition from in-person to virtual care. Our study explored the feasibility of a mixed in-person/telerehabilitation intervention for cancer patients and its effects on cancer-related fatigue (CRF), quality of life (QoL), physical function, patient satisfaction, and perceived usefulness. METHODS TRACE 2020 is an observational prospective study that enrolled adult cancer patients, between January 2021 and March 2023, who were eligible for a rehabilitation program to be provided also in telerehabilitation. Patients were assessed at baseline and after the rehabilitation program. Adherence to sessions, reasons for non-adherence and adverse events were collected. RESULTS Of the 23 patients enrolled, 87% received a mixed intervention, with an average of 60% in-person sessions and 40% telerehabilitation sessions. Adherence was very high (91%). Evaluation scales showed an improvement in CRF, QoL, and lower limb strength and a relevant increase in patients' level of physical activity (PA). Most patients reported good satisfaction; the few criticisms mainly concerned difficulties in connectivity, lack of physical contact and difficulties in understanding how to perform exercises during telerehabilitation sessions. The physiotherapist underlined the usefulness of the innovative approach and suggested ways to facilitate future implementation. CONCLUSION A mixed intervention including telerehabilitation is feasible and accepted by cancer patients. It may have a positive effect on their CRF, QoL, and level of PA and render patient care more flexible. The findings suggest what characteristics the target population for telerehabilitation should have, in order to integrate telerehabilitation in standard care for cancer patients.
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Affiliation(s)
- Monica Denti
- Physical Medicine and Rehabilitation UnitAzienda Unità Sanitaria Locale—IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Alessia Pecorari
- Physical Medicine and Rehabilitation UnitAzienda Unità Sanitaria Locale—IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Monia A. Accogli
- Physical Medicine and Rehabilitation UnitAzienda Unità Sanitaria Locale—IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Stefania Costi
- Physical Medicine and Rehabilitation UnitAzienda Unità Sanitaria Locale—IRCCS di Reggio EmiliaReggio EmiliaItaly
- Unit of Dentistry and Oral‐Maxillo‐Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences, with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO)University of Modena and Reggio EmiliaModenaItaly
| | - Carlotta Mainini
- Physical Medicine and Rehabilitation UnitAzienda Unità Sanitaria Locale—IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Martina Pellegrini
- Physical Medicine and Rehabilitation UnitAzienda Unità Sanitaria Locale—IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Chiara Boni
- Department of Surgery, Medicine, Dentistry and Morphological SciencesUniversity of Modena and Reggio EmiliaModenaItaly
| | - Bressi Barbara
- Physical Medicine and Rehabilitation UnitAzienda Unità Sanitaria Locale—IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Luca Braglia
- Clinical Trials Center, Azienda USL‐IRCSS di Reggio EmiliaReggio EmiliaItaly
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation UnitAzienda Unità Sanitaria Locale—IRCCS di Reggio EmiliaReggio EmiliaItaly
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10
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Shirozhan S, Rafiee-Vardanjani L, Motie M, Mohamadi S. Home-based telerehabilitation in multiple sclerosis: a scoping review. BMJ Support Palliat Care 2024:spcare-2024-004821. [PMID: 39084690 DOI: 10.1136/spcare-2024-004821] [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: 02/06/2024] [Accepted: 07/15/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Introducing home-based telerehabilitation (TR) approaches helps clinical experts to choose appropriate and effective interventions and researchers identify knowledge gaps to design clinical trial studies and systematic reviews. PURPOSE This study aimed to review the knowledge of home-based TR in multiple sclerosis. METHOD This scoping review study was conducted based on Arksey and O'Malley's five-step approach. The Embase, PubMed, Cochrane, Web of Sciences, Scopus and ProQuest databases were searched in 2017-2024 to find full-text English-language articles. FINDINGS In 25 studies reviewed, various and extensive home-based interventions have been used in physical and cognitive aspects. CONCLUSION Home-based rehabilitation is applicable, useful, safe and affordable, maintains the continuity of the rehabilitation process and increases patients' adherence to the rehabilitation programme. However, there are challenges such as patients' lack of familiarity with technology and limitations of outcome measurement tools that should be addressed in future studies.
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Affiliation(s)
- Shima Shirozhan
- Department of Nursing, Health in Emergency and Disaster Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Leila Rafiee-Vardanjani
- Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mahdieh Motie
- Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Shamaneh Mohamadi
- Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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11
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Barzacchi V, Mangani G, Del Lucchese B, Menici V, Bombonato C, Beani E, Biagioni E, Palla I, Posteraro F, Trieste L, Turchetti G, Sgandurra G, Cioni G, Consortium OBOTT. TABLET TOSCANA to Develop Innovative Organizational Models for Tele-Rehabilitation in Subjects with Congenital and Acquired Developmental Disabilities: A Wait-List Control Group Trial Protocol. J Clin Med 2024; 13:4159. [PMID: 39064206 PMCID: PMC11277580 DOI: 10.3390/jcm13144159] [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: 06/19/2024] [Revised: 07/04/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Background/Objectives: In recent years, the advent of new technologies has fostered their application in neuro-psychomotor and language rehabilitation, particularly since the COVID-19 pandemic. Tele-rehabilitation has emerged as an innovative and timely solution, enabling personalized interventions monitored by clinicians. TABLET TOSCANA project aims to develop innovative tele-rehabilitation organizational models in children, adolescents and young adults with congenital and acquired developmental disabilities, using the Virtual Reality Rehabilitation System (VRRS) Home Kit and the MedicoAmico APP. Methods: The trial is designed according to the CONSORT statement guidelines. The project encompasses three phases: adapting the technologies for pediatric use, validating them through a wait-list study, and analyzing feasibility and effectiveness data to define new organizational models. A randomized wait-list-control study with 100 subjects aged 6 to 30 years will compare tele-rehabilitation versus prosecution of standard care. Discussion: Although literature highlights tele-rehabilitation benefits such as improved access, cost savings, and enhanced treatment adherence, practical implementation remains limited (i.e., the definition of standardized procedures). TABLET TOSCANA project seeks to address these gaps by focusing on multi-domain treatments for neurodevelopmental disabilities and emphasizing the integration of tele-rehabilitation into local health services. Conclusion: The project aims to improve the continuity and intensity of care through innovative models that integrate tele-rehabilitation into local health services. The results could inform healthcare policies and promote the development of innovative and collaborative models of care, paving the way for more effective and widespread tele-rehabilitation solutions and fostering collaborative networks among professionals.
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Affiliation(s)
- Veronica Barzacchi
- Developmental Neurology and Neurorehabilitation Unit, IRCCS Stella Maris Foundation, 56126 Pisa, Italy; (V.B.); (G.M.); (B.D.L.); (V.M.); (C.B.); (E.B.); (G.C.)
- Tuscan Ph.D. Programme of Neuroscience, University of Florence, 50121 Florence, Italy
| | - Gloria Mangani
- Developmental Neurology and Neurorehabilitation Unit, IRCCS Stella Maris Foundation, 56126 Pisa, Italy; (V.B.); (G.M.); (B.D.L.); (V.M.); (C.B.); (E.B.); (G.C.)
| | - Benedetta Del Lucchese
- Developmental Neurology and Neurorehabilitation Unit, IRCCS Stella Maris Foundation, 56126 Pisa, Italy; (V.B.); (G.M.); (B.D.L.); (V.M.); (C.B.); (E.B.); (G.C.)
| | - Valentina Menici
- Developmental Neurology and Neurorehabilitation Unit, IRCCS Stella Maris Foundation, 56126 Pisa, Italy; (V.B.); (G.M.); (B.D.L.); (V.M.); (C.B.); (E.B.); (G.C.)
- Ph.D. Programme in Clinical and Translational Sciences, University of Pisa, Via Roma 67, 56126 Pisa, Italy
| | - Clara Bombonato
- Developmental Neurology and Neurorehabilitation Unit, IRCCS Stella Maris Foundation, 56126 Pisa, Italy; (V.B.); (G.M.); (B.D.L.); (V.M.); (C.B.); (E.B.); (G.C.)
| | - Elena Beani
- Developmental Neurology and Neurorehabilitation Unit, IRCCS Stella Maris Foundation, 56126 Pisa, Italy; (V.B.); (G.M.); (B.D.L.); (V.M.); (C.B.); (E.B.); (G.C.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Enrico Biagioni
- UOC Neuropsichiatria Infantile, ASL Toscana Nord-Ovest, 56126 Pisa, Italy;
| | - Ilaria Palla
- Institute of Management, Scuola Superiore Sant’Anna, 56126 Pisa, Italy; (I.P.); (L.T.); (G.T.)
| | - Federico Posteraro
- Rehabilitation Department, Versilia Hospital, AUSL Toscana Nord Ovest, 55049 Lucca, Italy;
| | - Leopoldo Trieste
- Institute of Management, Scuola Superiore Sant’Anna, 56126 Pisa, Italy; (I.P.); (L.T.); (G.T.)
| | - Giuseppe Turchetti
- Institute of Management, Scuola Superiore Sant’Anna, 56126 Pisa, Italy; (I.P.); (L.T.); (G.T.)
| | - Giuseppina Sgandurra
- Developmental Neurology and Neurorehabilitation Unit, IRCCS Stella Maris Foundation, 56126 Pisa, Italy; (V.B.); (G.M.); (B.D.L.); (V.M.); (C.B.); (E.B.); (G.C.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Giovanni Cioni
- Developmental Neurology and Neurorehabilitation Unit, IRCCS Stella Maris Foundation, 56126 Pisa, Italy; (V.B.); (G.M.); (B.D.L.); (V.M.); (C.B.); (E.B.); (G.C.)
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12
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Cerfoglio S, Verme F, Capodaglio P, Rossi P, Cvetkova V, Boldini G, Galli M, Cimolin V. Motor and Respiratory Tele-Rehabilitation in Patients with Long COVID-19 after Hospital Discharge: An Interventional Study. Life (Basel) 2024; 14:864. [PMID: 39063618 PMCID: PMC11277623 DOI: 10.3390/life14070864] [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: 06/04/2024] [Revised: 07/05/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
The persistence of symptoms following COVID-19 infection represents a significant challenge in healthcare management. During the outbreak, tele-rehabilitation emerged as a new tool to support healthcare structures in providing rehabilitation services. This study assessed the effectiveness and the feasibility of a 3-week home-based motor and respiratory rehabilitation program for individuals with long COVID-19 after traditional rehabilitation. Twenty-three patients completed the program and underwent functional tests at different time points (i.e., baseline, at discharge from in-hospital rehabilitation and after tele-rehabilitation). Motor function was evaluated using the instrumented Six-Minutes Walking Test (i6MWT), with monitored heart rate and oxygen saturation. Additionally, respiratory function was measured via forced vital capacity (FVC) and maximal voluntary ventilation (MVV) tests. Significant improvements (p < 0.05) in motor and respiratory function were observed throughout the intervention, including an 18.3% increase in walked distance from the baseline. The findings suggest that the proposed home-based tele-rehabilitation shows potential in enhancing motor and respiratory function in patients with long COVID. Despite limitations such as the small sample size, lack of control group and the preliminary nature of the outcomes observed, the overall findings seem to support the feasibility of the proposed tele-rehabilitation program in managing long COVID symptoms and promoting functional recovery. Nevertheless, further research is needed to validate these findings and explore tele-rehabilitation's potential in broader and different patient populations.
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Affiliation(s)
- Serena Cerfoglio
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy; (S.C.); (M.G.); (V.C.)
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy; (F.V.); (G.B.)
| | - Federica Verme
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy; (F.V.); (G.B.)
| | - Paolo Capodaglio
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy; (F.V.); (G.B.)
- Department of Surgical Sciences, Physical Medicine and Rehabilitation, University of Turin, 10126 Turin, Italy
| | - Paolo Rossi
- Clinica Hildebrand, Centro di Riabilitazione Brissago, CH-6614 Brissago, Switzerland; (P.R.); (V.C.)
| | - Viktoria Cvetkova
- Clinica Hildebrand, Centro di Riabilitazione Brissago, CH-6614 Brissago, Switzerland; (P.R.); (V.C.)
| | - Gabriele Boldini
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy; (F.V.); (G.B.)
| | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy; (S.C.); (M.G.); (V.C.)
| | - Veronica Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy; (S.C.); (M.G.); (V.C.)
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy; (F.V.); (G.B.)
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13
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Olowoyo P, Dhamija RK, Owolabi MO. Telerehabilitation - historical perspectives and conceptual framework in reference to neurological disorders: A narrative review. NeuroRehabilitation 2024:NRE240079. [PMID: 38995808 DOI: 10.3233/nre-240079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2024]
Abstract
BACKGROUND Telerehabilitation as a new subdiscipline of telehealth is the application of information technology to support and deliver rehabilitation services via two-way or multipoint interactive online telecommunication technology. This enables the therapist to optimize the timing, intensity, and duration of therapy which is often not possible within the constraints of face-to-face treatment protocols in current health systems. OBJECTIVE To review the historical perspective and conceptual framework of telerehabilitation in neurological disorders. METHODS A narrative review of the literature was performed for the historical perspective and a systematic review of the conceptual framework was performed using the PRISMA guidelines on chronic neurological disorders; multiple sclerosis, spinal cord injury, stroke, Parkinson's disease, cognitive impairment, and headaches. The search included articles from the past 20 years (2004 to 2024). RESULTS Telerehabilitation dates back to the 1960s and early 1970s. Documented effective interventions were mostly on therapies for speech disorders. The conceptual framework consisted of three major components of telerehabilitation programmes including development, implementation, and evaluation. The COVID-19 pandemic suddenly made telerehabilitation come to the limelight because physical distancing became necessary. Out of the 110,000 articles downloaded, 43 met the inclusion criteria for review on the conceptual framework of telerehabilitation in relation to neurological disorders. The articles discussed multiple sclerosis (2), spinal cord disorders (1), stroke (17), Parkinson's disease (15), headaches (3), and cognitive disorders (5). All articles reviewed assessed the effectiveness of telemedicine except for the articles on multiple sclerosis and spinal cord disorders which examined the interphase between the technology and the end users. CONCLUSION The future of telerehabilitation looks promising with the subsequent integration of innovative tools and applications. This will require the adaption of technology, continuous capacity building, education, and training of healthcare professionals to ensure that they are adequately equipped with the necessary skills to provide quality virtual reality rehabilitation care.
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Affiliation(s)
- Paul Olowoyo
- Department of Medicine, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Rajinder K Dhamija
- Department of Neurology, Institute of Human Behaviour and Allied Sciences, New Delhi, India
| | - Mayowa O Owolabi
- Neurology Department, University College Hospital, Ibadan, Nigeria
- Center for Genomics and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Lebanese American University, Beirut, Lebanon
- Department of Medicine, University College Hospital, Ibadan, Nigeria
- Blossom Specialist Medical Center, Ibadan, Nigeria
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14
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Yang J, Li H, Zhao H, Xie Y, Li J, Wang M. Effectiveness of telerehabilitation in patients with post-COVID-19: a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2024; 14:e074325. [PMID: 38964791 PMCID: PMC11227776 DOI: 10.1136/bmjopen-2023-074325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/25/2024] [Indexed: 07/06/2024] Open
Abstract
OBJECTIVE To assess the effects of telerehabilitation on clinical symptoms, physical function, psychological function and quality of life (QoL) in patients with post-COVID-19. DESIGN Systematic review and meta-analysis of randomised controlled trials (RCTs). DATA SOURCES PubMed, Web of Science, Embase and Cochrane Library were searched for publications from 1 January 2020 to 17 April 2024. ELIGIBILITY CRITERIA RCTs investigating the effects of telerehabilitation in patients with post-COVID-19 were included. The outcomes of interest encompassed clinical symptoms, physical function, psychological function and QoL. Only studies reported in English were included. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data and evaluated the risk of bias. Statistical analysis was conducted using Review Manager V.5.3, employing mean difference (MD) with a 95% CI, and the corresponding P value was used to ascertain the treatment effect between groups. Heterogeneity was quantified using the I2 statistic. The quality of evidence was assessed by GRADE. RESULTS 16 RCTs (n=1129) were included in this systematic review, 15 of which (n=1095, 16 comparisons) were included in the meta-analysis. The primary pooled analysis demonstrated that, compared with no rehabilitation or usual care, telerehabilitation can improve physical function (measured by 30 s sit-to-stand test [6 RCTs, n=310, MD=1.58 stands, 95% CI 0.50 to 2.66; p=0.004]; 6 min walking distance [6 RCTs, n=324, MD=76.90 m, 95% CI 49.47 to 104.33; p<0.00001]; and physical function from the 36-item short-form health survey [5 RCTs, n=380, MD=6.12 units, 95% CI 2.85 to 9.38; p=0.0002]). However, the pooled results did not indicate significant improvements in clinical symptoms, pulmonary function, psychological function or QoL. The quality of the evidence was graded as low for physical function and Hospital Anxiety and Depression Scale-anxiety and very low for other assessed outcomes. The overall treatment completion rate was 78.26%, with no reports of severe adverse events in any included trials. CONCLUSIONS Despite the lack of significant improvements in certain variables, telerehabilitation could be an effective and safe option for enhancing physical function in patients with post-COVID-19. It is advisable to conduct further well-designed trials to continue in-depth exploration of this topic. STUDY REGISTRATION PROSPERO, CRD42023404647.
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Affiliation(s)
- Jiang Yang
- First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
- Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases co-constructed by Henan province & Education Ministry of P.R. China, Zhengzhou, Henan, China
| | - Huiru Li
- First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
- Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases co-constructed by Henan province & Education Ministry of P.R. China, Zhengzhou, Henan, China
| | - Hulei Zhao
- Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases co-constructed by Henan province & Education Ministry of P.R. China, Zhengzhou, Henan, China
- Department of Respiratory Critical Care, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Yang Xie
- Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases co-constructed by Henan province & Education Ministry of P.R. China, Zhengzhou, Henan, China
- Department of Respiratory Critical Care, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Jiansheng Li
- Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases co-constructed by Henan province & Education Ministry of P.R. China, Zhengzhou, Henan, China
| | - Minghang Wang
- Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases co-constructed by Henan province & Education Ministry of P.R. China, Zhengzhou, Henan, China
- Department of Respiratory Critical Care, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China
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Paramita N, Santoso DIS, Nusdwinuringtyas N, Rasmin M, Kartinah NT, Jusman SWA, Abdullah M, Tinduh D, Widjanantie SC, Harini M, Sianipar IR, Nugraha B, Gutenbrunner C, Widaty S. The Delphi Method: Developing a Telerehabilitation Practice Guideline for Patients in Indonesia with Long COVID. Int J Telerehabil 2024; 16:e6610. [PMID: 39022434 PMCID: PMC11249837 DOI: 10.5195/ijt.2024.6610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Telerehabilitation has the potential to help expand the reach of rehabilitation intervention. An online questionnaire-based Delphi method set out to develop a telerehabilitation guideline for patients in Indonesia with Long COVID. A Delphi panel comprised of 24 experts was selected from all relevant disciplines. Over two rounds of Delphi testing, panelists gave opinions and indicated their level of agreement with each recommendation. Key elements of consensus for a telerehabilitation guideline for patients with Long COVID includes: the benefit of telerehabilitation, types of rehabilitation intervention needed, methods of intervention, criteria for home-based self-exercise training, set-up of rehabilitation prescription, exercise monitoring, evaluation of rehabilitation intervention and duration of rehabilitation intervention. Further research is needed to determine the feasibility and effectiveness of this guideline.
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Affiliation(s)
- Nurul Paramita
- Doctoral Program in Medical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Department of Medical Physiology and Biophysics, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Dewi Irawati Soeria Santoso
- Department of Medical Physiology and Biophysics, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Nury Nusdwinuringtyas
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Menaldi Rasmin
- Department of Pulmonology and Respiratory Medicine, Persahabatan National Respiratory Referral Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Neng Tine Kartinah
- Department of Medical Physiology and Biophysics, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Sri Widia A. Jusman
- Department of Biochemistry and Molecular Biology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Murdani Abdullah
- Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Damayanti Tinduh
- Faculty of Medicine, Airlangga University, Surabaya, Indonesia
- Department of Physical Medicine and Medical Rehabilitation, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Siti Chandra Widjanantie
- Department of Physical Medicine and Rehabilitation, Persahabatan National Respiratory Referral Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Melinda Harini
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Imelda Rosalyn Sianipar
- Department of Medical Physiology and Biophysics, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Boya Nugraha
- Department of Rehabilitation and Sport Medicine, Hannover Medical School, 30625 Hannover, Germany
- Hannover Rehabilitation Services & Science Consulting, 30627 Hannover, Germany
| | - Christoph Gutenbrunner
- Department of Rehabilitation and Sport Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Sandra Widaty
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Department of Medical Education, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Uddin M, Ganapathy K, Syed-Abdul S. Digital Technology Enablers of Tele-Neurorehabilitation in Pre- and Post-COVID-19 Pandemic Era - A Scoping Review. Int J Telerehabil 2024; 16:e6611. [PMID: 39022438 PMCID: PMC11250154 DOI: 10.5195/ijt.2024.6611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Neurorehabilitation (NR), a major component of neurosciences, is the process of restoring a patient's damaged/disorganized neurological function, through training, therapy, and education, while focusing on patient's independence and well-being. Since the advent of the COVID-19 pandemic, various applications of telecare and telehealth services surged drastically and became an integral part of current clinical practices. Tele-Neurorehabilitation (TNR) is one of such applications. When rehabilitation services were disrupted globally due to lockdown and travel restrictions, the importance of TNR was recognized, especially in developed, low, and middle-income countries. With exponential deployment of telehealth interventions in neurosciences, TNR has become a distinct stand-alone sub-specialty of neurosciences and telehealth. Digital technologies, such as wearables, robotics, and Virtual Reality (VR) have enabled TNR to improve the quality of patients' lives. Providing NR remotely using digital technologies and customized digital devices is now a reality, and likely to be the new norm soon. This article provides an overview of the needs, utilization, and deployment of TNR, and focuses on digital technology enablers of TNR in pre- and post-COVID-19 pandemic era.
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Affiliation(s)
- Mohy Uddin
- Research Quality Management Section, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Krishnan Ganapathy
- Distinguished Visiting Professor IIT Kanpur & Director Apollo Telemedicine Networking Foundation, India
| | - Shabbir Syed-Abdul
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
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17
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Ogedengbe TO, Kreidy C, Gürke N, Twahirwa BN, Boateng MA, Eslahi M, Khodayari F, Nemargut JP, Martiniello N, Wittich W. Feasibility of telerehabilitation to address the orientation and mobility needs of individuals with visual impairment: perspectives of current guide dog users. Disabil Rehabil 2024:1-11. [PMID: 38907578 DOI: 10.1080/09638288.2024.2368058] [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: 03/08/2024] [Accepted: 06/11/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVE To assess guide dog users' perspectives on the feasibility of telerehabilitation for their O&M needs. METHOD An online survey gathered insights from 56 guide dog (GD) users (Mean age = 59, Mean GD used = 4, Mean duration of use = 22 years). Thirteen GD users further participated in interviews or focus groups to explore survey responses. Data were analyzed using content analysis. FINDINGS Most (40) were blind, and 16 had low vision, with intermediate (25) and advanced (25) communication technology proficiency. Most GD users (46) underwent residential training, and 10 received one-on-one visits. Qualitative analysis revealed acceptance of telerehabilitation services, citing accessibility as an advantage. However, GD users expressed concerns about safety, potential loss of behavioral observation, and social contact loss. Success depended on the type of technology, service type, and personal attributes. CONCLUSION While feasible, telerehabilitation services may not be universally suitable for all training stages. Flexibility and applicability in service design are necessary to accommodate individual preferences and experience levels.
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Affiliation(s)
- Tosin Omonye Ogedengbe
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, Québec, Canada
| | - Chantal Kreidy
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, Québec, Canada
| | - Nora Gürke
- Vrije Universiteit Amsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam, Noord-Holland, Netherlands
| | | | - Mark A Boateng
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | - Mina Eslahi
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | | | - Joseph P Nemargut
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, Québec, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, Québec, Canada
- Centre de Réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Natalina Martiniello
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, Québec, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, Québec, Canada
- Centre de Réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Walter Wittich
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, Québec, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, Québec, Canada
- Centre de Réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montréal, Québec, Canada
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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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Manenti R, Baglio F, Pagnoni I, Gobbi E, Campana E, Alaimo C, Rossetto F, Di Tella S, Pagliari C, Geviti A, Bonfiglio NS, Calabrò RS, Cimino V, Binetti G, Quartarone A, Bramanti P, Cappa SF, Rossini PM, Cotelli M. Long-lasting improvements in episodic memory among subjects with mild cognitive impairment who received transcranial direct current stimulation combined with cognitive treatment and telerehabilitation: a multicentre, randomized, active-controlled study. Front Aging Neurosci 2024; 16:1414593. [PMID: 38966802 PMCID: PMC11223647 DOI: 10.3389/fnagi.2024.1414593] [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: 04/09/2024] [Accepted: 05/31/2024] [Indexed: 07/06/2024] Open
Abstract
Background In recent years, an increasing number of studies have examined the potential efficacy of cognitive training procedures in individuals with normal ageing and mild cognitive impairment (MCI). Objective The aims of this study were to (i) evaluate the efficacy of the cognitive Virtual Reality Rehabilitation System (VRRS) combined with anodal transcranial direct current stimulation (tDCS) applied to the left dorsolateral prefrontal cortex compared to placebo tDCS stimulation combined with VRRS and (ii) to determine how to prolong the beneficial effects of the treatment. A total of 109 subjects with MCI were assigned to 1 of 5 study groups in a randomized controlled trial design: (a) face-to-face (FTF) VRRS during anodal tDCS followed by cognitive telerehabilitation (TR) (clinic-atDCS-VRRS+Tele@H-VRRS); (b) FTF VRRS during placebo tDCS followed by TR (clinic-ptDCS-VRRS+Tele@H-VRRS); (c) FTF VRRS followed by cognitive TR (clinic-VRRS+Tele@H-VRRS); (d) FTF VRRS followed by at-home unstructured cognitive stimulation (clinic-VRRS+@H-UCS); and (e) FTF cognitive treatment as usual (clinic-TAU). Results An improvement in episodic memory was observed after the end of clinic-atDCS-VRRS (p < 0.001). We found no enhancement in episodic memory after clinic-ptDCS-VRRS or after clinic-TAU.Moreover, the combined treatment led to prolonged beneficial effects (clinic-atDCS-VRRS+Tele@H-VRRS vs. clinic-ptDCS-VRRS+Tele@H-VRRS: p = 0.047; clinic-atDCS-VRRS+Tele@H-VRRS vs. clinic-VRRS+Tele@H-VRRS: p = 0.06). Discussion The present study provides preliminary evidence supporting the use of individualized VRRS combined with anodal tDCS and cognitive telerehabilitation for cognitive rehabilitation. Clinical trial registration https://clinicaltrials.gov/study/NCT03486704?term=NCT03486704&rank=1, NCT03486704.
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Affiliation(s)
- Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Ilaria Pagnoni
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Campana
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Cristina Alaimo
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Sonia Di Tella
- IRCCS Fondazione Don Carlo Gnocchi – ONLUS, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Andrea Geviti
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | | | | | - Giuliano Binetti
- MAC Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Placido Bramanti
- IRCCS Centro Neurolesi “Bonino Pulejo”, Messina, Italy
- Università Degli Studi eCAMPUS, Novedrate, Italy
| | - Stefano F. Cappa
- Istituto Universitario Studi Superiori IUSS, Pavia, Italy
- IRCCS Fondazione Mondino, Pavia, Italy
| | - Paolo Maria Rossini
- Department Neuroscience and Neurorehabilitation, IRCCS San Raffaele Roma, Rome, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Ouendi N, Avril E, Dervaux B, Pudlo P, Wallard L. Effectiveness of Telerehabilitation Programs in Elderly with Hip or Knee Arthroplasty: A Systematic Review. Telemed J E Health 2024; 30:1507-1521. [PMID: 38574249 DOI: 10.1089/tmj.2023.0622] [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] [Indexed: 04/06/2024] Open
Abstract
Background: Lower limb osteoarthritis (OA) often generates musculoskeletal pain causing functional impairment and decreasing mobility, autonomy, and quality of life. Patients with OA are commonly prescribed specific care for total hip arthroplasty or total knee arthroplasty (THA or TKA), when patients present symptoms that are refractory to nondrug treatments. Currently, when patients are discharged from orthopedic surgery, they are either referred to a rehabilitation department, or sent directly home with assistance such as remote monitoring by teleconsultation or a mobile application. In recent years, there has been an evolution in digital health and in particular telerehabilitation. To determine utility and effectiveness, the aim of this systematic review was to highlight and evaluate different telerehabilitation programs using new information and communication technologies. Methods: Five databases, ScienceDirect, PubMed, Web of Sciences, Scopus, and Google scholar, were searched until 30 June 30, 2023. All studies written in English and meeting our inclusion criteria were included. Databases were screened for "Total Hip Arthroplasty," "Total Knee Arthroplasty," "Total Hip Replacement," "Total Knee Replacement," "Rehabilitation," "Physical Activity," "Physiotherapy," "Telerehabilitation," "Telecommunication*," "Senior*," and "Elderly" in accordance with PRISMA-ScR guideline. Results: Fourteen articles were selected according to inclusion criteria. Telerehabilitation was offered in seven different ways (video call, applications smartphones, website, etc.). Assessments included were mainly quality of life questionnaires, perceived effort after exercises, field surveys on the tool experience, and physical tests to assess motor functions. Conclusion: This review highlights the importance and relevance of evaluating the contributions and limits of new health technologies to improve patient monitoring and thus enable better remote clinical care.
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Affiliation(s)
- Nawel Ouendi
- Laboratoire LAMIH - UMR CNRS 8201, Département de Recherche Sciences de l'Homme et du Vivant, Univ Polytechnique Hauts-de-France, Valenciennes, France
- Pôle SSR - Maison Sport Santé - Institut Jean Stablinski, Centre Hospitalier de Valenciennes, Valenciennes, France
| | - Eugénie Avril
- Laboratoire LAMIH - UMR CNRS 8201, Département de Recherche Sciences de l'Homme et du Vivant, Univ Polytechnique Hauts-de-France, Valenciennes, France
| | - Benjamin Dervaux
- Pôle SSR - Maison Sport Santé - Institut Jean Stablinski, Centre Hospitalier de Valenciennes, Valenciennes, France
| | - Philippe Pudlo
- Laboratoire LAMIH - UMR CNRS 8201, Département de Recherche Sciences de l'Homme et du Vivant, Univ Polytechnique Hauts-de-France, Valenciennes, France
| | - Laura Wallard
- Laboratoire LAMIH - UMR CNRS 8201, Département de Recherche Sciences de l'Homme et du Vivant, Univ Polytechnique Hauts-de-France, Valenciennes, France
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21
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Chae HJ, Lee SH. Effectiveness of the online-based comprehensive cognitive training application, Smart Brain, for community-dwelling older adults with dementia: a randomized controlled trial. Eur J Phys Rehabil Med 2024; 60:423-432. [PMID: 38647533 PMCID: PMC11261305 DOI: 10.23736/s1973-9087.24.08043-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 03/11/2024] [Accepted: 04/08/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND The fourth industrial revolution has brought about developments in information and communication technologies for interventions in older adults with dementia. Currently, most interventions focus on single interventions. However, community-dwelling older adults with dementia require comprehensive cognitive interventions, and clinical studies analyzing the effects of comprehensive interventions based on randomized controlled trials are lacking. AIM The aim of the study was to examine the effects of an information and communication technology-based comprehensive cognitive training program, Smart Brain, on multi-domain function among community-dwelling older adults with dementia. DESIGN This was a two-group, randomized, controlled trial. SETTING This study was conducted at participant's home. POPULATION We analyzed older adults with dementia. METHODS Participants were randomly allocated to either the intervention group (N.=30) or the control group (N.=30). Older adults with dementia in the intervention group received 8 weeks of Smart Brain comprehensive cognitive training using a tablet, whereas the control group received a similar tablet but without the training. We measured the outcomes at baseline, and at 4 and 8 weeks. Cognitive function, depression, quality of life, balance confidence, physical ability, nutrition, and caregiver burden were compared between groups. RESULTS In the intervention group, cognitive function statistically increased from baseline to both week 4 (2.03; 95% CI 1.26 to 2.81) and week 8 (2.70; 95% CI 1.76 to 3.64). Depression was statistically different from week 0 to week 8 (-1.67, 95% CI -2.85 to -0.48). Physical ability statistically increased from baseline to both week 4 (-0.85; 95% CI 1.49 to -0.20) and week 8 (-1.44; 95% CI -2.29 to -0.59). Nutrition statistically increased from baseline to both week 4 (0.67; 95% CI 0.05 to 1.28) and week 8 (1.10; 95% CI 0.36 to 1.84). CONCLUSIONS Smart Brain significantly improved cognitive function, reduced depression, and enhanced physical and nutritional status in older adults with dementia. This demonstrates its potential as an effective non-pharmacological intervention in community-based dementia care. CLINICAL REHABILITATION IMPACT Smart Brain's personalized approach, which integrates user-specific preferences and expert guidance, enhances engagement and goal achievement in dementia care. This enhances self-esteem and clinical outcomes, demonstrates the application's potential to innovate rehabilitation practices.
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Affiliation(s)
- Hee-Jae Chae
- Department of Nursing Science, College of Nursing, Gachon University, Incheon, South Korea
| | - Seon-Heui Lee
- Department of Nursing Science, College of Nursing, Gachon University, Incheon, South Korea -
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Tsang MP, Man GCW, Xin H, Chong YC, Ong MTY, Yung PSH. The effectiveness of telerehabilitation in patients after total knee replacement: A systematic review and meta-analysis of randomized controlled trials. J Telemed Telecare 2024; 30:795-808. [PMID: 35549756 DOI: 10.1177/1357633x221097469] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Total knee replacement is a commonly adopted surgical intervention to reduce physical limitations and pain in advanced-stage knee osteoarthritis. However, these patients may experience physical dysfunction to limit their access during conventional rehabilitation after total knee replacement. The use of telemedicine may be the promising solution. This study aims to compare the effectiveness of telerehabilitation with conventional in-person rehabilitation in patients who underwent a total knee replacement. METHODS For this systematic review on randomized controlled trials, PubMed, Medline, EMBASE, Cochrane Library, ScienceDirect and CINAHL databases were searched for eligible articles published between 1 January 2003 and 28 February 2022. The eligibility criteria were patients who underwent total knee replacement, randomized controlled trials and publications in English. The main outcome measures were focused on pain and physical function. Reference lists of relevant studies were also manually checked to find additional studies. Two independent reviewers conducted study selection separately. PEDro scale was used to assess the methodological quality of the included randomized controlled trials. A meta-analysis was performed on the collected data. Review Manager (RevMan, version 5.3) was used for all analyses. RESULTS A total of 11 studies met the eligibility criteria and included 1825 participants in the systematic review. Overall, the results revealed that the effectiveness of telerehabilitation is comparable to conventional in-person rehabilitation in improving various pain and functional outcomes in patients who underwent a total knee replacement. In the meta-analysis with the fixed-effects model, no significant difference was found in the improvement of pain and physical function in patients with knee osteoarthritis compared with conventional rehabilitation (Standardized Mean Difference (SMD) -0.15, 95% CI -0.47 to 0.16, P = 0.34 and SMD -0.04, 95% CI -0.19 to 0.12, P = 0.62, respectively). In addition, the utilization of hospital resources and costs were significantly lower in telerehabilitation when compared with in-person rehabilitation. CONCLUSION Telerehabilitation was comparable to conventional in-person rehabilitation in improving clinical outcomes following total knee replacement. However, it might be a more preferable alternative rehabilitation intervention for patients following total knee replacement given the significantly lower cost of telerehabilitation.
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Affiliation(s)
- Mei Po Tsang
- Physiotherapy Department, Tai Po Hospital, New Territory, Hong Kong
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Gene Chi Wai Man
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - He Xin
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yau Chun Chong
- Department of Orthopaedics & Traumatology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - Michael Tim-Yun Ong
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Patrick Shu-Hang Yung
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
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Özel M, Kaya Ciddi P. The effectiveness of telerehabilitation-based structured exercise therapy for chronic nonspecific neck pain: A randomized controlled trial. J Telemed Telecare 2024; 30:823-833. [PMID: 35570728 DOI: 10.1177/1357633x221095782] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The aim of this research was to investigate the effects of telerehabilitation-based remote supervised or unsupervised structured exercise therapy on pain, disability, and quality of life related to chronic nonspecific neck pain. METHOD The study was designed as a single-blinded randomized controlled trial. Sixty-six eligible chronic nonspecific neck pain patients were randomized across three groups: remote supervised group (RSG, n = 22), unsupervised group (UG, n = 22), and waitlist control group (CG, n = 22). Progressive structured exercise therapy program was delivered weekly to patients in remote supervised group and unsupervised group to perform four days a week for four weeks. Remote supervised group was supervised by videoconference and text message. Pain, disability, and quality of life of participants were assessed at baseline, week 2, and post-therapy. RESULTS Post-therapy pain and disability total change scores were -3.64 (95% CI -4.85 to -2.42) and -7.27 (95% CI -11.05 to -3.50) for remote supervised group compared with a change of -2.44 (95% CI -3.46 to -1.43) and -5.77 (95% CI -8.54 to -3.01) for unsupervised group, respectively. Post-therapy, quality of life improvements were greater for remote supervised group than unsupervised group overall (general health; remote supervised group: 19.01 (95% CI 6.86 to 31.16), unsupervised group: 12.50 (95% CI 4.79 to 20.21), and physical health; remote supervised group: 18.35 (95% CI 10.35 to 26.35), unsupervised group: 7.31 (95% CI 0.01 to 14.60)). Significant improvements in psychological health and environment-telerehabilitation for remote supervised group were not seen for unsupervised group and outcomes differences did not reach significance for control group (p > 0.05) post-therapy, except environment-telerehabilitation. DISCUSSION Structured exercise therapy can improve chronic nonspecific neck pain outcomes when remotely supervised or unsupervised. Structured exercise therapy content and frequent communication are important for remote chronic nonspecific neck pain management.
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Affiliation(s)
- Merve Özel
- Physiotherapy and Rehabilitation Department, Medipol University, Health Sciences Institute, Istanbul, Turkey
| | - Pınar Kaya Ciddi
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Istanbul Medipol University, Istanbul, Turkey
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24
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Çelik EB, Tuncer A. Comparing the Efficacy of Manual Therapy and Exercise to Synchronized Telerehabilitation with Self-Manual Therapy and Exercise in Treating Subacromial Pain Syndrome: A Randomized Controlled Trial. Healthcare (Basel) 2024; 12:1074. [PMID: 38891149 PMCID: PMC11171729 DOI: 10.3390/healthcare12111074] [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: 04/08/2024] [Revised: 05/18/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
This study aimed to investigate the efficacy of manual therapy and exercise versus synchronized telerehabilitation with self-manual therapy and exercise in treating Subacromial Pain Syndrome (SAPS). Sixty individuals diagnosed with SPS, aged 18-50 years, were randomly assigned to home exercise (HE), manual therapy (MT), and telerehabilitation (TR) groups. Treatment protocols were administered over 8 weeks and included specific exercises and therapy interventions. Outcome measures included the Visual Pain Scale (VAS), shoulder range of motion (ROM) via goniometric measurements, Quick Disability Arm-Shoulder-Hand Problems Survey (Q-DASH), and patient satisfaction. Results revealed that both MT and TR groups exhibited reduced pain, increased ROM, lower Q-DASH scores, and higher patient satisfaction than the HE group. However, no significant differences were found between the MT and TR groups regarding pain levels, ROM, Q-DASH scores, or patient satisfaction. The study concludes that both telerehabilitation and manual therapy effectively alleviate pain and are well-received by patients with SPS. Additionally, manual therapy demonstrates superiority in enhancing functional levels compared to exercise-based interventions (Registration: NCT05200130).
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Affiliation(s)
- Erman Berk Çelik
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Mardin Artuklu University, 47200 Mardin, Türkiye
| | - Aysenur Tuncer
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Hasan Kalyoncu University, 27410 Gaziantep, Türkiye;
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25
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Munce SE. Introducing JMIR Rehabilitation and Assistive Technologies: A Venue for Publishing Interdisciplinary Research on the Development, Implementation, and Evaluation of Health Innovations and Emerging Technologies in the Field of Rehabilitation. JMIR Rehabil Assist Technol 2024; 11:e56348. [PMID: 38648632 DOI: 10.2196/56348] [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: 01/13/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/25/2024] Open
Abstract
Rehabilitation supports the affected individual and their caregivers in managing the health condition and its associated symptoms, altering the environment to accommodate needs, adapting tasks for safe and independent performance, facilitating self-management, and using assistive devices and technologies. JMIR Rehabilitation and Assistive Technologies focuses on pragmatic yet rigorous and impactful science that reports on the development, implementation, and evaluation of health innovations and interventions as well as emerging technologies in the field of rehabilitation.
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Affiliation(s)
- Sarah Ep Munce
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
- Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada
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26
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M K, Josyula S, S JA, J H, M N, J V. Revolutionizing Sports Rehabilitation: Unleashing the Power of Tele-Rehabilitation for Optimal Physiotherapy Results. Telemed J E Health 2024; 30:e1180-e1186. [PMID: 37976124 DOI: 10.1089/tmj.2023.0299] [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] [Indexed: 11/19/2023] Open
Abstract
Background: Tele-rehabilitation programs have emerged as a promising approach to improve access to physiotherapy services for athletes with sports-related injuries. This randomized controlled trial aimed to compare the effectiveness of a tele-rehabilitation program with traditional in-person physiotherapy in improving outcomes for this population. Methods: This randomized controlled trial enrolled a large sample of 780 athletes with sports-related injuries to compare the effectiveness of tele-rehabilitation and traditional in-person physiotherapy. Blinding procedures were implemented to minimize bias. The intervention group received tele-rehabilitation physiotherapy, whereas the control group received traditional in-person physiotherapy. Pre- and post-intervention assessments were conducted to measure outcome measures, including range of motion, muscle strength, pain levels, and functional performance. Results: Significant improvements were observed in all outcome measures in both the tele-rehabilitation and in-person groups from baseline to postintervention. Independent t tests demonstrated no significant differences between the two groups in any of the outcome measures. These findings indicate that the tele-rehabilitation program was as effective as traditional in-person physiotherapy in improving the outcomes of athletes with sports-related injuries, even in a large sample size of 780 participants. Conclusion: This study provides robust evidence supporting the feasibility and effectiveness of tele-rehabilitation programs as viable alternatives to traditional in-person physiotherapy for athletes with sports-related injuries. These findings highlight the potential of tele-rehabilitation to significantly expand access to high-quality physiotherapy services for a large number of athletes. Further research should focus on evaluating the long-term effectiveness and cost-effectiveness of tele-rehabilitation programs in sports rehabilitation using larger sample sizes.
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Affiliation(s)
- Kamalakannan M
- Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | | | - Jenifer Augustina S
- Department of Physiotherapy, Hindustan Institute of Technology and Science, Chennai, India
| | - Hariharan J
- Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Naveen M
- Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Vignesh J
- Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, India
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Ariza-Vega P, Prieto-Moreno R, Mora-Traverso M, Molina-García P, Ashe MC, Martín-Matillas M. Co-creation of mHealth intervention for older adults with hip fracture and family caregivers: a qualitative study. Disabil Rehabil Assist Technol 2024; 19:1009-1018. [PMID: 36308295 DOI: 10.1080/17483107.2022.2138999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 09/30/2022] [Accepted: 10/18/2022] [Indexed: 10/31/2022]
Abstract
PURPOSE Hip fracture results in an older person's loss of independence. Limited healthcare resources make mobile Health (mHealth) an alternative. Engaging key stakeholders in health technology development is essential to overcome existing barriers. The aim of this study was to establish perspectives of older adults with hip fracture, family caregivers and health professionals (stakeholders) on the development of a mHealth system. MATERIALS AND METHODS Qualitative study guided by user-centered design principles with focus groups to engage stakeholders during the development. Seven focus groups were conducted [older adults with hip fracture (n = 2), caregivers (n = 3), and health providers (n = 2)] with 45 participants (14 older adults, 21 caregivers and 10 health providers). Inclusion criteria were older adults ≥ 65 years who sustained a hip fracture in the previous 3 months; family caregiver of a person with hip fracture; and health providers with 2+ years of clinical experience working older adults with hip fracture. We followed standard methods for focus groups, including recording sessions, transcription and conducting an inductive content analysis. The same moderator, with clinical and research experience, conducted all focus groups. RESULTS Three themes were generated to consider for a future mHealth intervention: (1) user-friendly design; (2) content to include recovery and prevention information; and (3) implementation factors. Our mHealth system was developed based on feedback from participants. CONCLUSIONS Co-creating mHealth technology with stakeholders is essential for uptake and adherence. We provide an overview of the development of ActiveHip+, an mHealth system for the clinical care of older adults with hip fracture.
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Affiliation(s)
- Patrocinio Ariza-Vega
- Department of Physiotherapy, Faculty of Health Science, University of Granada, Granada, Spain
- PA-HELP "Physical Activity for HEaLth Promotion" Research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Rafael Prieto-Moreno
- PA-HELP "Physical Activity for HEaLth Promotion" Research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Marta Mora-Traverso
- PA-HELP "Physical Activity for HEaLth Promotion" Research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Pablo Molina-García
- Instituto de Investigación Biosanitaria ibs.GRANADA, 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
| | - Maureen C Ashe
- Department of Family Practice, The University of British Columbia, Vancouver, Canada
| | - 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
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Agnihotri S, Gupta N, Sindwani P, Srivastava A, Ahmad A, Karki M. Telerehabilitation: Exploring the Untapped Potential. Cureus 2024; 16:e57405. [PMID: 38694631 PMCID: PMC11062579 DOI: 10.7759/cureus.57405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2024] [Indexed: 05/04/2024] Open
Abstract
Telerehabilitation is a burgeoning field that holds immense promise in revolutionizing the delivery of rehabilitation services. Defined as a branch of telecommunication utilizing technologies such as the internet, it facilitates remote interaction between healthcare providers and patients, transcending geographical barriers. This method proves invaluable in patient assessment, counseling, and treatment across various medical domains, including physical therapy, speech therapy, psychotherapy, and occupational therapy. Particularly beneficial for individuals with disabilities or those unable to access traditional healthcare facilities, telerehabilitation mitigates the constraints of time and cost associated with travel. This paper explores the evolution, types, uses, and research findings in telerehabilitation, shedding light on its transformative potential in health care.
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Affiliation(s)
| | - Nalina Gupta
- Neurological Physiotherapy and Community Rehabilitation, College of Physiotherapy, Sumandeep Vidyapeeth Deemed to be University, Vadodara, IND
| | - Pooja Sindwani
- Community Medicine, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, IND
| | | | - Aftab Ahmad
- Community Medicine, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, IND
| | - Medha Karki
- Physiotherapy, Teerthanker Mahaveer University, Moradabad, IND
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Kocyigit BF, Assylbek MI, Yessirkepov M. Telerehabilitation: lessons from the COVID-19 pandemic and future perspectives. Rheumatol Int 2024; 44:577-582. [PMID: 38321330 DOI: 10.1007/s00296-024-05537-0] [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: 12/16/2023] [Accepted: 01/05/2024] [Indexed: 02/08/2024]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has had an enormous effect on healthcare, notably rehabilitation for neurological, rheumatological, musculoskeletal, and cognitive diseases. Telerehabilitation provides rehabilitation services via multiple modalities, such as real-time chats, computerized consultations, and distant evaluations, emphasizing assessment, diagnosis, and intervention. While the use of telerehabilitation had restrictions before COVID-19, regulatory changes have accelerated its adoption, broadening therapy provision beyond traditional healthcare settings. Telerehabilitation has been examined for its effectiveness in a variety of health concerns, including stroke, traumatic brain injury, Parkinson's disease, musculoskeletal disorders, and rheumatic diseases. Despite the constraints of the COVID-19 environment, telerehabilitation settings, which include patient and therapist aspects, have emerged to ensure optimal treatment delivery. Key themes include home-based rehabilitation initiatives, wearable gadgets, and the integration of analytics and artificial intelligence. The growing acceptance of telehealth and telerehabilitation is expected to drive further progress in this discipline.
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Affiliation(s)
- Burhan Fatih Kocyigit
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Adana City Research and Training Hospital, Adana, Turkey.
| | - 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
| | - Marlen Yessirkepov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
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Gamble CJ, van Haastregt JCM, van Dam van Isselt EF, Zwakhalen SMG, Schols JMGA. Effectiveness of guided telerehabilitation on functional performance in community-dwelling older adults: A systematic review. Clin Rehabil 2024; 38:457-477. [PMID: 38013415 PMCID: PMC10898211 DOI: 10.1177/02692155231217411] [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: 09/08/2022] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVE To systematically review the effectiveness of guided telerehabilitation on improving functional performance in community-dwelling older adults. DATA SOURCES Articles published in PubMed, Cochrane Library and Embase (Ovid) from 01 January 2010 up to 17 October 2023. REVIEW METHODS Included studies had (1) a randomised controlled trial design, (2) an average population age of 65 years or older, (3) a home-based setting and (4) evaluated the effectiveness of functional performance outcome measures. The intervention was considered telerehabilitation when guided by a healthcare professional using video, audio and/or text communication technologies with a minimum frequency of once per week. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 statement guideline was followed. Methodological quality was appraised using the revised Cochrane Risk of Bias tool. RESULTS A total of 26 randomised controlled trials were included. Telerehabilitation had superior (N = 15), non-superior (N = 16) or non-inferior (N = 11) effectiveness for improving functional performance outcome measures compared to control interventions. No studies found the control intervention to be superior over telerehabilitation. Between study differences in intervention characteristics contributed to significant clinical heterogeneity. Five studies were found to present an overall 'low' risk of bias, 12 studies to present 'some' risk of bias and 9 studies to present an overall 'high' risk of bias. CONCLUSION The findings suggest that telerehabilitation could be a promising alternative to in-person rehabilitation for improving functional performance in community-dwelling older adults. Additional well-designed studies with minimised bias are needed for a better understanding of effective telerehabilitation intervention strategies.
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Affiliation(s)
- CJ Gamble
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab of Ageing and Long Term Care, Maastricht, The Netherlands
- Stichting Valkenhof, Valkenswaard, The Netherlands
| | - JCM van Haastregt
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab of Ageing and Long Term Care, Maastricht, The Netherlands
| | - EF van Dam van Isselt
- University Network for the Care sector Zuid-Holland, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands
| | - SMG Zwakhalen
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab of Ageing and Long Term Care, Maastricht, The Netherlands
| | - JMGA Schols
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab of Ageing and Long Term Care, Maastricht, The Netherlands
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Boschetti A, Maida E, Dini M, Tacchini M, Gamberini G, Comi G, Leocani L. A Review on the Feasibility and Efficacy of Home-Based Cognitive Remediation in People with Multiple Sclerosis. J Clin Med 2024; 13:1916. [PMID: 38610681 PMCID: PMC11012426 DOI: 10.3390/jcm13071916] [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: 02/21/2024] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
Cognitive impairment affects 34-65% of People with Multiple Sclerosis (PwMS), significantly impacting their quality of life. Clinicians routinely address cognitive deficits with in-clinic neuro-behavioural interventions, but accessibility issues exist. Given these challenges, coupled with the lifelong need for continuous assistance in PwMS, researchers have underscored the advantageous role of telerehabilitation in addressing these requirements. Nonetheless, the feasibility and efficacy of home-based cognitive remediation remain to be firmly established. In this narrative review, we aimed to investigate the feasibility and efficacy of digital telerehabilitation for cognition in PwMS. Thirteen relevant studies were identified and carefully assessed. Regarding the feasibility of cognitive telerehabilitation, evidence shows adherence rates are generally good, although, surprisingly, not all studies reported measures of compliance with the cognitive training explored. Considering the efficacy of rehabilitative techniques on cognitive performance in PwMS, findings are generally inconsistent, with only one study reporting uniformly positive results. A range of methodological limitations are reported as potential factors contributing to the variable results. Future research must address these challenges, as more rigorous studies are required to draw definitive conclusions regarding the efficacy of home-based cognitive remediation in PwMS. Researchers must prioritise identifying optimal intervention approaches and exploring the long-term effects of telerehabilitation.
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Affiliation(s)
- Angela Boschetti
- Experimental Neurophysiology Unit, Institute of Experimental Neurology—INSPE, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.B.); (M.T.)
- San Raffaele Vita-Salute University, 20132 Milan, Italy
| | - Elisabetta Maida
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Michelangelo Dini
- Experimental Neurophysiology Unit, Institute of Experimental Neurology—INSPE, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.B.); (M.T.)
- San Raffaele Vita-Salute University, 20132 Milan, Italy
| | - Marta Tacchini
- Experimental Neurophysiology Unit, Institute of Experimental Neurology—INSPE, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.B.); (M.T.)
- San Raffaele Vita-Salute University, 20132 Milan, Italy
| | - Giulia Gamberini
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milan, Italy
| | - Giancarlo Comi
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milan, Italy
| | - Letizia Leocani
- Experimental Neurophysiology Unit, Institute of Experimental Neurology—INSPE, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.B.); (M.T.)
- San Raffaele Vita-Salute University, 20132 Milan, Italy
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milan, Italy
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Ettefagh A, Roshan Fekr A. Enhancing automated lower limb rehabilitation exercise task recognition through multi-sensor data fusion in tele-rehabilitation. Biomed Eng Online 2024; 23:35. [PMID: 38504279 PMCID: PMC10949721 DOI: 10.1186/s12938-024-01228-w] [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: 03/01/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Tele-rehabilitation is the provision of physiotherapy services to individuals in their own homes. Activity recognition plays a crucial role in the realm of automatic tele-rehabilitation. By assessing patient movements, identifying exercises, and providing feedback, these platforms can offer insightful information to clinicians, thereby facilitating an improved plan of care. This study introduces a novel deep learning approach aimed at identifying lower limb rehabilitation exercises. This is achieved through the integration of depth data and pressure heatmaps. We hypothesized that combining pressure heatmaps and depth data could improve the model's overall performance. METHODS In this study, depth videos and body pressure data from an accessible online dataset were used. This dataset comprises data from 30 healthy individuals performing 7 lower limb rehabilitation exercises. To accomplish the classification task, three deep learning models were developed, all based on an established 3D-CNN architecture. The models were designed to classify the depth videos, sequences of pressure data frames, and combination of depth videos and pressure frames. The models' performance was assessed through leave-one-subject-out and leave-multiple-subjects-out cross-validation methods. Performance metrics, including accuracy, precision, recall, and F1 score, were reported for each model. RESULTS Our findings indicated that the model trained on the fusion of depth and pressure data showed the highest and most stable performance when compared with models using individual modality inputs. This model could effectively identify the exercises with an accuracy of 95.71%, precision of 95.83%, recall of 95.71%, and an F1 score of 95.74%. CONCLUSION Our results highlight the impact of data fusion for accurately classifying lower limb rehabilitation exercises. We showed that our model could capture different aspects of exercise movements using the visual and weight distribution data from the depth camera and pressure mat, respectively. This integration of data provides a better representation of exercise patterns, leading to higher classification performance. Notably, our results indicate the potential application of this model in automatic tele-rehabilitation platforms.
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Affiliation(s)
- Alireza Ettefagh
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Ave., Toronto, M5G 2A2, Ontario, Canada.
- Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, M5S 3E2, Ontario, Canada.
| | - Atena Roshan Fekr
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Ave., Toronto, M5G 2A2, Ontario, Canada
- Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, M5S 3E2, Ontario, Canada
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Irish J, Sharma A, Labbe D, Arsenault S, White K, Sakakibara BM. Stroke virtual rehabilitation in rural communities: exploring the perceptions of stroke survivors, caregivers, clinicians, and health administrators. Disabil Rehabil 2024:1-8. [PMID: 38493294 DOI: 10.1080/09638288.2024.2328308] [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: 05/24/2023] [Accepted: 03/02/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Rural-dwelling stroke survivors have unmet rehabilitation needs after returning to community-living. Virtual rehabilitation, defined as the use of technology to provide rehabilitation services from a distance, could be a viable and timely solution to address this need, especially within the COVID-19 pandemic context. There is still a minimal understanding of virtual rehabilitation delivery within rural contexts. This study sought to explore the perceptions of rural stakeholders about virtual stroke rehabilitation. METHODS Following an interpretive description approach, 17 qualitative interviews were conducted with stroke survivors (n = 5), caregivers (n = 2), clinicians (n = 7), and health administrators (n = 3), and analyzed to understand their experiences and perceptions of virtual stroke rehabilitation. RESULTS We identified three overarching themes from the participant responses (1) The Root of the (Rural) Problem considered how systemic inequities impact stroke survivors' and caregivers' access to stroke recovery services; (2) Common Benefits, Different Challenges identified the unique benefits and challenges of delivering virtual rehabilitation within rural contexts; and (3) Ingredients for Success described important considerations for implementing virtual rehabilitation. CONCLUSION Virtual rehabilitation is generally accepted by all stakeholders as a supplement to in-person services. Addressing the unique barriers faced by rural clinicians and stroke survivors is necessary to provide successful virtual rehabilitation.
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Affiliation(s)
- Jessica Irish
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Annu Sharma
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Delphine Labbe
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Disability and Human Development Department, University of IL at Chicago, Chicago, IL, USA
| | - Sacha Arsenault
- Stroke Services British Columbia, Provincial Health Services Authority, Vancouver, British Columbia, Canada
| | - Katie White
- Stroke Services British Columbia, Provincial Health Services Authority, Vancouver, British Columbia, Canada
| | - Brodie M Sakakibara
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Chronic Disease Prevention and Management, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
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Naamanka E, Salakka I, Parkkila M, Hotti J, Poutiainen E. Effectiveness of teleneuropsychological rehabilitation: Systematic review of randomized controlled trials. J Int Neuropsychol Soc 2024; 30:295-312. [PMID: 37746802 DOI: 10.1017/s1355617723000565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
OBJECTIVE The effectiveness of neuropsychological rehabilitation is supported by the evidence found in previous reviews, but there is a lack of research regarding the effectiveness of remotely conducted neuropsychological rehabilitation. This review aimed to identify and evaluate the results of studies investigating the effectiveness of teleneuropsychological rehabilitation. METHODS Relevant articles were extracted from electronic databases and filtered to include studies published in 2016 or later to focus on recent practices. Data were synthesized narratively. RESULTS A total of 14 randomized controlled studies were included in the synthesis (9 for children/adolescents, 5 for adults). The most common type of intervention was computerized cognitive training with regular remote contact with the therapist (seven studies). Regarding children and adolescents, the evidence for the effectiveness was found only for these types of interventions with improvements in cognitive outcomes. The results regarding the family-centered interventions were mixed with improvements only found in psychosocial outcomes. No support was found for the effectiveness of interventions combining cognitive and motor training. Regarding adults, all included studies offered support for the effectiveness, at least to some extent. There were improvements particularly in trained cognitive functions. Long-term effects of the interventions with generalization to global functioning remained somewhat unclear. CONCLUSION Remote interventions focused on computerized cognitive training are promising methods within teleneuropsychological rehabilitation. However, their impact on long-term meaningful, everyday functioning remained unclear. More research is needed to reliably assess the effectiveness of teleneuropsychological interventions, especially with more comprehensive approaches.
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Affiliation(s)
| | - Ilja Salakka
- Rehabilitation Foundation, Helsinki, Finland
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Joona Hotti
- Rehabilitation Foundation, Helsinki, Finland
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Daniels K, Mourad J, Bonnechère B. Exploring the Use of Mobile Health for the Rehabilitation of Long COVID Patients: A Scoping Review. Healthcare (Basel) 2024; 12:451. [PMID: 38391826 PMCID: PMC10887561 DOI: 10.3390/healthcare12040451] [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: 01/09/2024] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
The COVID-19 pandemic has led to a substantial revolution in the incorporation of digital solutions in healthcare. This systematic review investigates the enduring physical and psychological consequences individuals experience up to two years post-recovery. Additionally, it focuses on examining the influence of mHealth interventions on these effects. Significantly, 41.7% of survivors experience lingering symptoms that have not been addressed, while 14.1% encounter difficulties in returning to work. The presence of anxiety, compromised respiratory functioning, and persistent symptoms highlight the immediate requirement for specific therapies. Telehealth, particularly telerehabilitation, presents itself as a possible way to address these difficulties. The study thoroughly examines 10 studies encompassing 749 COVID-19 patients, investigating the efficacy of telerehabilitation therapies in addressing various health markers. Telerehabilitation-based breathing exercises yield substantial enhancements in functional performance, dyspnea, and overall well-being. The results emphasize the potential of telerehabilitation to have a favorable effect on patient outcomes; however, more research is needed to strengthen the existing evidence base, as one of the most important limitations is the limited number of trials and the evaluation of varied therapies. This analysis highlights the significance of digital solutions in post-COVID care and calls for ongoing research to improve the comprehension and implementation of telehealth interventions in a swiftly changing healthcare environment.
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Affiliation(s)
- Kim Daniels
- Department of PXL-Healthcare, PXL University of Applied Sciences and Arts, 3500 Hasselt, Belgium
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Joanna Mourad
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Bruno Bonnechère
- Department of PXL-Healthcare, PXL University of Applied Sciences and Arts, 3500 Hasselt, Belgium
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, 3590 Diepenbeek, Belgium
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Abedi A, Colella TJF, Pakosh M, Khan SS. Artificial intelligence-driven virtual rehabilitation for people living in the community: A scoping review. NPJ Digit Med 2024; 7:25. [PMID: 38310158 PMCID: PMC10838287 DOI: 10.1038/s41746-024-00998-w] [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: 04/14/2023] [Accepted: 01/03/2024] [Indexed: 02/05/2024] Open
Abstract
Virtual Rehabilitation (VRehab) is a promising approach to improving the physical and mental functioning of patients living in the community. The use of VRehab technology results in the generation of multi-modal datasets collected through various devices. This presents opportunities for the development of Artificial Intelligence (AI) techniques in VRehab, namely the measurement, detection, and prediction of various patients' health outcomes. The objective of this scoping review was to explore the applications and effectiveness of incorporating AI into home-based VRehab programs. PubMed/MEDLINE, Embase, IEEE Xplore, Web of Science databases, and Google Scholar were searched from inception until June 2023 for studies that applied AI for the delivery of VRehab programs to the homes of adult patients. After screening 2172 unique titles and abstracts and 51 full-text studies, 13 studies were included in the review. A variety of AI algorithms were applied to analyze data collected from various sensors and make inferences about patients' health outcomes, most involving evaluating patients' exercise quality and providing feedback to patients. The AI algorithms used in the studies were mostly fuzzy rule-based methods, template matching, and deep neural networks. Despite the growing body of literature on the use of AI in VRehab, very few studies have examined its use in patients' homes. Current research suggests that integrating AI with home-based VRehab can lead to improved rehabilitation outcomes for patients. However, further research is required to fully assess the effectiveness of various forms of AI-driven home-based VRehab, taking into account its unique challenges and using standardized metrics.
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Affiliation(s)
- Ali Abedi
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
| | - Tracey J F Colella
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Maureen Pakosh
- Library & Information Services, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Shehroz S Khan
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
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Blasco JM, Navarro-Bosch M, Aroca-Navarro JE, Hernández-Guillén D, Puigcerver-Aranda P, Roig-Casasús S. A Virtual Assistant to Guide Early Postoperative Rehabilitation after Reverse Shoulder Arthroplasty: A Pilot Randomized Trial. Bioengineering (Basel) 2024; 11:152. [PMID: 38391638 PMCID: PMC10885890 DOI: 10.3390/bioengineering11020152] [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: 12/26/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION Rehabilitation can improve outcomes after reverse shoulder arthroplasty (RSA). However, low adherence to rehabilitation and compliance rates are some of the main barriers. To address this public health issue, the goal of this research was to pilot test and evaluate the effectiveness of a chatbot to promote adherence to home rehabilitation in patients undergoing RSA. METHODS A randomized pilot trial including patients undergoing RSA and early postoperative rehabilitation was performed. The control group received standard home rehabilitation; the experimental group received the same intervention supervised with a chatbot, with automated interactions that included messages to inform, motivate, and remember the days and exercises for 12 weeks. Compliance with rehabilitation and clinical measures of shoulder function, pain, and quality of life were assessed. RESULTS 31 patients (17 experimental) with an average age of 70.4 (3.6) completed the intervention. Compliance was higher in the experimental group (77% vs. 65%; OR95% = 2.4 (0.5 to 11.4)). Statistically significant between-group differences with a CI of 95% were found in the QuickDASH questionnaire and self-reported quality of life. No differences were found in the rest of the measures. CONCLUSIONS This pilot study suggests that the chatbot tool can be useful in promoting compliance with early postoperative home rehabilitation in patients undergoing RSA. Future randomized trials with adequate power are warranted to determine the clinical impact of the proposal.
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Affiliation(s)
- José-María Blasco
- Group in Physiotherapy of the Ageing Processes-Social and Healthcare Strategies, Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Marta Navarro-Bosch
- Orthopedic and Trauma Surgery Service, Hospital Universitari i Politècnic La Fe de València, 46026 Valencia, Spain
| | - José-Enrique Aroca-Navarro
- Orthopedic and Trauma Surgery Service, Hospital Universitari i Politècnic La Fe de València, 46026 Valencia, Spain
| | - David Hernández-Guillén
- Group in Physiotherapy of the Ageing Processes-Social and Healthcare Strategies, Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | | | - Sergio Roig-Casasús
- Group in Physiotherapy of the Ageing Processes-Social and Healthcare Strategies, Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- Orthopedic and Trauma Surgery Service, Hospital Universitari i Politècnic La Fe de València, 46026 Valencia, Spain
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Claassen J, Kondziella D, Alkhachroum A, Diringer M, Edlow BL, Fins JJ, Gosseries O, Hannawi Y, Rohaut B, Schnakers C, Stevens RD, Thibaut A, Monti M. Cognitive Motor Dissociation: Gap Analysis and Future Directions. Neurocrit Care 2024; 40:81-98. [PMID: 37349602 DOI: 10.1007/s12028-023-01769-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/26/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Patients with disorders of consciousness who are behaviorally unresponsive may demonstrate volitional brain responses to motor imagery or motor commands detectable on functional magnetic resonance imaging or electroencephalography. This state of cognitive motor dissociation (CMD) may have prognostic significance. METHODS The Neurocritical Care Society's Curing Coma Campaign identified an international group of experts who convened in a series of monthly online meetings between September 2021 and April 2023 to examine the science of CMD and identify key knowledge gaps and unmet needs. RESULTS The group identified major knowledge gaps in CMD research: (1) lack of information about patient experiences and caregiver accounts of CMD, (2) limited epidemiological data on CMD, (3) uncertainty about underlying mechanisms of CMD, (4) methodological variability that limits testing of CMD as a biomarker for prognostication and treatment trials, (5) educational gaps for health care personnel about the incidence and potential prognostic relevance of CMD, and (6) challenges related to identification of patients with CMD who may be able to communicate using brain-computer interfaces. CONCLUSIONS To improve the management of patients with disorders of consciousness, research efforts should address these mechanistic, epidemiological, bioengineering, and educational gaps to enable large-scale implementation of CMD assessment in clinical practice.
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Affiliation(s)
- Jan Claassen
- Department of Neurology, Neurological Institute, Columbia University Irving Medical Center, NewYork Presbyterian Hospital, 177 Fort Washington Avenue, MHB 8 Center, Room 300, New York, NY, 10032, USA.
| | - Daniel Kondziella
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Michael Diringer
- Department of Neurology, Washington University, St. Louis, MO, USA
| | - Brian L Edlow
- Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Joseph J Fins
- Division of Medical Ethics, Department of Medicine, Weill Cornell Medical College, NewYork Presbyterian Hospital, New York, NY, 10032, USA
| | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness, University of Liege, Liege, Belgium
- Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Yousef Hannawi
- Division of Cerebrovascular Diseases and Neurocritical Care, Department of Neurology, The Ohio State University, Columbus, OH, USA
| | - Benjamin Rohaut
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP) - Pitié Salpêtrière, Paris, France
| | | | - Robert D Stevens
- Department of Anesthesiology and Critical Care Medicine, Neurology, and Radiology, School of Medicine, Secondary Appointment in Biomedical Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Aurore Thibaut
- Coma Science Group, GIGA Consciousness, University of Liege, Liege, Belgium
- Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Martin Monti
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
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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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Oliveira NKD, Santos LHCGD, Reis GCD, Pereira ND. Reliability and validity of remote Life Space Assessment: LSA in persons with chronic stroke. ARQUIVOS DE NEURO-PSIQUIATRIA 2024; 82:1-6. [PMID: 38325388 PMCID: PMC10849820 DOI: 10.1055/s-0044-1779297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/28/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND StepWatch Activity Monitor (SAM) is used to measure the mobility of chronic hemiparetic patients and the Life Space Assessment (LSA) scale was developed to assess the displacement of hemiparetic patients in different contexts through self-reporting. Studies that apply the LSA remotely and correlate it with the number of steps measured by the SAM were not found. OBJECTIVE To evaluate the measurement properties of the LSA applied remotely and to evaluate the correlation between the LSA scale score and the number of steps measured by the SAM in post-stroke chronic hemiparetic patients. METHODS Nineteen patients participated in the study. The LSA scale was applied remotely and later, face to face. The SAM measured the steps taken by the participants over a period of three consecutive days. The correlation between the LSA and the SAM was performed using Pearson's correlation. The measurement properties calculated of remote LSA were the intraclass correlation coefficient (ICC), Cronbrach's alpha, standard error of measurement (SEM), and smallest real difference (SRD). RESULTS The reproducibility of the LSA scale between remote and face-to-face applications was considered excellent with ICC = 0.85 (IC 95% 0.62-0.94); SEM = 8.4; SRD = 23.2, and Cronbach's alpha = 0.85. The correlation between SAM and LSA was positive, considered moderate (r = 0.51) and significant (p = 0.025). CONCLUSION The LSA is a reproducible measure for post-stroke chronic hemiparetic patients even if applied remotely and can be used as a remote measurement for mobility in a real-world environment for people with chronic hemiparesis after stroke.
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Whale R, Hasani F, Haines T, Munteanu SE, Ellis K, Patel S, Buchholtz K, Warne J, Vallance P, Malliaras P. Assessing calf exercise fidelity among people with Achilles tendinopathy using videos recorded via Zoom®: an observational study. Disabil Rehabil 2024; 46:697-704. [PMID: 36755434 DOI: 10.1080/09638288.2023.2174604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/24/2023] [Indexed: 02/10/2023]
Abstract
PURPOSE Exercise fidelity is a fundamental aspect of exercise prescription by physiotherapists. Assessing exercise fidelity via telehealth (videoconference) is potentially useful but its reproducibility has not been assessed. The objective was to evaluate agreement (reproducibility) of video rating of calf exercise fidelity within (over four weeks) and between telehealth raters and compared with live rating. METHODS Nineteen videos of participants with AT undertaking calf exercises were rated by physiotherapists in person (live) and by watching pre-recorded videos (replicating telehealth). Three forms of agreement were assessed: (i) between live assessment and recorded video (telehealth) assessment; (ii) between telehealth raters (inter-rater); (iii) agreement within telehealth raters over four weeks (intra-rater). RESULTS There was weak to almost perfect agreement (Kappa = 0.65 to 1.00, rater 1, Kappa = 0.57 to 1.00, rater 2) between the telehealth and live raters. There was moderate to almost perfect agreement (Kappa = 0.65 to 1.00) when assessing intra-rater reliability, aside from one of the six criteria (quality of movement). CONCLUSION Assessing calf exercise fidelity via videos recorded on Zoom® appears to demonstrate weak or greater agreement versus live rating and over time. Inter-rater agreement was lower, suggesting that the criteria developed may be better suited to use by individual raters over time.Implications for rehabilitationTelehealth assessment (when compared with live, in person assessment) shows a moderate or greater agreement for the majority of assessment criteria when assessing calf exercise fidelity.The calf exercise fidelity criteria developed can be used as an adjunct to assessment and management of people with Achilles Tendinopathy.Intra-rater assessment was shown to be moderately or more consistent over a four-week period when assessing calf exercise fidelity.
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Affiliation(s)
- Rhiannon Whale
- Physiotherapy Department, Monash University, Melbourne, Victoria, Australia
| | - Fatmah Hasani
- Physiotherapy Department, Monash University, Melbourne, Victoria, Australia
- Physiotherapy Department, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Terry Haines
- School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Building G, Peninsula Campus, Monash University, Frankston, Victoria, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Kirsten Ellis
- Faculty of Information Technology, Monash University, Melbourne, Victoria, Australia
| | - Shalin Patel
- Back in Motion Physiotherapy, Melbourne, Victoria, Australia
| | - Kim Buchholtz
- Department of Physiotherapy, LUNEX University, Differdange, Luxembourg
| | - Jonathan Warne
- Physiotherapy department, Brunel University London, London, UK
| | - Patrick Vallance
- Physiotherapy Department, Monash University, Melbourne, Victoria, Australia
| | - Peter Malliaras
- Physiotherapy Department, Monash University, Melbourne, Victoria, Australia
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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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Mehrabi S, Drisdelle S, Dutt HR, Middleton LE. "If I want to be able to keep going, I must be active." Exploring older adults' perspectives of remote physical activity supports: a mixed-methods study. Front Public Health 2024; 12:1328492. [PMID: 38327585 PMCID: PMC10847274 DOI: 10.3389/fpubh.2024.1328492] [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: 10/26/2023] [Accepted: 01/02/2024] [Indexed: 02/09/2024] Open
Abstract
Introduction Pandemic-related public health restrictions limited older adults' physical activity programs and opportunities. Physical activity supports shifted to remote options, however, information on their adoption and effectiveness is limited. This study aims to describe the remote supports received by older adults and their perceived effectiveness. Additionally, it aims to describe facilitators and barriers to remote supports for physical activity among older adults, particularly those reliant on technology. Methods This study used an explanatory, sequential, mixed-methods design. Community-dwelling older adults (≥ 60 years) were recruited to partake in a web-based survey and an optional semi-structured follow-up interview informed by the COM-B model. Participant characteristics, perceived effectiveness of remote supports, and the presence and severity of barriers were described. Changes in physical activity levels before and during the pandemic were analyzed using the Wilcoxon signed-rank test. Qualitative data underwent inductive thematic analysis. Results Fifty seven older adults (68.3 ± 7.1 years, 43 Female) completed the survey, of which 15 participants (67.4 ± 5.8 years, 12 Female) participated in interviews. The majority were Caucasian, highly educated, and resided in Canada. Total physical activity levels showed no statistically significant change from before to during the pandemic (p = 0.74); however, at-home exercise participation and technology usage increased. Pre-recorded and real-time virtual exercise supports were perceived as most effective. Main barriers included limited contact with exercise professionals, limited access to exercise equipment or space, and decreased mental wellness. Thematic analysis identified five main themes: (i) Enabled by knowledge and resources; (ii) Diverse motivations for physical activity; (iii) Fostering participation through social connection; (iv) Supervision and safety: enabling adherence; and (v) Virtual exercise: a sustainable option with technological considerations. Conclusion Virtual platforms show promise in supporting older adults' physical activity at home, especially for those with limited in-person access. Our study suggests that both real-time and pre-recorded virtual exercise supports are feasible, depending on technological capacity and support. While interactive real-time virtual programs allow interaction with professionals and peers, pre-recorded programs provide timing flexibility. Further research is needed to establish best practices for safe and effective virtual exercise programming, promoting its long-term adoption for supporting a wider range of older adults.
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Affiliation(s)
- Samira Mehrabi
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Sara Drisdelle
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Hanna R Dutt
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Laura E Middleton
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Research Institute for Aging, Waterloo, ON, Canada
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Barboza NM, Laskovski L, Volpe RP, Silva TCOD, Pereira LA, Silva PGBD, Smaili SM. Perceptions of individuals with Parkinson's disease about a telerehabilitation protocol performed during the COVID-19 pandemic: a qualitative study. Disabil Rehabil 2024:1-10. [PMID: 38264886 DOI: 10.1080/09638288.2024.2305687] [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: 08/18/2023] [Accepted: 01/10/2024] [Indexed: 01/25/2024]
Abstract
PURPOSE To understand the perceptions and meaning of the experience of individuals with Parkinson's disease (PD) when participating in a telerehabilitation protocol during COVID-19 pandemic. METHODS This is a qualitative descriptive analytical study with a phenomenological basis, regarding the individuals' perceptions of telerehabilitation. The interviews were conducted by a semi-structured interview guide and carried out via recorded phone calls, which were later transcribed, categorized, and analyzed based on the principles of phenomenology according to the propositions of Martins and Bicudo. RESULTS From the qualitative analysis, four themes that configure the structure of the phenomenon emerged: 1) Expectations regarding physical therapy through telerehabilitation during the pandemic; 2) Experiences of the new routine; 3) Perceptions about oneself in the light of the proposed telerehabilitation program; 4) A view of the protocol. CONCLUSION Apprehension and fear were present during the implementation of the protocol, however, previous experience with face-to-face physical therapy and the team allowed feelings of happiness, contentment, welcomeness, and satisfaction with the possibility of resuming the activities. The individuals actively participated in the program with commitment and co-responsibility, but the lack of physical contact, limited equipment, and constant concern for the safety and individuality of the participants must be emphasized.
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Affiliation(s)
- Natália Mariano Barboza
- Neurofunctional Physical Therapy Research Group (GPFIN), Postgraduate Program in Rehabilitation Sciences, State University of Londrina, Paraná, Brazil
| | - Larissa Laskovski
- Neurofunctional Physical Therapy Research Group (GPFIN), Postgraduate Program in Rehabilitation Sciences, State University of Londrina, Paraná, Brazil
| | - Renata Pasquarelli Volpe
- Neurofunctional Physical Therapy Research Group (GPFIN), Postgraduate Program in Rehabilitation Sciences, State University of Londrina, Paraná, Brazil
| | - Taís Caroline Oliveira da Silva
- Neurofunctional Physical Therapy Research Group (GPFIN), Postgraduate Program in Rehabilitation Sciences, State University of Londrina, Paraná, Brazil
| | - Larissa Alessandra Pereira
- Neurofunctional Physical Therapy Research Group (GPFIN), Postgraduate Program in Rehabilitation Sciences, State University of Londrina, Paraná, Brazil
| | - Patrícia Gonçalves Broto da Silva
- Neurofunctional Physical Therapy Research Group (GPFIN), Postgraduate Program in Rehabilitation Sciences, State University of Londrina, Paraná, Brazil
| | - Suhaila Mahmoud Smaili
- Neurofunctional Physical Therapy Research Group (GPFIN), Postgraduate Program in Rehabilitation Sciences, State University of Londrina, Paraná, Brazil
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Willingham TB, Stowell J, Collier G, Backus D. Leveraging Emerging Technologies to Expand Accessibility and Improve Precision in Rehabilitation and Exercise for People with Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:79. [PMID: 38248542 PMCID: PMC10815484 DOI: 10.3390/ijerph21010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/20/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024]
Abstract
Physical rehabilitation and exercise training have emerged as promising solutions for improving health, restoring function, and preserving quality of life in populations that face disparate health challenges related to disability. Despite the immense potential for rehabilitation and exercise to help people with disabilities live longer, healthier, and more independent lives, people with disabilities can experience physical, psychosocial, environmental, and economic barriers that limit their ability to participate in rehabilitation, exercise, and other physical activities. Together, these barriers contribute to health inequities in people with disabilities, by disproportionately limiting their ability to participate in health-promoting physical activities, relative to people without disabilities. Therefore, there is great need for research and innovation focusing on the development of strategies to expand accessibility and promote participation in rehabilitation and exercise programs for people with disabilities. Here, we discuss how cutting-edge technologies related to telecommunications, wearables, virtual and augmented reality, artificial intelligence, and cloud computing are providing new opportunities to improve accessibility in rehabilitation and exercise for people with disabilities. In addition, we highlight new frontiers in digital health technology and emerging lines of scientific research that will shape the future of precision care strategies for people with disabilities.
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Affiliation(s)
- T. Bradley Willingham
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
- Department of Physical Therapy, Georgia State University, Atlanta, GA 30302, USA
| | - Julie Stowell
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
- Department of Physical Therapy, Georgia State University, Atlanta, GA 30302, USA
| | - George Collier
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
| | - Deborah Backus
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
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Kushnir A, Kachmar O, Bonnechère B. STASISM: A Versatile Serious Gaming Multi-Sensor Platform for Personalized Telerehabilitation and Telemonitoring. SENSORS (BASEL, SWITZERLAND) 2024; 24:351. [PMID: 38257442 PMCID: PMC10818392 DOI: 10.3390/s24020351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/21/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024]
Abstract
Telemonitoring and telerehabilitation have shown promise in delivering individualized healthcare remotely. We introduce STASISM, a sensor-based telerehabilitation and telemonitoring system, in this work. This platform has been created to facilitate individualized telerehabilitation and telemonitoring for those who need rehabilitation or ongoing monitoring. To gather and analyze pertinent and validated physiological, kinematic, and environmental data, the system combines a variety of sensors and data analytic methodologies. The platform facilitates customized rehabilitation activities based on individual needs, allows for the remote monitoring of a patient's progress, and offers real-time feedback. To protect the security of patient data and to safeguard patient privacy, STASISM also provides secure data transmission and storage. The platform has the potential to significantly improve the accessibility and efficacy of telerehabilitation and telemonitoring programs, enhancing patients' quality of life and allowing healthcare professionals to provide individualized care outside of traditional clinical settings.
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Affiliation(s)
- Anna Kushnir
- Elita Rehabilitation Center, 79000 Lviv, Ukraine;
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium;
| | - Oleh Kachmar
- Elita Rehabilitation Center, 79000 Lviv, Ukraine;
| | - Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium;
- Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, 3590 Diepenbeek, Belgium
- Department of PXL-Healthcare, PXL University of Applied Sciences and Arts, 3500 Hasselt, Belgium
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Widmann CN, Henkel C, Seibert S. "Brain Fog" After COVID-19 Infection: How the Field of Neuropsychology Can Help Clear the Air. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1458:59-76. [PMID: 39102190 DOI: 10.1007/978-3-031-61943-4_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] [Indexed: 08/06/2024]
Abstract
The chapter explores the role of neuropsychology in understanding brain fog as a subjective complaint in the context of COVID-19. It discusses the historical and medical significance of the term "brain fog" and its psychological and neurological aspects. The chapter identifies the cognitive domains commonly affected by brain fog, such as attention, executive function, memory, and language. Additionally, it emphasizes the impact of societal changes during the COVID-19 pandemic on the general population as a crucial backdrop for understanding the issue. The chapter also highlights the important role of clinical and research neuropsychologists in gaining clarity on grouped data and individual patients' cognitive and emotional difficulties after COVID-19 infection. It discusses indications for neuropsychological rehabilitation and therapy and describes typical therapy phases and methods, including new approaches like telemedicine, virtual reality, and mobile app-based rehabilitation and self-tracking. The chapter underscores that experiences of brain fog can vary among COVID-19 patients and may change over time. It provides clinicians and interested parties with an in-depth understanding of brain fog and its manifestations, concomitant subtypes, and concrete strategies for addressing it. The chapter emphasizes the critical role of neuropsychology in scientifically examining brain fog and advocating for personalized approaches to cognitive rehabilitation.
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Affiliation(s)
- Catherine N Widmann
- Clinical Neuropsychology, Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn Medical Center, Venusberg-Campus 1, 53127, Bonn, Germany.
- German Center for Neurodegenerative Diseases, Göttingen, Germany.
| | - Cornelia Henkel
- Clinical Neuropsychology, Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn Medical Center, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Susan Seibert
- Clinical Neuropsychology, Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn Medical Center, Venusberg-Campus 1, 53127, Bonn, Germany
- German Center for Neurodegenerative Diseases, Göttingen, Germany
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Kara S, Nokay AE. What are the novel rehabilitation methods in knee arthroplasty? A bibliographic review. Technol Health Care 2024; 32:3643-3648. [PMID: 38848208 DOI: 10.3233/thc-240628] [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] [Indexed: 06/09/2024]
Abstract
BACKGROUND Total knee arthroplasty (TKA) is a common procedure for treating end-stage degenerative knee osteoarthritis (OA). Despite the generally excellent outcomes, postoperative complications such as loss of muscle strength and joint limitation can occur. Therefore, postoperative physical rehabilitation is crucial for regaining strength, functionality, and managing pain. Various rehabilitation strategies employ different methods to reduce pain severity, regain muscle strength, assist patients in returning to daily activities, and increase functionality. In recent years, technological advancements have transformed rehabilitation methods. In addition to traditional applications, new methods have been incorporated into treatment plans. OBJECTIVE This study aimed to evaluate novel physical rehabilitation methods and options following OA. METHODS A literature review was conducted to identify and investigate recent and commonly used novel rehabilitation methods. The search terms "Total Knee Arthroplasty," "New Rehabilitation TKA," "Novel Rehabilitation" "Novel Rehabilitation in Arthroplasty" and "Technology Knee Rehabilitation" were searched across PubMed and Google Scholar databases, covering literature from the past 15 years. Studies on telerehabilitation, functional electric stimulation, virtual reality, yoga, and their reported outcomes were evaluated using specific keywords. The results of various studies on novel rehabilitation methods were gathered and compared to traditional treatment plans based on functionality and applicability. RESULTS Several studies reported that telerehabilitation was not inferior to traditional rehabilitation, with some showing positive outcomes. Telerehabilitation following TKA demonstrated positive effects on functionality and patient satisfaction. Functional electric stimulation showed significant improvements in muscle strength and pain reduction. Virtual reality demonstrated superior effects on proprioception and posture outcomes. The use of yoga in rehabilitation also resulted in improved proprioception and pain reduction. CONCLUSION In addition to traditional rehabilitation methods, new approaches have shown significant positive outcomes for patients who have received TKA. We are in an era of digital development, and as such, new rehabilitation techniques, particularly those involving digital advancements, will continue to emerge. With the trend toward personalized approaches in medicine, more new techniques or methods will be incorporated into rehabilitation plans, leading to better recovery outcomes from TKA.
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Affiliation(s)
- Seher Kara
- Erenköy Physical Therapy and Rehabilitation Hospital, Istanbul, Turkey
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Veras M, Sigouin J, Auger C, Auger LP, Ahmed S, Boychuck Z, Cavallo S, Lévesque M, Lovo S, Miller WC, Nelson M, Norouzi-Gheidari N, O’Neil J, Perreault K, Urbanowski R, Sheehy L, Singh H, Vincent C, Wang R, Zidarov D, Hudon A, Kairy D. A rapid review protocol of physiotherapy and occupational therapy telerehabilitation to inform ethical and equity concerns. Digit Health 2024; 10:20552076241260367. [PMID: 39229467 PMCID: PMC11369859 DOI: 10.1177/20552076241260367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 05/21/2024] [Indexed: 09/05/2024] Open
Abstract
Background Telerehabilitation (TR) has emerged as a feasible and promising approach for delivering rehabilitation services remotely, utilizing technology to bridge the gap between healthcare providers and patients. As new modalities of virtual care and health technologies continue to emerge, it is crucial to stay informed about the growing landscape of virtual care to ensure that telehealth service delivery is ethical and equitable, and improves the quality of services and patient outcomes. Objective The primary objective of this article is to present the protocol of a rapid review to examine the equity-related aspects surrounding the implementation of TR. This includes a comprehensive analysis of the ethical dimensions and fairness concerns linked to this practice. Methods A rapid review protocol was developed in accordance with Cochrane Rapid Reviews Methods Guidance. Medline and EMBASE databases were searched between January 2010 and March 2023. Study selection and data extraction will be conducted in two phases (Phase I) by two independent reviewers and subsequently (Phase II) by a single reviewer. Our study will utilize the PROGRESS-Plus and Equitable virtual rehabilitation in the metaverse era framework to identify dimensions where potential inequities may exist within TR interventions. Results This rapid review is anticipated to enhance our knowledge of TR in the fields of physiotherapy and occupational therapy, with a specific focus on its influence on ethical and equitable practices and providing a foundation for informed decision-making and improved patient care. Conclusion This rapid review will contribute to the advancement of our understanding of TR within physiotherapy and occupational therapy. Through synthesizing existing evidence, this study not only addresses current gaps in knowledge but also offers valuable insights for future research and clinical practice in TR services.
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Affiliation(s)
- Mirella Veras
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Canada
| | - Jennifer Sigouin
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Canada
| | - Claudine Auger
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Canada
| | - Louis-Pierre Auger
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Sara Ahmed
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Zachary Boychuck
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Sabrina Cavallo
- Faculté de médecine, Université de Montréal, School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Canada
| | - Martine Lévesque
- École de readaptation, Faculté de Médecine, Université de Montréal, Montreal, Canada
| | - Stacey Lovo
- École de réadaptation, Université de Montréal, School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Canada
| | - William C Miller
- Occupational Science & Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Michelle Nelson
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health; University of Toronto, Toronto, Canada
| | | | - Jennifer O’Neil
- École des sciences de la réadaptation, Faculté des Sciences de la Santé, University of Ottawa, Ottawa, Canada
| | - Kadija Perreault
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Canada
| | - Reg Urbanowski
- College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Lisa Sheehy
- Bruyère Research Institute, University of Toronto, Toronto, Canada
| | - Hardeep Singh
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Claude Vincent
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Canada
| | - Rosali Wang
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Diana Zidarov
- Programme de physiothérapie, École de réadaptation, Faculté de Médecine, Université de Montréal, Montreal, Canada
| | - Anne Hudon
- Programme de physiothérapie, École de réadaptation, Faculté de Médecine, Université de Montréal, Montreal, Canada
| | - Dahlia Kairy
- Programme de physiothérapie, École de réadaptation, Faculté de Médecine, Université de Montréal, Montreal, Canada
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Vizza P, Marotta N, Ammendolia A, Guzzi PH, Veltri P, Tradigo G. REHABS: An Innovative and User-Friendly Device for Rehabilitation. Bioengineering (Basel) 2023; 11:5. [PMID: 38275573 PMCID: PMC11154369 DOI: 10.3390/bioengineering11010005] [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: 11/23/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Rehabilitation is a complex set of interventions involving the assessment, management, and treatment of injuries. It aims to support and facilitate an individual's recovery process by restoring a physiological function, e.g., limb movement, compromised by physical impairments, injuries or diseases to a condition as close to normal as possible. Innovative devices and solutions make the rehabilitation process of patients easier during their daily activities. Devices support physicians and physiotherapists in monitoring and measuring patients' physical improvements during rehabilitation. In this context, we report the design and implementation of a low-cost rehabilitation system, which is a programmable device designed to support tele-rehabilitation of the upper limbs. The proposed system includes a mechanism to acquire and analyze data and signals related to rehabilitation processes.
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Affiliation(s)
- Patrizia Vizza
- Department of Medical and Surgical Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (A.A.); (P.H.G.)
| | - Nicola Marotta
- Department of Clinical and Experimental Medicine, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy;
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (A.A.); (P.H.G.)
| | - Pietro Hiram Guzzi
- Department of Medical and Surgical Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (A.A.); (P.H.G.)
| | | | - Giuseppe Tradigo
- Department of Theoretical and Applied Sciences, University e-Campus, 22060 Novedrate, Italy;
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