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Silva-Batista C, de Almeida FO, Wilhelm JL, Horak FB, Mancini M, King LA. Telerehabilitation by Videoconferencing for Balance and Gait in People with Parkinson's Disease: A Scoping Review. Geriatrics (Basel) 2024; 9:66. [PMID: 38920422 PMCID: PMC11202546 DOI: 10.3390/geriatrics9030066] [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: 03/30/2024] [Revised: 05/14/2024] [Accepted: 05/21/2024] [Indexed: 06/27/2024] Open
Abstract
Although supervised and real-time telerehabilitation by videoconferencing is now becoming common for people with Parkinson's disease (PD), its efficacy for balance and gait is still unclear. This paper uses a scoping approach to review the current evidence on the effects of telerehabilitation by videoconferencing on balance and gait for patients with PD. We also explored whether studies have used wearable technology during telerehabilitation to assess and treat balance and gait via videoconferencing. Literature searches were conducted using PubMed, ISI's Web of Knowledge, Cochrane's Library, and Embase. The data were extracted for study design, treatment, and outcomes. Fourteen studies were included in this review. Of these, seven studies investigated the effects of telerehabilitation (e.g., tele-yoga and adapted physiotherapy exercises) on balance and gait measures (e.g., self-reported balance, balance scale, walking speed, mobility, and motor symptoms) using videoconferencing in both assessment and treatment. The telerehabilitation programs by videoconferencing were feasible and safe for people with PD; however, the efficacy still needs to be determined, as only four studies had a parallel group. In addition, no study used wearable technology. Robust evidence of the effects of telerehabilitation by videoconferencing on balance and gait for patients with PD was not found, suggesting that future powered, prospective, and robust clinical trials are needed.
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Affiliation(s)
- Carla Silva-Batista
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239, USA; (C.S.-B.); (J.L.W.); (F.B.H.); (M.M.)
- Exercise Neuroscience Research Group, University of São Paulo, São Paulo 05508-070, Brazil;
| | | | - Jennifer L. Wilhelm
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239, USA; (C.S.-B.); (J.L.W.); (F.B.H.); (M.M.)
| | - Fay B. Horak
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239, USA; (C.S.-B.); (J.L.W.); (F.B.H.); (M.M.)
| | - Martina Mancini
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239, USA; (C.S.-B.); (J.L.W.); (F.B.H.); (M.M.)
| | - Laurie A. King
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239, USA; (C.S.-B.); (J.L.W.); (F.B.H.); (M.M.)
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Colón-Semenza C, Zajac JA, Schwartz A, Darbandsari P, Ellis TD. Experiences from the implementation of physical therapy via telehealth for individuals with Parkinson disease during the COVID-19 pandemic. Disabil Rehabil 2024; 46:1593-1601. [PMID: 37088939 DOI: 10.1080/09638288.2023.2202418] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE To (1) determine the characteristics and participation rate of adults with Parkinson disease (PD) in physical therapy (PT) delivered via telehealth, (2) identify the outcome measures and interventions implemented, (3) determine the safety of and (4) patient and therapist satisfaction with PT via telehealth in a clinic specializing in the care of people with PD during the coronavirus pandemic. MATERIALS & METHODS A retrospective analysis of PT services via telehealth was conducted. Participating patients completed a satisfaction survey. Physical therapists (PTs) who delivered this care were interviewed. Three coders conducted thematic analysis of interviews. Descriptive statistics described the participation rate, demographics, outcome measures, interventions, and safety. RESULTS There was a 71.4% participation rate. Participants (n = 55) were white (96%), non-Hispanic (100%), older adult (mean = 69.5 years (8.3)) males (65.5%). Non-participants (n = 22) had similar demographics. Therapists selected patient-reported measures more often than performance-based measures. Therapeutic exercise was the most common intervention. All patients (80% response rate) reported satisfaction with their experience. PTs reported the home enhanced specificity of training but impeded evaluation. Therapists endorsed a hybrid model for future practice. CONCLUSIONS Patients reported satisfaction with PT via telehealth during the pandemic. A hybrid model may support optimal delivery of PT.IMPLICATIONS FOR REHABILITATIONPhysical therapy via telehealth for patients with Parkinson disease was acceptable to patients and physical therapists in our study.Physical therapy via telehealth was safe for people with Parkinson disease in our study, although availability and benefits may not be reaching all populations equitably.Both physical therapists and patients endorse a hybrid model of care (a combination of in-person and remote assessment and treatment) to profit from the strengths of in-person and virtual formats while minimizing barriers to access.
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Affiliation(s)
- C Colón-Semenza
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - J A Zajac
- Department of Physical Therapy, Boston University, Boston, MA, USA
| | - A Schwartz
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - P Darbandsari
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - T D Ellis
- Department of Physical Therapy, Boston University, Boston, MA, USA
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Schneider RB, Phillips O, Kalia L. Conventionvs. Innovation I: Digital technology will replace clinic-based care in Parkinson disease. Parkinsonism Relat Disord 2024:106067. [PMID: 38443214 DOI: 10.1016/j.parkreldis.2024.106067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 02/21/2024] [Indexed: 03/07/2024]
Affiliation(s)
- Ruth B Schneider
- University of Rochester, 265 Crittenden Blvd, Box MIND, Rochester, NY, 14642, United States.
| | - Oliver Phillips
- Geisel School of Medicine at Dartmouth, 18 Old Etna Road, Lebanon, Hanover, NH, 03756, United States.
| | - Lorraine Kalia
- University of Toronto, Krembell Discovery Tower 8th Floor, 60 Leonard Avenue, Toronto, Ontario, M5T 2S8, Canada.
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Maggio MG, Baglio F, Arcuri F, Borgnis F, Contrada M, Diaz MDM, Leochico CF, Neira NJ, Laratta S, Suchan B, Tonin P, Calabrò RS. Cognitive telerehabilitation: an expert consensus paper on current evidence and future perspective. Front Neurol 2024; 15:1338873. [PMID: 38426164 PMCID: PMC10902044 DOI: 10.3389/fneur.2024.1338873] [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: 11/15/2023] [Accepted: 01/16/2024] [Indexed: 03/02/2024] Open
Abstract
The progressive improvement of the living conditions and medical care of the population in industrialized countries has led to improvement in healthcare interventions, including rehabilitation. From this perspective, Telerehabilitation (TR) plays an important role. TR consists of the application of telemedicine to rehabilitation to offer remote rehabilitation services to the population unable to reach healthcare. TR integrates therapy-recovery-assistance, with continuity of treatments, aimed at neurological and psychological recovery, involving the patient in a family environment, with an active role also of the caregivers. This leads to reduced healthcare costs and improves the continuity of specialist care, as well as showing efficacy for the treatment of cognitive disorders, and leading to advantages for patients and their families, such as avoiding travel, reducing associated costs, improving the frequency, continuity, and comfort of performing the rehabilitation in its own spaces, times and arrangements. The aim of this consensus paper is to investigate the current evidence on the use and effectiveness of TR in the cognitive field, trying to also suggest some recommendations and future perspectives. To the best of our knowledge, this is the first consensus paper among multiple expert researchers that comprehensively examines TR in different neurological diseases. Our results supported the efficacy and feasibility of TR with good adherence and no adverse events among patients. Our consensus summarizes the current evidence for the application of cognitive TR in neurological populations, highlighting the potential of this tool, but also the limitations that need to be explored further.
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Affiliation(s)
| | | | - Francesco Arcuri
- S. Anna Institute and Research in Advanced Neurorehabilitation, Crotone, Italy
| | | | - Marianna Contrada
- S. Anna Institute and Research in Advanced Neurorehabilitation, Crotone, Italy
| | | | - Carl Froilan Leochico
- University of the Philippines Manila, Manila, Philippines
- St. Luke’s Medical Center, Quezon City, Philippines
| | | | - Stefania Laratta
- S. Anna Institute and Research in Advanced Neurorehabilitation, Crotone, Italy
| | - Boris Suchan
- Department of Neuropsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Paolo Tonin
- S. Anna Institute and Research in Advanced Neurorehabilitation, Crotone, Italy
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Patrick SE, Knox KB, Evans C, Levin M, Linassi G, Poliakov I, Rajput A, Donkers SJ. Participants' perspectives of "NeuroSask: Active and Connect"-a virtual chronic disease management program for individuals with a neurological condition. Front Neurol 2024; 15:1332859. [PMID: 38327624 PMCID: PMC10847521 DOI: 10.3389/fneur.2024.1332859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/05/2024] [Indexed: 02/09/2024] Open
Abstract
Introduction Neurological conditions account from more than half of Canadians requiring chronic care. Both physical activity and the development of a self-management skillset are critical components supporting individuals with chronic health conditions. "NeuroSask: Active and Connected" is a virtual chronic disease management program offering twice weekly neuro-physiotherapist directed "active" exercise sessions, followed by weekly knowledge-exchange "connect" sessions with invited guest experts. NeuroSask was launched April 2020 in response to the restricted services and supports for people with neurological conditions. The program aimed to provide seated physical activity, social interaction, and access to expertise in neurological conditions and neurorehabilitation. A program evaluation of NeuroSask was conducted to gain participants' perspectives. Methods All participants registered for the NeuroSask program were invited to complete optional online surveys (SurveyMonkey) circulated by email at 3 occasions post-program launch: 10 weeks, 1 year, and 2 years. Participants could complete any one or all of the surveys, at their discretion. The number of potential respondents changed dependent on the total number of participants registered for NeuroSask at the time the survey was circulated. Questions were co-designed by multi-stakeholder team members. Descriptive statistics were used for closed-ended questions and a reflexive thematic analysis was completed with coding conducted in NVivo 12 Plus for open-ended text. Results Response rates (participants/registrants) were as follows: 10-week survey 260/793, one year survey 326/1224, and 2-year survey 434/1989. 90% of participants reported being in either the age categories of 40-59 years or above 60 years. 75% of both survey respondents and program registrants were female. 70% of both survey respondents and program registrants reported a diagnosis of multiple sclerosis and 30% reported other neurological conditions. Survey respondents were from all ten Canadian provinces, with 45% reporting living outside of large cities. Respondents reported preferring online vs. in person format for this type of programming. Three main themes, and eight corresponding subthemes were identified highlighting the perceived impact and key components of the NeuroSask program: Theme 1 "together in a positive and encouraging environment" (subthemes 1a: connection, 1b: empowerment); Theme 2 "access to enthusiastic qualified leaders from home" (subthemes 2a: leader characteristics, 2b: accessibility, 2c: program logistics); Theme 3 "being able to enjoy everyday life" (subthemes 3a: symptom benefits and beyond, 3b: carry-over, 3c: keep going, please do not cancel). Conclusion NeuroSask is an example of an accessible and meaningful virtual approach to providing ongoing support for some individuals with neurological conditions. It was perceived as beneficial for fostering community and connection in a positive environment with perceived benefits extending beyond symptom management to participant reported improvements in function, daily life, and disease experience.
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Affiliation(s)
- Stephen E. Patrick
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Katherine B. Knox
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Charity Evans
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - Michael Levin
- Anatomy and Cell Biology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Office of the Saskatchewan Multiple Sclerosis Research Chair and Division of Neurology, Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Gary Linassi
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Ilia Poliakov
- Multiple Sclerosis Clinic, Division of Neurology, Department of Medicine, College of Medicine, Multiple Sclerosis Clinic, University of Saskatchewan, Saskatoon, SK, Canada
| | - Alex Rajput
- Movement Disorders Program, Division of Neurology, Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Sarah J. Donkers
- School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Macpherson CE, Fineman J, Chandrana A, Quinn L. Development of a Physical Therapy Telehealth Examination Battery for People with Parkinson Disease. Int J Telerehabil 2023; 15:e6592. [PMID: 38162943 PMCID: PMC10754248 DOI: 10.5195/ijt.2023.6592] [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: 01/03/2024] Open
Abstract
Scope The rapid transition to telehealth following the COVID-19 pandemic raised challenges for remote delivery of physical therapy. One challenge was identifying outcome measures for people with Parkinson Disease (PwP) that could safely be conducted via telehealth. This paper evaluates the feasibility of a telehealth physical therapy examination battery for PwP in early to middle stage of disease progression. Methodology We reviewed recommended outcome measures from the American Physical Therapy Association's Academy of Neurologic Physical Therapy (ANPT) Parkinson Evidence Database to Guide Effectiveness (EDGE) document and evaluated their appropriateness for remote administration. A clinical decision tree was created to streamline the examination process, incorporating elements of the ANPT movement analysis of tasks as a movement screen. The examination battery was then conducted on three PwP and evaluated for safety and feasibility. Conclusion This physical therapy telehealth examination battery provides physical therapists with a method to conduct safe and efficient remote assessments for PwP.
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Affiliation(s)
- Chelsea E. Macpherson
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Julie Fineman
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
- Doctor of Physical Therapy Program, Marist College, Poughkeepsie, NY, USA
| | - Anuja Chandrana
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
- Department of Rehabilitation and Regenerative Medicine (Physical Therapy), Columbia University Irving Medical Center, New York, NY, USA
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Silva-Batista C, Wilhelm JL, Scanlan KT, Stojak M, Carlson-Kuhta P, Chen S, Liu W, de la Huerta TNG, Horak FB, Mancini M, King LA. Balance telerehabilitation and wearable technology for people with Parkinson's disease (TelePD trial). BMC Neurol 2023; 23:368. [PMID: 37833645 PMCID: PMC10571293 DOI: 10.1186/s12883-023-03403-3] [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: 09/16/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Balance impairments, that lead to falls, are one of the main symptoms of Parkinson's disease (PD). Telerehabilitation is becoming more common for people with PD; however, balance is particularly challenging to assess and treat virtually. The feasibility and efficacy of virtual assessment and virtual treatment of balance in people with PD are unknown. The present study protocol has three aims: I) to determine if a virtual balance and gait assessment (instrumented L-shape mobility test) with wearable sensors can predict a gold-standard, in-person clinical assessment of balance, the Mini Balance Evaluation Systems Test (Mini-BESTest); II) to explore the effects of 12 sessions of balance telerehabilitation and unsupervised home exercises on balance, gait, executive function, and clinical scales; and III) to explore if improvements after balance telerehabilitation transfer to daily-life mobility, as measured by instrumented socks with inertial sensors worn for 7 days. METHODS The TelePD Trial is a prospective, single-center, parallel-group, single-blind, pilot, randomized, controlled trial. This trial will enroll 80 eligible people with PD. Participants will be randomized at a 1:1 ratio into receiving home-based balance exercises in either: 1) balance telerehabilitation (experimental group, n = 40) or 2) unsupervised exercises (control group, n = 40). Both groups will perform 12 sessions of exercise at home that are 60 min long. The primary outcome will be Mini-BESTest. The secondary outcomes will be upper and lower body gait metrics from a prescribed task (instrumented L-shape mobility test); daily-life mobility measures over 7 days with wearable sensors in socks, instrumented executive function tests, and clinical scales. Baseline testing and 7 days of daily-life mobility measurement will occur before and after the intervention period. CONCLUSION The TelePD Trial will be the first to explore the usefulness of using wearable sensor-based measures of balance and gait remotely to assess balance, the feasibility and efficacy of balance telerehabilitation in people with PD, and the translation of balance improvements after telerehabilitation to daily-life mobility. These results will help to develop a more effective home-based balance telerehabilitation and virtual assessment that can be used remotely in people with balance impairments. TRIAL REGISTRATION This trial was prospectively registered on ClinicalTrials.gov (NCT05680597).
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Affiliation(s)
- Carla Silva-Batista
- Balance Disorders Laboratory, Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, OP-3297239, USA
| | - Jennifer L Wilhelm
- Balance Disorders Laboratory, Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, OP-3297239, USA
| | - Kathleen T Scanlan
- Balance Disorders Laboratory, Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, OP-3297239, USA
| | - Margaret Stojak
- Balance Disorders Laboratory, Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, OP-3297239, USA
| | - Patricia Carlson-Kuhta
- Balance Disorders Laboratory, Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, OP-3297239, USA
| | - Siting Chen
- School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - William Liu
- Balance Disorders Laboratory, Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, OP-3297239, USA
| | - Tomas Nicolás García de la Huerta
- Balance Disorders Laboratory, Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, OP-3297239, USA
| | - Fay B Horak
- Balance Disorders Laboratory, Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, OP-3297239, USA
- APDM Precision Motion of Clario, Portland, OR, USA
| | - Martina Mancini
- Balance Disorders Laboratory, Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, OP-3297239, USA
| | - Laurie A King
- Balance Disorders Laboratory, Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, OP-3297239, USA.
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Pastana Ramos LF, Vilacorta-Pereira TDCS, Duarte JDS, Yamada ES, Santos-Lobato BL. Feasibility and effectiveness of a remote individual rehabilitation program for people with Parkinson's disease living in the Brazilian Amazon: a randomized clinical trial. Front Neurol 2023; 14:1244661. [PMID: 37693755 PMCID: PMC10485362 DOI: 10.3389/fneur.2023.1244661] [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: 06/22/2023] [Accepted: 08/07/2023] [Indexed: 09/12/2023] Open
Abstract
Parkinson's disease (PD) is a chronic and progressive neurodegenerative disorder, and the current treatment involves pharmacological intervention and physiotherapy. Telerehabilitation, which involves remote support and guidance for patients undergoing rehabilitation, can potentially improve access to physiotherapy services for people with Parkinson's disease, especially those who face geographic barriers to healthcare. The primary aim of this study was to assess the feasibility and efficacy of a telerehabilitation program for people with Parkinson's disease living in an underrepresented community of the Brazilian Amazon. We conducted a parallel-group, single-center, single-blind, phase 2 randomized controlled clinical trial involving 19 participants diagnosed with Parkinson's disease from Belém, Brazil. Participants were assigned to a 4-week individual telerehabilitation program or a booklet-based exercise program (control group). Assessments were conducted before the intervention, immediately after the intervention, and 4 weeks after the end of the intervention. We showed that our telerehabilitation program had high adherence among patients, with minimal adverse effects. Both telerehabilitation and booklet orientation reduced the time to complete the Timed Up and Go test. In conclusion, our telerehabilitation program was feasible and effective for people with Parkinson's disease in an Amazonian setting. This trial was registered at the Registro Brasileiro de Ensaios Clínicos (ReBEC) under the identifier: RBR-6sz837s.
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Affiliation(s)
| | | | | | - Elizabeth Sumi Yamada
- Laboratório de Neuropatologia Experimental, Universidade Federal do Pará, Belém, PA, Brazil
| | - Bruno Lopes Santos-Lobato
- Laboratório de Neuropatologia Experimental, Universidade Federal do Pará, Belém, PA, Brazil
- Serviço de Neurologia, Hospital Ophir Loyola, Belém, PA, Brazil
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Roy AL, Duruflé A, Piette P, Fraudet B, Lofficial V, Gallien P. Telerehabilitation during the COVID-19 pandemic, what are the determinants of satisfaction for chronic diseases? a retrospective study. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1108087. [PMID: 36776736 PMCID: PMC9909006 DOI: 10.3389/fresc.2023.1108087] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023]
Abstract
Background During the Covid-19 health crisis, telerehabilitation provided a solution to ensure the continuity of care. Since then, it has been offered as an alternative to face-to-face rehabilitation in chronic conditions. Data measuring satisfaction are essential to adapt and increase the effectiveness of this type of programme. Aim and scope This research focused on determining the most significant determinants of participant satisfaction in a telerehabilitation programme. Methods We conducted a retrospective study by analysing the satisfaction questionnaire used from the start of the programme. Result Two hundred and ten (210) participants completed the programme; 180 questionnaires were filled in and 175 analyzed of which 70 with chronic low back pain (CLBP), 59 for multiple sclerosis (MS) and 22 with parkinson's disease (PD). Satisfaction was high for all participants (scoring out of 10, mean = 8.22 sd = 1.53), but the determinants reported for the three main conditions involved in the programme differed. Main determinant was "benefice" for CLBP (p = 1.23e-05), "home exercises adapted" for MS (p = 0.000679) and "interest in staying at home" for PD (p = 1.84e-05). Conclusion Depending on the context of the condition/disease, the drivers of satisfaction were not identical. Knowledge of these determinants will allow us to further improve the programme. However, some unresolved questions remain regarding the place of therapists, their role and the skills required for a successful telerehabilitation programme. Further studies are required to understand the impact.
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