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Fucarino A, Fabbrizio A, Garrido ND, Iuliano E, Reis VM, Sausa M, Vilaça-Alves J, Zimatore G, Baldari C, Macaluso F, Giorgio AD, Cantoia M. Emerging Technologies and Open-Source Platforms for Remote Physical Exercise: Innovations and Opportunities for Healthy Population-A Narrative Review. Healthcare (Basel) 2024; 12:1466. [PMID: 39120170 PMCID: PMC11312124 DOI: 10.3390/healthcare12151466] [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: 06/08/2024] [Revised: 07/15/2024] [Accepted: 07/21/2024] [Indexed: 08/10/2024] Open
Abstract
The emergence of tele-exercise as a response to the impact of technology on physical activity has opened up new possibilities for promoting physical health. By integrating innovative technologies and open-source platforms, tele-exercise encourages people to stay active. In our latest analysis, we delved into the scientific literature surrounding the use of tele-exercise technologies in training healthy individuals. After conducting an extensive search on the PubMed database using the keywords "tele-exercise" and "physical activity" (from 2020 to 2023), we identified 44 clinical trials that were applicable to tele-exercise, but less than 10% of them were aimed at healthy individuals, precisely 9.09% (four out of forty-four studies analyzed). Our review highlights the potential of tele-exercise to help maintain physical fitness and psychological well-being, especially when traditional fitness facilities are not an option. We also underscore the importance of interoperability, standardization, and the incorporation of biomechanics, exercise physiology, and neuroscience into the development of tele-exercise platforms. Nevertheless, despite these promising benefits, research has shown that there is still a significant gap in the knowledge concerning the definition and evaluation of training parameters for healthy individuals. As a result, we call for further research to establish evidence-based practices for tele-exercise in the healthy population.
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Affiliation(s)
- Alberto Fucarino
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - Antonio Fabbrizio
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - Nuno D. Garrido
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal; (N.D.G.); (V.M.R.); (J.V.-A.)
| | - Enzo Iuliano
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - Victor Machado Reis
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal; (N.D.G.); (V.M.R.); (J.V.-A.)
| | - Martina Sausa
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - José Vilaça-Alves
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal; (N.D.G.); (V.M.R.); (J.V.-A.)
- Sciences Departament, University of Tra’s-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
| | - Giovanna Zimatore
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - Carlo Baldari
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - Filippo Macaluso
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - Andrea De Giorgio
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
| | - Manuela Cantoia
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy; (A.F.); (A.F.); (E.I.); (M.S.); (G.Z.); (C.B.); (A.D.G.); (M.C.)
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Prieto-Moreno R, Mora-Traverso M, Estévez-López F, Molina-Garcia P, Ortiz-Piña M, Salazar-Graván S, Cruz-Guisado V, Gago ML, Martín-Matillas M, Ariza-Vega P. Effects of the ActiveHip+ mHealth intervention on the recovery of older adults with hip fracture and their family caregivers: a multicentre open-label randomised controlled trial. EClinicalMedicine 2024; 73:102677. [PMID: 38911836 PMCID: PMC11192790 DOI: 10.1016/j.eclinm.2024.102677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 05/18/2024] [Accepted: 05/20/2024] [Indexed: 06/25/2024] Open
Abstract
Background Mobile health (mHealth) systems are a promising alternative for rehabilitation of hip fracture, addressing constrained healthcare resources. Half of older adults fails to recover their pre-fracture routines, which imposes a burden on caregivers. We aimed to test the effectiveness of the 3-month ActiveHip + mHealth intervention on physical and psychological outcomes of older adults with hip fracture and their family caregivers. Methods In a multicentre open-label randomised controlled trial conducted across 3 hospitals in Andalusia (Spain), patients older than 65 with a hip fracture, who were previously independent and lacked cognitive impairment were recruited alongside with their caregivers. Participants were randomly allocated (1:1) to the intervention group (ActiveHip+) or control (usual care) group. The intervention group underwent a 12-week health education and tele-rehabilitation programme through the ActiveHip + mHealth intervention. The primary outcome, physical performance, was assessed using the Short Physical Performance Battery at three time points: at hospital discharge (baseline), 3-month after surgery (post intervention) and 1-year after surgery follow-up. Primary analyses of primary outcomes and safety data followed an intention-to-treat approach. This study is registered at ClinicalTrials.gov, NCT04859309. Findings Between June 1st, 2021 and June 30th, 2022 data from 105 patients and their caregivers were analysed. Patients engaged in the ActiveHip + mHealth intervention (mean 7.11 points, SE 0.33) showed higher physical performance compared with patients allocated in the control group (mean 5.71 points, SE 0.32) at 3 months after surgery (mean difference in change from baseline 1.40 points, SE 0.36; puncorrected = 0.00011). These benefits were not maintained at 1-year after surgery follow-up (mean difference in change from baseline 0.19 points, SE 0.47; puncorrected = 0.68). No adverse events, including falls and refractures, were reported during the tele-rehabilitation sessions. At 3-months, the intervention group had 2 falls, compared to 4 in the control group, with no observed refractures. At the 1-year follow-up, the intervention group experienced 7 falls and 1 refracture, while the control group had 13 falls and 2 refractures. Interpretation This study suggests that the ActiveHip + mHealth intervention may be effective for recovering physical performance in older adults with hip fracture. Importantly, the implementation of ActiveHip + into daily clinical practice may be feasible and has already been adopted in 18 hospitals, mostly in Spain but also in Belgium and Portugal. Thus, ActiveHip + could offer a promising solution when rehabilitation resources are limited. However, its dependence on caregiver support and the exclusion of participants with cognitive impairment makes it necessary to be cautious about its applicability. In addition, the non-maintenance of the effectiveness at 1-year follow-up highlights the need of refinement the ActiveHip + intervention to promote long-lasting behavioural changes. Funding EIT Health and the Ramón y Cajal 2021 Excellence Research Grant action from the Spanish Ministry of Science and Innovation.
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Affiliation(s)
- Rafael Prieto-Moreno
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), Lisbon, Portugal
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain
- Biomedical Research Unit, Torrecárdenas University Hospital, 04009, Almería, Spain
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
| | - Marta Mora-Traverso
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical Education and Sports, Faculty of Sport Science, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- Department of Physiotherapy, Faculty of Health Science, University of Granada, Granada, Spain
| | - Fernando Estévez-López
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain
- Biomedical Research Unit, Torrecárdenas University Hospital, 04009, Almería, Spain
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | | | - Mariana Ortiz-Piña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Susana Salazar-Graván
- Orthopaedic Surgery and Traumatology Service, University Hospital Virgen de las Nieves, Granada, Spain
| | - Víctor Cruz-Guisado
- Department of Physical Medicine and Rehabilitation, University Hospital Jerez de la Frontera, Cadiz, Spain
| | - Marta Linares Gago
- Department of Physical Medicine and Rehabilitation, University Hospital Puerto Real, Cadiz, Spain
| | - Miguel Martín-Matillas
- PROFITH (PROmoting FITness and Health Through Physical Activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Science, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Patrocinio Ariza-Vega
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical Education and Sports, Faculty of Sport Science, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- Department of Physiotherapy, Faculty of Health Science, University of Granada, Granada, Spain
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Pliannuom S, Pinyopornpanish K, Buawangpong N, Wiwatkunupakarn N, Mallinson PAC, Jiraporncharoen W, Angkurawaranon C. Characteristics and Effects of Home-Based Digital Health Interventions on Functional Outcomes in Older Patients With Hip Fractures After Surgery: Systematic Review and Meta-Analysis. J Med Internet Res 2024; 26:e49482. [PMID: 38865706 PMCID: PMC11208838 DOI: 10.2196/49482] [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: 06/06/2023] [Revised: 10/07/2023] [Accepted: 04/29/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Digital health interventions (DHIs) have been used to improve postoperative functional ability in older patients with hip fractures. However, there is limited information on the characteristics of home-based DHIs, and controversy exists regarding their impact on functional outcomes in this population. OBJECTIVE This study aims to provide an overview of the characteristics and effects of home-based DHIs on functional outcomes in older patients with hip fractures after surgery. METHODS We conducted a systematic review and meta-analysis following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Five electronic medical databases (PubMed, Embase, Cochrane, ProQuest, and CINAHL) were searched up until January 3, 2023. We included clinical trials or randomized controlled trials (RCTs) in English involving home-based DHIs for postoperative care among older patients with hip fractures. Excluded studies involved patients not hospitalized, not discharged to home, not directly using DHIs, or with inaccessible full text. The PROSPERO registration number is CRD42022370550. Two independent reviewers screened and extracted data (SP and NB). Disagreements were resolved through discussion and agreement with the third author (KP). Home-based DHIs were characterized in terms of purpose and content, mode of delivery, and health care provider. Functional outcomes assessed included Timed Up and Go (TUG) test, Short Physical Performance Battery (SPPB), and Functional Independence Measure (FIM). Summary measures were calculated using mean differences with 95% CIs. Risk of bias was assessed using the Risk-of-Bias 2 assessment tool for RCTs and ROBINS-I for non-RCTs. The quality of evidence was assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation). RESULTS Of 2125 identified studies, 16 were included in the systematic review, involving 1467 participants. Six studies were included in the meta-analysis (4 for TUG, 4 for SPPB, and 2 for FIM). Home-based DHIs predominantly involved communication and feedback, education, and telerehabilitation. Telephone calls were the most common mode of delivery, followed by web-based software and mobile apps. Physical therapists were the main health care providers. The meta-analysis showed that home-based DHIs improved functional outcomes compared with usual care, with decreased TUG scores (mean difference=-7.89; 95% CI -10.34 to -5.45; P<.001), significantly increased SPPB scores (mean difference=1.11; 95% CI 0.51-1.72; P<.001), and increased FIM scores (mean difference=7.98; 95% CI 5.73-10.24; P<.001). CONCLUSIONS Home-based DHIs that integrate communication and feedback, education, and telerehabilitation have demonstrated effectiveness in enhancing functional outcomes among older patients recovering from hip fractures after surgery. These interventions are commonly administered by physical therapists, who play a crucial role in facilitating and guiding the rehabilitation process. However, while the existing evidence supports the efficacy of such interventions, further research is needed to enhance our understanding and optimize the implementation of home-based DHIs for this specific population.
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Affiliation(s)
- Suphawita Pliannuom
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Kanokporn Pinyopornpanish
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Nida Buawangpong
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Nutchar Wiwatkunupakarn
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Poppy Alice Carson Mallinson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Wichuda Jiraporncharoen
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
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Prieto-Moreno R, Molina-García P, Ortiz-Piña M, Mora-Traverso M, Estévez-López F, Martín-Matillas M, Ariza-Vega P. Association of the @ctivehip tele-rehabilitation with the fear of falling of older adults with hip fracture and their family caregivers: Secondary analysis of a non-randomised controlled trial. J Telemed Telecare 2024:1357633X241257972. [PMID: 38836335 DOI: 10.1177/1357633x241257972] [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: 06/06/2024]
Abstract
INTRODUCTION Osteoporotic hip fracture is a major health problem. Falls, the primary cause, might lead to a persistent fear of falling (FoF) among older adults, affecting their daily activities and rehabilitation. While in-person interventions exist, limited research is available on the effects of tele-rehabilitation on the FoF after a hip fracture. Thus, this study aims to test the association of the @ctivehip tele-rehabilitation programme on reducing the levels of FoF experienced by both older adults with hip fracture and their family caregivers. METHODS A non-randomised controlled trial (ClinicalTrials.gov; Identifier: NCT02968589) that compared a webpage-based tele-rehabilitation (@ctivehip) against usual care. Fear of falling was assessed using the Short Falls Efficacy Scale-International. Patients' functional status was evaluated using the Functional Independence Measure. Physical performance was assessed by the Timed Up and Go test and Short Physical Performance Battery. We conducted a per-protocol analysis as the primary outcome, and an intention-to-treat approach as secondary analysis. RESULTS A total of 71 patients with hip fracture (78.75 ± 6.12 years, 75% women) and their family caregivers participated. Participants in the intervention showed a higher decrease in FoF in comparison to those in the usual care (0.5 Cohen's d; p = 0.042). The reduction in FoF resulting from participation in the tele-rehabilitation programme was mediated by improvements in functional status by 79%. The @ctivehip programme did not decrease FoF of family caregivers. DISCUSSION @ctivehip is associated with a reduction of the FoF in older adults with hip fractures, but not in their family caregivers, with the reduction being mostly explained by improvements in the patients' functional status. Although the intervention seems promising, it should not be applied in clinical settings until confirmed by appropriate-designed randomised clinical trials.
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Affiliation(s)
- Rafael Prieto-Moreno
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | | | - Mariana Ortiz-Piña
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain
| | - Marta Mora-Traverso
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Fernando Estévez-López
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Miguel Martín-Matillas
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain
| | - Patrocinio Ariza-Vega
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
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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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Mora-Traverso M, Prieto-Moreno R, Molina-Garcia P, Salas-Fariña Z, Martín-Martín L, Martín-Matillas M, Ariza-Vega P. Effects of the @ctivehip telerehabilitation program on the quality of life, psychological factors and fitness level of patients with hip fracture. J Telemed Telecare 2024; 30:549-558. [PMID: 35060784 DOI: 10.1177/1357633x211073256] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
INTRODUCTION Telerehabilitation has emerged in the last decade as a promising alternative to conduct the rehabilitation process at home. However, there are no studies testing the effects of telerehabilitation interventions for patients with hip fracture on quality of life nor psychological factors, whereas the evidence on fitness level is scarce. Thus, the aim of this study is to test the effects of the @ctivehip telerehabilitation program on the quality of life, psychological factors and fitness level of patients who had suffered a hip fracture. METHODS The present study is a non-randomized clinical trial that includes patients older than 65 years old with a hip fracture and their family caregivers (ClinicalTrials.gov; Identifier: NCT02968589). Per-protocol (64 participants) and intention-to-treat (71 participants) analyses were performed, the first being the main analysis. The intervention group received a home-based multidisciplinary telerehabilitation intervention, called @ctivehip, that lasted 12 weeks. The control group received the traditional care and rehabilitation provided by the Andalusian Public Health Care System. The outcomes measured were the patients' quality of life through the EuroQol Quality of Life Questionnaire (EQ-5D), physiological factors (anxiety and depression) using the Hospital Anxiety and Depression Scale (HADS) and the fitness level, assessed with the International Fitness Scale. RESULTS The quality of life of the telerehabilitation group increased, while the control group scored worsened at the 3-month follow-up (medium effect size: 0.66 SDs; p = 0.006). The telerehabilitation group demonstrated a greater decrease than the control group in the total HADS score (medium effect size: -0.50 SDs; p = 0.015). Lastly, the telerehabilitation group recovered a fitness level close to the pre-hip fracture in comparison with the control group (small effect size: 0.49 SDs; p = 0.022). DISCUSSION The @ctivehip telerehabilitation program seems to be a promising treatment to improve the quality of life and psychological factors (i.e. anxiety and depression) of older adults after a hip fracture, as well as to recover their previous fitness level.
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Affiliation(s)
- Marta Mora-Traverso
- Biohealth Research Institute (ibs.Granada) Physical Medicine and Rehabilitation Service, Virgen de las Nieves University Hospital, Granada, Spain
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain
| | - Rafael Prieto-Moreno
- Biohealth Research Institute (ibs.Granada) Physical Medicine and Rehabilitation Service, Virgen de las Nieves University Hospital, Granada, Spain
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain
| | - Pablo Molina-Garcia
- Biohealth Research Institute (ibs.Granada) Physical Medicine and Rehabilitation Service, Virgen de las Nieves University Hospital, Granada, Spain
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Zeus Salas-Fariña
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Lydia Martín-Martín
- Department of Physiotherapy, Faculty of Health Science, University of Granada, Granada, Spain
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain
- Sport and Health University Research Institute (iMUDS), Universtity of Granada, Granada, Spain
| | - Miguel Martín-Matillas
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Patrocinio Ariza-Vega
- Biohealth Research Institute (ibs.Granada) Physical Medicine and Rehabilitation Service, Virgen de las Nieves University Hospital, Granada, Spain
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain
- Department of Physiotherapy, Faculty of Health Science, University of Granada, Granada, Spain
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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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Wang L, Wang X, Zhang R, He C. Emerging trends and prospects in telerehabilitation for hip fracture: Bibliometric and visualization study. Digit Health 2024; 10:20552076241255465. [PMID: 38798887 PMCID: PMC11128182 DOI: 10.1177/20552076241255465] [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: 10/20/2023] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Background Telerehabilitation provide distant physical rehabilitation services and help overcome the barriers associated with face-to-face interventions for hip fractures. This study aims to analyse the progress of the application of telerehabilitation in hip fracture and reveal its research profile, hotspots and development trends. Methods The articles and reviews related to telerehabilitation in hip fracture were retrieved from 1992 to 2024. A bibliometric visualization and comparative analysis of countries, institutions, journals, authors, references and keywords were conducted using Java-based CiteSpace and VOSviewer. Results A total of 79 documents were obtained. Spain was the most academically influential country. The University of Granada was the most prolific institution. The author Ariza-vega P listed first in terms of publications and citations. Most publications were published in high academic impact journals. The major frontier keywords were "older adults," "functional recovery," "reliability," "mortality," "rehabilitation," "mobility" and "quality of life." The most popular keywords from 2020 to 2024 were "geriatric medicine," "family caregiver" and "digital health." Conclusions The historical and prospective perspective in telerehabilitation following hip fracture were presented. A primary focus in the early years was the impact of telerehabilitation on functional independence for hip fracture patients. Future outcomes are expected to include patient satisfaction, health-related quality of life and psychiatric symptoms. Exercise was also designed to eliminate travel burdens and strengthen self-efficacy, and improve the physical and psychosocial function of hip fracture patients. This work will provide a fundamental reference as well as a directional guide for future research.
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Affiliation(s)
- Liqiong Wang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Xiangxiu Wang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Ruishi Zhang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Chengqi He
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
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Cedeno-Veloz BA, Casadamon-Munarriz I, Rodríguez-García A, Lozano-Vicario L, Zambom-Ferraresi F, Gonzalo-Lázaro M, Hidalgo-Ovejero ÁM, Izquierdo M, Martínez-Velilla N. Effect of a Multicomponent Intervention with Tele-Rehabilitation and the Vivifrail© Exercise Programme on Functional Capacity after Hip Fracture: Study Protocol for the ActiveFLS Randomized Controlled Trial. J Clin Med 2023; 13:97. [PMID: 38202104 PMCID: PMC10779784 DOI: 10.3390/jcm13010097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Hip fractures are the most common fracture leading to hospitalization and are associated with high costs, mortality rates and functional decline. Although several guidelines exist for preventing new fractures and promoting functional recovery, they tend to focus on osteoporosis treatment and do not take into account the complexity of frailty in older adults and geriatric syndromes, which are important factors in individuals at risk of suffering from frailty fractures. Moreover, most health systems are fragmented and are incapable of providing appropriate management for frail and vulnerable individuals who are at risk of experiencing fragility fractures. Multicomponent interventions and physical exercise using tele-rehabilitation could play a role in the management of hip fracture recovery. However, the effectiveness of exercise prescription and its combination with a comprehensive geriatric assessment (CGA) is still unclear. METHODS This randomized clinical trial will be conducted at the Hospital Universitario de Navarra (Pamplona, Spain). A total of 174 older adults who have suffered a hip fracture and fulfil the criteria for inclusion will be randomly allocated to either the intervention group or the control group. The intervention group will receive a multicomponent intervention consisting of individualized home-based exercise using the @ctive hip app for three months, followed by nine months of exercise using Vivifrail. Additionally, the intervention group will receive nutrition intervention, osteoporosis treatment, polypharmacy adjustment and evaluation of patient mood, cognitive impairment and fear of falling. The control group will receive standard outpatient care according to local guidelines. This research aims to evaluate the impact of the intervention on primary outcome measures, which include changes in functional status during the study period based on the Short Physical Performance Battery. DISCUSSION The findings of this study will offer valuable insights into the efficacy of a comprehensive approach that considers the complexity of frailty in older adults and geriatric syndromes, which are important factors in individuals at risk of suffering from frailty fractures. This study's findings will contribute to the creation of more effective strategies tailored to the requirements of these at-risk groups.
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Affiliation(s)
- Bernardo Abel Cedeno-Veloz
- Navarre University Hospital (HUN), Irunlarrea 3, 31008 Pamplona, Navarra, Spain; (I.C.-M.); (A.R.-G.); (L.L.-V.); (F.Z.-F.); (M.G.-L.); (N.M.-V.)
- Navarrabiomed, Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008 Pamplona, Navarra, Spain;
- Department of Health Sciences, Public University of Navarre, Av Cataluña s/n, 31006 Pamplona, Navarra, Spain
| | - Irache Casadamon-Munarriz
- Navarre University Hospital (HUN), Irunlarrea 3, 31008 Pamplona, Navarra, Spain; (I.C.-M.); (A.R.-G.); (L.L.-V.); (F.Z.-F.); (M.G.-L.); (N.M.-V.)
| | - Alba Rodríguez-García
- Navarre University Hospital (HUN), Irunlarrea 3, 31008 Pamplona, Navarra, Spain; (I.C.-M.); (A.R.-G.); (L.L.-V.); (F.Z.-F.); (M.G.-L.); (N.M.-V.)
| | - Lucia Lozano-Vicario
- Navarre University Hospital (HUN), Irunlarrea 3, 31008 Pamplona, Navarra, Spain; (I.C.-M.); (A.R.-G.); (L.L.-V.); (F.Z.-F.); (M.G.-L.); (N.M.-V.)
- Navarrabiomed, Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008 Pamplona, Navarra, Spain;
- Department of Health Sciences, Public University of Navarre, Av Cataluña s/n, 31006 Pamplona, Navarra, Spain
| | - Fabricio Zambom-Ferraresi
- Navarre University Hospital (HUN), Irunlarrea 3, 31008 Pamplona, Navarra, Spain; (I.C.-M.); (A.R.-G.); (L.L.-V.); (F.Z.-F.); (M.G.-L.); (N.M.-V.)
- Navarrabiomed, Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008 Pamplona, Navarra, Spain;
- Department of Health Sciences, Public University of Navarre, Av Cataluña s/n, 31006 Pamplona, Navarra, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Av Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - María Gonzalo-Lázaro
- Navarre University Hospital (HUN), Irunlarrea 3, 31008 Pamplona, Navarra, Spain; (I.C.-M.); (A.R.-G.); (L.L.-V.); (F.Z.-F.); (M.G.-L.); (N.M.-V.)
| | - Ángel María Hidalgo-Ovejero
- Department of Orthopaedics Clinics and Traumatology, University Hospital of Navarre (HUN), 31008 Pamplona, Navarra, Spain;
| | - Mikel Izquierdo
- Navarrabiomed, Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008 Pamplona, Navarra, Spain;
- Department of Health Sciences, Public University of Navarre, Av Cataluña s/n, 31006 Pamplona, Navarra, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Av Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Nicolás Martínez-Velilla
- Navarre University Hospital (HUN), Irunlarrea 3, 31008 Pamplona, Navarra, Spain; (I.C.-M.); (A.R.-G.); (L.L.-V.); (F.Z.-F.); (M.G.-L.); (N.M.-V.)
- Navarrabiomed, Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008 Pamplona, Navarra, Spain;
- Department of Health Sciences, Public University of Navarre, Av Cataluña s/n, 31006 Pamplona, Navarra, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Av Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
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Zhou Z, Zhou X, Cui N, Huang H, Yang F, Yang G, Liu D, Liu K, Zhang X, Wang J. Effectiveness of tele-rehabilitation after total hip replacement: a systematic review and meta-analysis of randomized controlled trials. Disabil Rehabil 2023:1-6. [PMID: 37990882 DOI: 10.1080/09638288.2023.2280070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/01/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE To identify articles that evaluated the efficacy of tele-rehabilitation after total hip replacement and to provide a reference for clinical decision-making and continuous improvement of rehabilitation exercise intervention strategies for clinical medical staff. METHODS Embase, PubMed, Web of Science, Medline, China National Knowledge Network and Google Scholar databases were searched for randomized controlled trials of tele-rehabilitation after total hip replacement from inception to March 4, 2023. The two researchers used the PEDro scale to assess the methodological quality of the included studies. Two researchers used the PEDro scale to assess the methodological quality of the included studies. RESULTS Ten studies with 632 participants were analysed.Compared to face-to-face rehabilitation, Internet-based telerehabilitation showed better outcomes in Get-up and go test (SMD -0.54, 95% CI -0.79 to -0.29). telerehabilitation showed no significant difference in outcomes of other functional tests and functional questionnaires. CONCLUSION In this systematic review and meta-analysis, internet-based tele-rehabilitation and face-to-face rehabilitation had the same effect on patients after total hip replacement, and compliance was higher in the tele-rehabilitation group, but attention should be devoted to standardizing this form of rehabilitation to avoid adverse events. In addition, the number and quality of included studies in this study are limited, and the outcome indicators and intervention means have not been unified. More high-quality studies are needed to verify these conclusions to better evaluate the effectiveness and advantages of telerehabilitation.Implications for rehabilitationWith the development of science and technology, remote rehabilitation technology will be applied to various fields of rehabilitation, providing personalized and extensive rehabilitation services.The application of tele-rehabilitation technology to postoperative rehabilitation after total hip arthroplasty is feasible and can reduce the workload of healthcare professionals to a certain extent.This review evaluated the randomized controlled trials of telerehabilitation after total hip arthroplasty, and the results showed that the clinical efficacy of telerehabilitation after total hip arthroplasty was not inferior to that of traditional rehabilitation.
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Affiliation(s)
- Zheng Zhou
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Institute of Sport, Exercise & Health, Tianjin University of Sport, Tianjin, China
| | - Xiang Zhou
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Na Cui
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Institute of Sport, Exercise & Health, Tianjin University of Sport, Tianjin, China
| | - Hongjie Huang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Fan Yang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Gang Yang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Dingge Liu
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Kaiping Liu
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Xin Zhang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Jianquan Wang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
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Unnanuntana A, Kuptniratsaikul V, Srinonprasert V, Charatcharoenwitthaya N, Kulachote N, Papinwitchakul L, Wattanachanya L, Chotanaphuti T. A multidisciplinary approach to post-operative fragility hip fracture care in Thailand - a narrative review. Injury 2023; 54:111039. [PMID: 37757673 DOI: 10.1016/j.injury.2023.111039] [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: 02/06/2023] [Revised: 08/21/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Appropriate care and rehabilitation following surgery for fragility hip fractures in older adults is associated with better outcomes and a greater likelihood of achieving pre-injury functioning. Clinical guidelines specifically for the post-operative care and rehabilitation of patients with hip fractures are scarce; as such, country-specific protocols benchmarked against established guidelines are essential given the wide variation in cultures and beliefs, clinical practice and diverse healthcare systems in Asia. We aimed to provide clinically relevant recommendations for post-operative fragility hip fracture care and rehabilitation to improve patient outcomes and prevent subsequent fractures in Thailand. METHODS A targeted literature review was conducted to identify key evidence on various elements of post-hip fracture care and rehabilitation. Further discussions at a meeting and over email correspondence led to the development of the recommendations which amalgamate available evidence with the clinical experience of the multidisciplinary expert panel. RESULTS Our recommendations are categorized by one period domain - acute post-operative period, and five major domains during the post-operative period - rehabilitation, optimization of bone health, prevention of falls, nutritional supplementation, and prophylaxis for venous thromboembolism. A multidisciplinary approach should be central to the rehabilitation process with the involvement of orthopedists, geriatricians/internists, physiatrists, physical and occupational therapists, endocrinologists, pharmacists and nursing staff. Other key components of our recommendations which we believe contribute to better functional outcomes in older patients undergoing hip fracture surgery include comprehensive pre-operative assessments, early surgery, goal setting for recovery and rehabilitation, early mobilization, medication optimization, tailored exercise plans, adequate coverage with analgesia, assessment and appropriate management of osteoporosis with due consideration of the fracture risk, fall prevention plans, and nutritional assessment and support. Patients and their caregivers should be a part of the recovery process at every step, and they should be counseled and educated appropriately, particularly on the importance of adherence to their rehabilitation plan. CONCLUSION We have provided guidance on the critical domains of clinical care in the post-operative setting to optimize patient outcomes and prevent fracture recurrence. Our recommendations for post-operative care and rehabilitation of older adults with hip fracture can serve as a framework for hospitals across Thailand.
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Affiliation(s)
- Aasis Unnanuntana
- Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand.
| | - Vilai Kuptniratsaikul
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Varalak Srinonprasert
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Natthinee Charatcharoenwitthaya
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Noratep Kulachote
- Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Lalita Wattanachanya
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Chulalongkorn University and Excellence Center for Diabetes, Hormone and Metabolism, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Thanainit Chotanaphuti
- Department of Orthopedics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
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12
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Zhao B, Liu H, Du K, Zhou W, Li Y. Effectiveness and safety of outpatient rehabilitation versus home-based rehabilitation after knee arthroplasty: a systematic review and meta-analysis. J Orthop Surg Res 2023; 18:704. [PMID: 37726800 PMCID: PMC10510230 DOI: 10.1186/s13018-023-04160-2] [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: 06/01/2023] [Accepted: 09/02/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Rehabilitation post-knee arthroplasty is integral to regaining knee function and ensuring patients' overall well-being. The debate over the relative effectiveness and safety of outpatient versus home-based rehabilitation persists. METHODS A thorough literature review was conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across four databases. Two researchers independently identified eligible studies centering on knee arthroplasty patients undergoing either outpatient or home-based rehabilitation. Study quality was assessed using the Cochrane Collaboration's risk of bias tool, while continuous outcomes were subject to meta-analyses using Stata 17 software. RESULTS Our analysis identified no significant differences in primary outcomes, including Range of Motion, Western Ontario and McMaster Universities Arthritis Index, Knee Injury and Osteoarthritis Outcome Score, Oxford Knee Score, and the Knee Society Score, between home-based and outpatient rehabilitation across different follow-up points. Adverse reactions, readmission rates, the need for manipulation under anesthesia, reoperation rate, and post-surgery complications were also similar between both groups. Home-based rehabilitation demonstrated cost-effectiveness, resulting in substantial annual savings. Furthermore, quality of life and patient satisfaction were found to be comparable in both rehabilitation methods. CONCLUSIONS Home-based rehabilitation post-knee arthroplasty appears as an effective, safe, and cost-efficient alternative to outpatient rehabilitation. Despite these findings, further multicenter, long-term randomized controlled trials are required to validate these findings and provide robust evidence to inform early rehabilitation choices post-knee arthroplasty.
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Affiliation(s)
- BiXia Zhao
- Department of Nursing, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, 28 Changsheng West Road, Hengyang, 421001, Hunan Province, China
| | - Hui Liu
- Department of Nursing, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, 28 Changsheng West Road, Hengyang, 421001, Hunan Province, China
| | - Ke Du
- Department of Supervision Office, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, 28 Changsheng West Road, Hengyang, 421001, Hunan Province, China
| | - Wei Zhou
- Department of Emergency, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, 28 Changsheng West Road, Hengyang, 421001, Hunan Province, China.
| | - Ying Li
- Department of Hand and Foot Surgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, 28 Changsheng West Road, Hengyang, 421001, Hunan Province, China.
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Kato N, Iuchi T, Murabayashi K, Tanaka T. Comparison of Smoothness, Movement Speed and Trajectory during Reaching Movements in Real and Virtual Spaces Using a Head-Mounted Display. Life (Basel) 2023; 13:1618. [PMID: 37629476 PMCID: PMC10456102 DOI: 10.3390/life13081618] [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: 06/21/2023] [Revised: 07/11/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
Virtual reality is used in rehabilitation and training simulators. However, whether movements in real and virtual spaces are similar is yet to be elucidated. The study aimed to examine the smoothness, trajectory, and velocity of participants' movements during task performance in real and virtual space. Ten participants performed the same motor task in these two spaces, reaching for targets placed at six distinct positions. A head-mounted display (HMD) presented the virtual space, which simulated the real space environment. The smoothness of movements during the task was quantified and analysed using normalised jerk cost. Trajectories were analysed using the actual trajectory length normalised by the shortest distance to the target, and velocity was analysed using the time of peak velocity. The analysis results showed no significant differences in smoothness and peak velocity time between the two spaces. No significant differences were found in the placement of the six targets between the two spaces. Conversely, significant differences were observed in trajectory length ratio and peak velocity time, albeit with small effect sizes. This outcome can potentially be attributed to the fact that the virtual space was presented from a first-person perspective using an HMD capable of presenting stereoscopic images through binocular parallax. Participants were able to obtain physiological depth information and directly perceive the distance between the target and the effector, such as a hand or a controller, in virtual space, similar to real space. The results suggest that training in virtual space using HMDs with binocular disparity may be a useful tool, as it allows the simulation of a variety of different environments.
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Affiliation(s)
- Norio Kato
- Department of Physical Therapy, Faculty of Health Sciences, Hokkaido University of Science, Sapporo 006-8585, Japan
| | - Tomoya Iuchi
- Shin-Sapporo Orthopaedic Hospital, Sapporo 004-0051, Japan;
| | - Katsunobu Murabayashi
- Division of Rehabilitation Sciences, Graduate School of Health Sciences, Hokkaido University of Science, Sapporo 006-8585, Japan;
- Sapporo Keijinkai Rehabilitation Hospital, Sapporo 060-0010, Japan
| | - Toshiaki Tanaka
- Department of Physical Therapy, Faculty of Health Sciences, Hokkaido University of Science, Sapporo 006-8585, Japan
- The Research Center for Advanced Science and Technology, Institute of Gerontology, The University of Tokyo, Tokyo 113-8656, Japan;
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Mortality and outcome in fragility hip fracture care during COVID-19 pandemic in Police General Hospital, Thailand. Osteoporos Sarcopenia 2023; 9:22-26. [PMID: 37035092 PMCID: PMC10034845 DOI: 10.1016/j.afos.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/07/2023] [Accepted: 03/01/2023] [Indexed: 03/25/2023] Open
Abstract
Objectives The objective of this study is to assess outcomes and patient's mortality of Police General Hospital's fracture liaison service (PGH's FLS) during Coronavirus disease 2019 (COVID-19) outbreak comparing to the former period. Methods Retrospective cohort study was performed in patients aged 50 or older who were admitted with fragility hip fracture in Police General Hospital, Bangkok, between January 1, 2018 to December 31, 2019 (before pandemic) comparing to January 1, 2020 to December 31, 2021 (pandemic) using the electronic database. The outcomes were mortality and other outcomes in one-year follow up. Results A total of 139 fragility hip fractures were recorded in 2018–2019 (before pandemic) compared with 125 in 2020–2021 (pandemic). The 30-day mortality in hip fracture numerically increased from 0% to 2.4% during the pandemic. One-year mortality was significantly escalated from 2 cases (1.4%) to 5 cases (4%) (P = 0.033). However, the cause of mortality was not related with COVID-19 infection. We also found a significantly shorter time to surgery but longer wait time for bone mineral density (BMD) testing and initiation of osteoporosis medication in pandemic period. Conclusions The results of this study in COVID-19 pandemic period, 1-year mortality rate was significantly higher but they were not related with COVID-19 infection. We also found longer time to initial BMD testing and anti-osteoporotic medication and more loss of follow up, causing lower anti-osteoporotic medication taking. In contrast, the time to surgery became shorter during the pandemic.
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Hofmann UK, Hildebrand F, Mederake M, Migliorini F. Telemedicine in orthopaedics and trauma surgery during the first year of COVID pandemic: a systematic review. BMC Musculoskelet Disord 2023; 24:101. [PMID: 36750962 PMCID: PMC9903270 DOI: 10.1186/s12891-023-06194-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/24/2023] [Indexed: 02/09/2023] Open
Abstract
PURPOSE Prior to the COVID-19 pandemic, telemedicine in orthopaedics and trauma surgery had mostly developed for joint arthroplasty, fracture management, and general pre- and postoperative care including teleradiology. With the corona-outbreak, telemedicine was applied on a broad scale to prevent assemblage and to guarantee access to medical care protecting critical areas. The purpose of the present study was to give an overview of the spectrum of clinical applications and the efficacy of telemedicine in orthopaedic and trauma surgery as published in times of the COVID-19 pandemic. METHODS All published studies investigating the application of telemedicine related to orthopaedics and trauma during the COVID-19 pandemic were accessed and screened for suitability. The primary outcome of interest was the efficacy of telemedicine in various clinical applications. The secondary outcome of interest was the spectrum of different applications in which telemedicine applications were investigated. RESULTS The literature search resulted in 1047 articles. After the removal of duplicates, 894 articles were screened of which 31 finally met the inclusion criteria. Dimensions that were described by studies in the literature to have positive effects were preoperative patient optimisation, the usefulness of telemedicine to correctly diagnose a condition, conservative treatment, willingness to and feasibility for telemedicine in patients and doctors, and postoperative/post-trauma care improvement. The efficacy of telemedicine applications or interventions thereby strongly varied and seemed to depend on the exact study design and the research question addressed. CONCLUSION Various successful applications of telemedicine have already been reported in orthopaedics and trauma surgery, with a strong increase in scientific output during the COVID-19 years 2020-2021. Whether the advantages of such an approach will lead to a relevant implementation of telemedicine in everyday clinical practice should be monitored after the COVID-19 pandemic.
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Affiliation(s)
- Ulf Krister Hofmann
- grid.412301.50000 0000 8653 1507Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, Aachen, 52074 Germany
| | - Frank Hildebrand
- grid.412301.50000 0000 8653 1507Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, Aachen, 52074 Germany
| | - Moritz Mederake
- grid.10392.390000 0001 2190 1447Department of Trauma and Reconstructive Surgery, BG Klinik, University of Tübingen, Tübingen, 72076 Germany
| | - Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, Aachen, 52074, Germany.
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Fernández-González M, Lozano-Lozano M, Martín-Martín L, Ortiz-Piña M, Martín-Matillas M, Ariza-Vega P. Is a telerehabilitation programme for older adults with hip fracture associated with burden of family caregivers who provide support? Digit Health 2023; 9:20552076231213574. [PMID: 38025098 PMCID: PMC10656811 DOI: 10.1177/20552076231213574] [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: 01/23/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Objective @ctivehip is a home-based multidisciplinary telerehabilitation programme for older adults with hip fracture, conducted with the assistance of their family caregivers. This programme was useful in improving their functional recovery. Nevertheless, we were concerned about how the programme might have affected caregivers, whose assistance was essential for supporting older adults in using new technologies and ensuring their safety during the exercises and activities at home. The aim of the present study was to compare the burden, psychological factors and physical fitness of the family caregivers of older adults who opted the @ctivehip telerehabilitation programme versus those family caregivers of older adults who received the face-to-face rehabilitation provided by the Andalusian Public Healthcare System (in Spain). Methods In this single-blinded, non-randomized clinical trial, participants were older adults with hip fracture and their family caregivers. The telerehabilitation group (n = 30) underwent a 12-week multidisciplinary telerehabilitation programme, and the comparative group (n = 32) received face-to-face rehabilitation. Caregivers outcomes measured were (i) the burden using the Zarit Burden Interview, (ii) the anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and (iii) the Physical Fitness with the International Fitness Scale (IFIS). Results There were not statistically significant differences on caregiver burden between family caregivers in the @ctivehip and the comparative group, although there was a trend towards lower values [[Mean (95%CI); 14.73 (9.09 to 20.37) vs 16.03 (10.63 to 21.43); p = 0.771] as well as for anxiety and depression [5.66 (3.21 to 8.78) vs 11.19 (8.52 to 13.86); p = 0.022]. Likewise achieved better, though not statistically significant, scores in physical fitness [19.37 (17.94 to 20.81) vs 17.15 (15.77 to 18.53); p = 0.055]. Conclusion Caregiver burden is not associated with telerehabilitation. In addition, telerehabilitation is associated with lower anxiety and depression levels among family caregivers who opt for this programme. Physical fitness is not related with telerehabilitation.
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Affiliation(s)
- María Fernández-González
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- “Cuídate” Support Unit for Oncology Patients, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Lydia Martín-Martín
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- “Cuídate” Support Unit for Oncology Patients, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Mariana Ortiz-Piña
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Miguel Martín-Matillas
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Patrocinio Ariza-Vega
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical Education and Sports, Faculty of Sport Science, University of Granada, Granada, Spain
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17
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The telehealth program of occupational therapy among older people: an up-to-date scoping review. Aging Clin Exp Res 2023; 35:23-40. [PMID: 36344805 PMCID: PMC9640899 DOI: 10.1007/s40520-022-02291-w] [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: 06/14/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND The average life expectancy of older people is increasing, and most seniors desire to age at home and are capable of living independently. Occupational therapy (OT) is client-centered and uses patients' meaningful activities, or occupations, as treatment methods, thus playing an important role in later adulthood. Telemedicine removes the constraints of time and space, and the combination of OT and telemedicine can greatly improve medical efficiency and clinical effectiveness. AIMS The purpose of this scoping review was to examine the scope and effectiveness of telehealth OT for older people. METHODS This scoping review was conducted following the methodological framework proposed by Arksey and O'Malley. We searched the literature in five databases following the PICOS (Population, Intervention, Comparison, Outcome, Study design) guideline, from inception to April 2022. Two trained reviewers independently retrieved, screened, and extracted data, and used a descriptive synthesizing approach to summarize the results. RESULTS The initial search yielded 1249 studies from databases and manual searches, of which 20 were eligible and were included in the final review. A thematic analysis revealed five main themes related to telehealth OT: occupational assessment, occupational intervention, rehabilitation counseling, caregiver support, and activity monitoring. CONCLUSIONS Telehealth OT has been used widely for older people, focusing primarily on occupational assessment and intervention provided conveniently for occupational therapists and older clients. In addition, telehealth OT can monitor patients' activities and provide rehabilitation counseling and health education for the elderly and their caregivers, thus improving the security of their home life and the efficacy of OT. During the COVID-19 pandemic, telehealth will be an effective alternative to face-to-face modalities.
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18
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Impact of telecare interventions on quality of life in older adults: a systematic review. Aging Clin Exp Res 2023; 35:9-21. [PMID: 36417135 DOI: 10.1007/s40520-022-02294-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/20/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Recently, an increase in the older adult population, their chronic diseases, and functional disabilities have led to an increase in the need for more healthcare services. Telecare is one of the solutions for caring these people and can improve their quality of life. AIM The objective of this study was to investigate impact of telecare interventions on quality of life in older adults. METHODS This was a systematic review conducted in 2021. PubMed, Web of Science, Scopus, the Cochrane Library, Embase, IEEE Xplore, and ProQuest databases as well as Google Scholar were searched until the end of 2020 to retrieve relevant articles published in English. The quality of the studies was assessed using the National Institutes of Health (NIH) quality assessment checklists and the mixed-methods appraisal tool (MMAT). The risk of bias in the studies was assessed using version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2) and the risk of bias in non-randomized studies-of interventions (ROBINS-I). RESULTS In total, ten out of 1245 articles identified in the initial search, were included in this study. Telemonitoring (n = 7) and telerehabilitation (n = 3) were the most common methods of telecare interventions. Overall, the findings showed that in most studies, different dimensions of quality of life were improved after using these interventions (p < 0.05). CONCLUSION Evaluating impact of telecare interventions on quality of life, especially in older adults can help system developers to improve current and future telecare technologies to meet users' requirements. Future studies can focus on evaluating the impact of specific telecare systems for a particular target group using different research methodologies.
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Stonsaovapak C, Sangveraphunsiri V, Jitpugdee W, Piravej K. Telerehabilitation in Older Thai Community-Dwelling Adults. Life (Basel) 2022; 12:life12122029. [PMID: 36556393 PMCID: PMC9785691 DOI: 10.3390/life12122029] [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: 11/02/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
To investigate the impact on physical performance and walking abilities associated with fall risk and disability in the senior population, we created a telerehabilitation system. This is a multi-site, community setting, pre−post experimental study. We recruited participants from four rural areas in Thailand. All participants received eight weeks of tele-exercise, three sessions per week, via the telerehabilitation system. After the intervention, all participants underwent the Short Physical Performance Battery (SPPB), Timed Up and Go (TUG) test, and the six-minute walk test (6MWT) using a wearable sensor system. A total of 123 participants participated in the study and 2 participants dropped out while conducting the study, thus 121 participants were included in the analysis. In comparison to the baseline, we discovered a considerable improvement in the SPPB score (0.65 ± 0.22, p < 0.001), TUG (−1.70 ± 0.86, p < 0.001), and 6MWT (10.23 ± 7.33, p = 0.007). Our study demonstrates the benefits of telerehabilitation on SPPB, TUG, and 6MWT related to disabilities and fall risk. This telerehabilitation technology demonstrated its viability in the community environment and demonstrated its capacity to offer fundamental components of remote rehabilitation services within the healthcare system.
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Affiliation(s)
- Chernkhuan Stonsaovapak
- Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
- Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Viboon Sangveraphunsiri
- International School of Engineering Faculty of Engineering, Chulalongkorn University, Bangkok 10330, Thailand
| | - Weerachai Jitpugdee
- Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
| | - Krisna Piravej
- Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
- Correspondence: or
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20
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Backman C, Papp S, Harley A, Houle S, Mamo Y, Poitras S, Shah S, Berdusco R, Beaulé PE, French-Merkley V. Barriers and Enablers to the Use of Web-Based Applications for Older Adults and Their Caregivers Post-Hip Fracture Surgery: A Descriptive Qualitative Study. Clin Interv Aging 2022; 17:1635-1645. [PMID: 36415867 PMCID: PMC9675995 DOI: 10.2147/cia.s384822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/22/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose The purpose of this study was to describe the barriers and enablers to the use of web-based applications designed to help manage the personalized needs of older adults and their caregivers post-hip fracture surgery while transitioning from hospital to geriatric rehabilitation to home. Methods This was a descriptive qualitative study consisting of semi-structured interviews informed by the Theoretical Domains Framework. The study took place between March 2021 and April 2022 on an orthopaedic unit in a large academic health sciences centre and in a geriatric rehabilitation service in Ontario, Canada. The transcripts were analyzed using a systematic 6-step approach. Results Interviews were conducted with older adults (n = 10) and with caregivers (n = 8) post-hip fracture surgery. A total of 21 barriers and 24 enablers were identified. The top two barriers were a need for basic computer skills (n = 11, 61.1%) and a preference for direct verbal communication (n = 10, 55.6%). The top two enablers were having no concerns with using web-based applications (n = 12, 66.7%) and having ease of access to information (n = 10, 55.6%). Conclusion We described the key barriers and enablers to the use of web-based applications from the perspectives of older adults and their caregivers. These factors will inform further developments of web-based applications aimed at improving the care transition from hospital to geriatric rehabilitation to home post-hip fracture surgery.
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Affiliation(s)
- Chantal Backman
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
- Bruyère Research Institute, Ottawa, Canada
- Correspondence: Chantal Backman, 451, Smyth Road, RGN 3239, Ottawa, ON, K1H 8M5, Canada, Tel +1 613-562-5800 ext. 8418, Email
| | - Steve Papp
- Department of Orthopaedics, The Ottawa Hospital, Ottawa, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Anne Harley
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Geriatric Rehabilitation, Bruyère Continuing Care, Ottawa, Canada
| | - Sandra Houle
- Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Yeabsira Mamo
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Stephane Poitras
- Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Soha Shah
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Geriatric Rehabilitation, Bruyère Continuing Care, Ottawa, Canada
| | - Randa Berdusco
- Department of Orthopaedics, The Ottawa Hospital, Ottawa, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Paul E Beaulé
- Department of Orthopaedics, The Ottawa Hospital, Ottawa, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Veronique French-Merkley
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Geriatric Rehabilitation, Bruyère Continuing Care, Ottawa, Canada
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21
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Anusitviwat C, Vanitcharoenkul E, Chotiyarnwong P, Unnanuntana A. Surgical treatment for fragility hip fractures during the COVID-19 pandemic resulted in lower short-term postoperative functional outcome and a higher complication rate compared to the pre-pandemic period. Osteoporos Int 2022; 33:2217-2226. [PMID: 35809122 PMCID: PMC9540207 DOI: 10.1007/s00198-022-06485-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022]
Abstract
UNLABELLED The COVID-19 pandemic adversely affected the functional outcomes of fragility hip fracture patients. This study revealed a higher in-hospital complication rate and lower postoperative function at 3 months among patients treated during the pandemic. Therefore, modified in-hospital and post-discharge protocols should be developed for implementation during pandemic crisis periods. INTRODUCTION This study aims to investigate the in-hospital complication rate and short-term postoperative functional outcomes of fragility hip fracture (FHF) patients compared between during the COVID-19 pandemic and the same 14-month time period 1 year prior to the pandemic. METHODS Using data from the Siriraj Fracture Liaison Service registry, FHF patients treated during the COVID-19 pandemic (1 March 2020 to 30 April 2021) were time-matched with FHF patients treated during the pre-pandemic period (1 March 2018 to 30 April 2019). We collected the rate of in-hospital postoperative complications and the postoperative functional outcomes at discharge and 3 months as measured by the Barthel Index (BI) and EuroQol visual analog scale (EQ-VAS). Functional outcome measures were compared between the pre-pandemic and pandemic periods. RESULTS There were 197 and 287 patients in the pre-pandemic and pandemic groups, respectively. At the 3-month postoperative follow-up, the mean postoperative BI score and change in BI score were both significantly lower in the pandemic group indicating poorer postoperative function. Moreover, FHF patients treated during the pandemic had significantly more in-hospital complications (36.6% vs. 22.8%, p = 0.002). There was no significant difference in the 3-month EQ-VAS or change in the EQ-VAS between groups. CONCLUSION The results of this study revealed a higher in-hospital complication rate and lower postoperative function at 3 months among FHF patients treated during the COVID-19 pandemic compared to the pre-pandemic period. Therefore, modified in-hospital and post-discharge protocols should be developed for implementation during pandemic crisis periods.
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Affiliation(s)
- Chirathit Anusitviwat
- Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Ekasame Vanitcharoenkul
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pojchong Chotiyarnwong
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Aasis Unnanuntana
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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22
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Saag JL, Danila MI. Remote Management of Osteoporosis. CURRENT TREATMENT OPTIONS IN RHEUMATOLOGY 2022; 8:143-151. [PMID: 36068838 PMCID: PMC9438367 DOI: 10.1007/s40674-022-00195-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/28/2022]
Abstract
Purpose of Review Osteoporosis management has evolved significantly over the past decade, with telehealth emerging as an effective tool to manage bone health in a growing patient population. This review explores the advantages and disadvantages of telehealth use for osteoporosis management while highlighting recent studies of clinical importance. Recent Findings A wide variety of telehealth approaches are used today, from phone or video telemedicine appointments with physicians and advanced practice providers, to electronic systems for triage and consultation with osteoporosis specialists. Contemporary studies show that telehealth can facilitate health care access to underserved communities and enhance physician–patient communication, as well as provide patient education. However, barriers such as inexperience or lack of access to technology, suboptimal patient-clinician relationship building process, and difficulties with follow-up have limited the use of telehealth to certain situations. Summary Telehealth has proven to be an effective resource for managing and treating osteoporosis patients. As its use continues to grow, important limitations must be accounted for to avoid lapses in care. Further research should keep these factors in mind as the use of this technology progresses.
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Affiliation(s)
- Jordan L. Saag
- University of Central Florida College of Medicine, 6850 Lake Nona Blvd., Orlando, FL 32827 USA
| | - Maria I. Danila
- Geriatric Research Education and Clinical Center (GRECC) Birmingham VA Medical Center, 700 19th St. S., Birmingham, AL 35233 USA
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Mora‐Traverso M, Molina‐Garcia P, Prieto‐Moreno R, Borges‐Cosic M, Cruz Guisado V, Pino Algarrada R, Moreno‐Ramírez P, Gomez‐Jurado G, Gomez Tarrias C, Hidalgo Isla M, Jimenez Andrés P, Linares Gago M, Lirola‐Liebanas A, Mesa‐Ruiz A, Muñoz‐Garach A, Salazar‐Graván S, Estevez‐Lopez F, Martín‐Matillas M, Ariza‐Vega P. An m‐Health telerehabilitation and health education program on physical performance in patients with hip fracture and their family caregivers: Study protocol for the ActiveHip+ randomized controlled trial. Res Nurs Health 2022; 45:287-299. [DOI: 10.1002/nur.22218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Marta Mora‐Traverso
- Biohealth Research Institute (ibs.Granada) Physical Medicine and Rehabilitation Service Virgen de las Nieves University Hospital Granada Spain
| | - Pablo Molina‐Garcia
- Biohealth Research Institute (ibs.Granada) Physical Medicine and Rehabilitation Service Virgen de las Nieves University Hospital Granada Spain
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences Sport and Health University Research Institute (iMUDS), University of Granada Granada Spain
| | - Rafael Prieto‐Moreno
- Department of Physical and Sport Education, PA‐HELP “Physical Activity for HEaLth Promotion” Research Group, Faculty of Sports Sciences University of Granada Granada Spain
| | - Milkana Borges‐Cosic
- Department of Physical and Sport Education, PA‐HELP “Physical Activity for HEaLth Promotion” Research Group, Faculty of Sports Sciences University of Granada Granada Spain
- Department of Physical Education, Faculty of Education Sciences University of Cádiz Cádiz Spain
| | - Victor Cruz Guisado
- Department of Physical Medicine and Rehabilitation University Hospital Jerez de la Frontera Cadiz Spain
| | - Rogelio Pino Algarrada
- Department of Physical Medicine and Rehabilitation University Hospital Puerto Real Cadiz Spain
| | - Paz Moreno‐Ramírez
- Department of Physical Medicine and Rehabilitation University Hospital Virgen de las Nieves Granada Spain
| | - Gema Gomez‐Jurado
- Department of Physical Medicine and Rehabilitation University Hospital Virgen de las Nieves Granada Spain
| | - Consuelo Gomez Tarrias
- Department of Physical Medicine and Rehabilitation University Hospital Virgen de las Nieves Granada Spain
| | - Margarita Hidalgo Isla
- Department of Physical Medicine and Rehabilitation University Hospital Puerto Real Cadiz Spain
| | - Patricia Jimenez Andrés
- Department of Physical Medicine and Rehabilitation University Hospital Jerez de la Frontera Cadiz Spain
| | - Marta Linares Gago
- Department of Physical Medicine and Rehabilitation University Hospital Puerto Real Cadiz Spain
| | - Ana Lirola‐Liebanas
- Department of Physical Medicine and Rehabilitation University Hospital Virgen de las Nieves Granada Spain
| | - Antonio Mesa‐Ruiz
- Department of Physical Medicine and Rehabilitation University Hospital Virgen de las Nieves Granada Spain
| | - Araceli Muñoz‐Garach
- Department of Endocrinology and Nutrition University Hospital Virgen de las Nieves Granada Spain
| | - Susana Salazar‐Graván
- Department of Physical Medicine and Rehabilitation University Hospital Virgen de las Nieves Granada Spain
| | - Fernando Estevez‐Lopez
- Department of Child and Adolescent Psychiatry/Psychology Erasmus MC University Medical Center Rotterdam The Netherlands
| | - Miguel Martín‐Matillas
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences Sport and Health University Research Institute (iMUDS), University of Granada Granada Spain
| | - Patrocinio Ariza‐Vega
- Biohealth Research Institute (ibs.Granada) Physical Medicine and Rehabilitation Service Virgen de las Nieves University Hospital Granada Spain
- Department of Physical and Sport Education, PA‐HELP “Physical Activity for HEaLth Promotion” Research Group, 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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Hsu CH, Huang HT, Chen CH, Fu YC, Chou PH, Hsu NC. Global Impact of the COVID-19 Pandemic on Orthopedics and the Implications of Telemedicine: A Systematic Review of the Literature. J Clin Med 2022; 11:jcm11112983. [PMID: 35683371 PMCID: PMC9181233 DOI: 10.3390/jcm11112983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/16/2022] [Accepted: 05/21/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to systematically review the literature on the impact of the coronavirus disease (COVID-19) pandemic on the orthopedics field by focusing on multiple aspects, including orthopedic training and application, performance, work loading, change of practice, research work, and other psychological factors. Published articles were searched using the PubMed database. Articles were selected in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Of 58 studies published between 1 January 2020 and 1 October 2021, 57 peer-reviewed original articles were included. Nearly 90% of students experienced an impact of the pandemic on application. The impact on training stemmed from redeployment rates of 20.9–23.1%. The rate of emergency or outpatient visits decreased from 18% to 58.6%. The rates of all surgeries or emergency surgeries decreased by 15.6–49.4%, while the rates of elective surgeries decreased by 43.5–100%. The rate of work loading ranged from 33% to 66%. Approximately 50–100% of surgeons had a change of practice. A total of 40.5% of orthopedic surgeons experienced mild psychological pressure. Approximately 64% had stopped research participant recruitment. Most of the included studies were conducted in Europe, followed by Asia and North America. It is suggested orthopedic surgeons prepare more sufficient, flexible, and reservable staffing measures, proper preventive strategies and surgical scheduling algorithms, and set up dedicated venues and equipment for routine telemedicine with staff training for virtual teaching or consultations in case of future impacts on orthopedics.
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Affiliation(s)
- Chia-Hao Hsu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan; (C.-H.H.); (C.-H.C.); (P.-H.C.)
- Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, No. 68, Jhonghua 3rd Rd., Cianjin District, Kaohsiung 80145, Taiwan;
- Department of Orthopedics, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Sanmin District, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan
| | - Hsuan-Ti Huang
- Department of Orthopedics, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Sanmin District, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan
| | - Chung-Hwan Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan; (C.-H.H.); (C.-H.C.); (P.-H.C.)
- Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, No. 68, Jhonghua 3rd Rd., Cianjin District, Kaohsiung 80145, Taiwan;
- Department of Orthopedics, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Sanmin District, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan
| | - Yin-Chih Fu
- Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, No. 68, Jhonghua 3rd Rd., Cianjin District, Kaohsiung 80145, Taiwan;
- Department of Orthopedics, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Sanmin District, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan
| | - Pei-Hsi Chou
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan; (C.-H.H.); (C.-H.C.); (P.-H.C.)
- Department of Orthopedics, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Sanmin District, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, No. 100, Shiquan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan
| | - Nin-Chieh Hsu
- Department of Internal Medicine, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng District, Taipei 10002, Taiwan
- Correspondence: ; Tel.: +886-2-23123456 (ext. 65130)
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Orthopaedic, trauma surgery, and Covid-2019 pandemic: clinical panorama and future prospective in Europe. Eur J Trauma Emerg Surg 2022; 48:4385-4402. [PMID: 35523966 PMCID: PMC9075714 DOI: 10.1007/s00068-022-01978-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/16/2022] [Indexed: 12/13/2022]
Abstract
Purpose This study investigated the impact of the Covid-19 pandemic in Europe on consultations, surgeries, and traumas in the field of orthopaedic and trauma surgery. Strategies to resume the clinical activities were also discussed. Methods This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the 2020 PRISMA statement. All the comparative studies reporting data on the impact of Covid-19 in the field of orthopaedic and trauma surgery in Europe were accessed. Only comparative clinical studies which investigated the year 2020 versus 2019 were eligible. Results 57 clinical investigations were included in the present study. Eight studies reported a reduction of the orthopaedic consultations, which decreased between 20.9 and 90.1%. Seven studies reported the number of emergency and trauma consultations, which were decreased between 37.7 and 74.2%. Fifteen studies reported information with regard to the reasons for orthopaedic and trauma admissions. The number of polytraumas decreased between 5.6 and 77.1%, fractures between 3.9 and 63.1%. Traffic accidents admissions dropped by up to 88.9%, and sports-related injuries dropped in a range of 59.3% to 100%. The overall reduction of the surgical interventions ranged from 5.4 to 88.8%. Conclusion The overall trend of consultations, surgeries, and rate of traumas and fragility fractures appear to decrease during the 2020 European COVID pandemic compared to the pre-pandemic era. Given the heterogeneities in the clinical evidence, results from the present study should be considered carefully. Level of evidence Level IV, systematic review.
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Happe L, Sgraja M, Hein A, Diekmann R. Iterative Development and Applicability of a Tablet-Based e-Coach for Older Adults in Rehabilitation Units to Improve Nutrition and Physical Activity: Usability Study. JMIR Hum Factors 2022; 9:e31823. [PMID: 35293874 PMCID: PMC8968623 DOI: 10.2196/31823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/01/2021] [Accepted: 12/29/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Maintaining nutrition and exercise strategies after rehabilitation can be difficult for older people with malnutrition or limited mobility. A technical assistance system such as an e-coach could help to positively influence changes in dietary and exercise behavior and contribute to a sustainable improvement in one's nutrition and mobility status. Most apps do not provide a combination of nutrition and exercise content. In most cases, these apps were evaluated with healthy individuals aged <70 years, making transferability to vulnerable patients, with functional limitations and an assumed lower affinity for technology, in geriatric rehabilitation unlikely. OBJECTIVE This study aims to identify the potential for optimization and enhance usability through iterative test phases to develop a nutrition and mobility e-coach suitable for older adults (≥65 years) based on individual health behavior change stages in a rehabilitation setting. METHODS Iterative testing was performed with patients aged ≥65 years in a rehabilitation center. During testing, participants used an e-coach prototype with educational elements and active input options on nutrition and mobility as a 1-time application test. The participants performed navigation and comprehension tasks and subsequently provided feedback on the design aspects. Hints were provided by the study team when required, documented, and used for improvements. After testing, the participants were asked to rate the usability of the prototype using the System Usability Scale (SUS). RESULTS In all, 3 iterative test phases (T1-T3) were conducted with 49 participants (24/49, 49% female; mean 77.8, SD 6.2 years). Improvements were made after each test phase, such as adding explanatory notes on overview screens or using consistent chart types. The use of the user-centered design in this specific target group facilitated an increase in the average SUS score from 69.3 (SD 16.3; median 65) at T1 to 78.1 (SD 11.8; median 82.5) at T3. Fewer hints were required for navigation tasks (T1: 14.1%; T2: 26.5%; T3: 17.2%) than for comprehension questions (T1: 30.5%; T2: 21.6%; T3: 20%). However, the proportion of unsolved tasks, calculated across all participants in all tasks, was higher for navigation tasks (T1: 0%, T2: 15.2%, T3: 4.3%) than for comprehension tasks (T1: 1.9%, T2: 0%, T3: 2.5%). CONCLUSIONS The extensive addition of explanatory sentences and terms, instead of shorter keywords, to make it easier for users to navigate and comprehend the content was a major adjustment. Thus, good usability (SUS: 80th-84th percentile) was achieved using iterative optimizations within the user-centered design. Long-term usability and any possible effects on nutritional and physical activity behavior need to be evaluated in an additional study in which patients should be able to use the e-coach with increasing independence, thereby helping them to gain access to content that could support their long-term behavior change.
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Affiliation(s)
- Lisa Happe
- Department of Health Services Research, Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Marie Sgraja
- Department of Health Services Research, Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Andreas Hein
- Department of Health Services Research, Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Rebecca Diekmann
- Department of Health Services Research, Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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Prieto-Moreno R, Estévez-López F, Molina-Garcia P, Mora-Traverso M, Deschamps K, Claeys K, de Buyser J, Ariza-Vega P. ActiveHip+: A feasible mHealth system for the recovery of older adults after hip surgery during the COVID-19 pandemic. Digit Health 2022; 8:20552076221139694. [PMID: 36420319 PMCID: PMC9677169 DOI: 10.1177/20552076221139694] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/01/2022] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVE Half of older adults undergoing hip surgery do not recover their previous functional status. mHealth is a promising tool for rehabilitating older adults after hip surgery. This study aimed to test the feasibility of the ActiveHip+ mHealth system in older adults after hip surgery. METHODS Sixty-nine older adults who had undergone hip surgery and their family caregivers were recruited from hospitals in Spain and Belgium and used the ActiveHip+ mHealth system for 12 weeks. Assessments were made during hospital stay and 3 months after surgery. Feasibility assessment included: adoption (participation proportion), usage (access to the app), satisfaction with the app (Net Promoter Score) and user perception of the quality of the app (Mobile App Rating Scale). Clinical assessment included: patient-reported outcomes, such as functional status (Functional Independence Measure) and performance-based outcomes, such as physical fitness (Short Physical Performance Battery). RESULTS The ActiveHip+ mHealth system obtained satisfactory feasibility results in both countries. In Spain, we observed 85% adoption, 64% usage, 8.86/10 in satisfaction with the app and 4.42/5 in perceived quality of the app. In Belgium, we observed 82% adoption, 84% usage, 5.16/10 in satisfaction with the app and 3.52/5 in app's perceived quality. The intervention had positive effects on levels of functional status, pain and physical fitness. CONCLUSIONS The ActiveHip+ mHealth system is a feasible tool to conduct the rehabilitation in older adults after hip surgery. Although the intervention seemed beneficial clinically, we do not recommend its implementation in clinical settings until appropriately designed randomised clinical trials confirm these results.
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Affiliation(s)
- Rafael Prieto-Moreno
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
| | - Fernando Estévez-López
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Pablo Molina-Garcia
- 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 Sports Science, University of Granada, Granada, Spain
| | - Marta Mora-Traverso
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
| | - Kevin Deschamps
- Department of Rehabilitation Sciences, KU Leuven, Musculoskeletal Rehabilitation Research Group, Campus Brugge, Leuven, Flanders, Belgium
- Clinical Motion Analysis Laboratorium, University Hospitals Leuven, Campus Pellenberg, Leuven, Flanders, Belgium
- Division of Podiatry, Haute Ecole Leonard De Vinci, Institut D’Enseignement Supérieur Parnasse Deux-Alice, Bruxelles, Belgium
- Department of Podiatry, Artevelde University College, Gent, Belgium
| | - Kurt Claeys
- Department of Rehabilitation Sciences, KU Leuven, Musculoskeletal Rehabilitation Research Group, Campus Brugge, Leuven, Flanders, Belgium
| | - Janou de Buyser
- Department of Rehabilitation Sciences, KU Leuven, Musculoskeletal Rehabilitation Research Group, Campus Brugge, Leuven, Flanders, Belgium
| | - Patrocinio Ariza-Vega
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
- Department of Physiotherapy, Faculty of Health Science, University of Granada, Granada, Spain
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Does Telerehabilitation Help in Reducing Disability among People with Musculoskeletal Conditions? A Preliminary Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010072. [PMID: 35010331 PMCID: PMC8751178 DOI: 10.3390/ijerph19010072] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 01/23/2023]
Abstract
Introduction: During the coronavirus pandemic, an initiative was launched in Saudi Arabia to provide telerehabilitation for people with musculoskeletal conditions who were unable to access in-person physiotherapy due to the associated lockdown. The purpose of this study was to explore the therapeutic impact and acceptability of telerehabilitation among the Saudi population. Methods: Ninety-five participants were recruited through an online advertisement and received a physiotherapy consultation and interventions via an online video conference platform (Google Meet). Following screening for red flags, participants received tailored education and conditioning exercises 2–3 times a week for 6 weeks. Outcome measures were recorded at baseline and 6 weeks and comprised the Pain Self-Efficacy Questionnaire, Patient-Specific Functional Scale, Musculoskeletal Health Questionnaire and a satisfaction survey. Results: The most frequent musculoskeletal conditions reported were lower back (37%), knee (14%) and neck (10%) pain and post-operative conditions (15%). Participants showed significant improvements in outcomes at the end of the program (p < 0.001) with effect sizes ranging from 0.6 to −1.9 and reported a high level of satisfaction with the telerehabilitation intervention. Conclusion: This study showed that telerehabilitation was an acceptable method of providing physiotherapy interventions for patients with musculoskeletal conditions in Saudi Arabia.
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Kokorelias KM, Nelson MLA, Tang T, Steele Gray C, Ellen M, Plett D, Jarach CM, Xin Nie J, Thavorn K, Singh H. Who is Included in Digital Health Technologies to Support Hospital to Home Transitions for Older Adults?: Secondary analysis of a rapid review and equity-informed recommendations (Preprint). JMIR Aging 2021; 5:e35925. [PMID: 35475971 PMCID: PMC9096639 DOI: 10.2196/35925] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 12/25/2022] Open
Affiliation(s)
- Kristina Marie Kokorelias
- St John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, Sinai Health System/University Health Network, Toronto, ON, Canada
| | - Michelle LA Nelson
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- March of Dimes Canada, Toronto, ON, Canada
| | - Terence Tang
- Institute for Better Health, Trillium Health Partners, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Carolyn Steele Gray
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Moriah Ellen
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Health Policy and Management, Ben-Gurion University of the Negev, Eilat, Israel
- Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Eilat, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Eilat, Israel
| | - Donna Plett
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Carlotta Micaela Jarach
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Jason Xin Nie
- Institute for Better Health, Trillium Health Partners, Toronto, ON, Canada
| | - Kednapa Thavorn
- Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Hardeep Singh
- March of Dimes Canada, Toronto, ON, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Ariza-Vega P, Prieto-Moreno R, Castillo-Pérez H, Martínez-Ruiz V, Romero-Ayuso D, Ashe MC. Family Caregivers' Experiences with Tele-Rehabilitation for Older Adults with Hip Fracture. J Clin Med 2021; 10:jcm10245850. [PMID: 34945145 PMCID: PMC8708159 DOI: 10.3390/jcm10245850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/02/2021] [Accepted: 12/08/2021] [Indexed: 01/17/2023] Open
Abstract
Background: There is a knowledge gap for implementing tele-rehabilitation (telerehab) after hip fracture. We recently conducted a clinical trial (ClinicalTrials.gov Identifier: NCT02968589) to test a novel online family caregiver-supported rehabilitation program for older adults with hip fracture, called @ctivehip. In this qualitative substudy, our objective was to use semi-structured interviews to explore family caregivers experience with the telerehab program. Methods: Twenty-one family caregivers were interviewed between three and six months after the older adults completed @ctivehip. One occupational therapist with research and clinical experience, but not involved in the main trial, conducted and transcribed the interviews. We conducted a multi-step content analysis, and two authors completed one coding cycle and two recoding cycles. Results: Family caregivers who enrolled in @ctivehip were satisfied with the program, stated it was manageable to use, and perceived benefits for older adults’ functional recovery after hip fracture. They also suggested improvements for the program content, such as more variety with exercises, and increased monitoring by health professionals. Conclusions: This work extends existing literature and generates research hypotheses for future studies to test telerehab content and program implementation.
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Affiliation(s)
- Patrocinio Ariza-Vega
- Department of Physiotherapy, University of Granada, 18016 Granada, Spain; (P.A.-V.); (D.R.-A.)
- Physical Medicine and Rehabilitation Service, Biohealth Research Institute, Virgen de las Nieves University Hospital, 18012 Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, 18071 Granada, Spain
| | - Rafael Prieto-Moreno
- Physical Medicine and Rehabilitation Service, Biohealth Research Institute, Virgen de las Nieves University Hospital, 18012 Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, 18071 Granada, Spain
- Correspondence:
| | | | - Virginia Martínez-Ruiz
- Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, 18016 Granada, Spain;
- Center for Biomedical Research in Network of Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18014 Granada, Spain
| | - Dulce Romero-Ayuso
- Department of Physiotherapy, University of Granada, 18016 Granada, Spain; (P.A.-V.); (D.R.-A.)
| | - Maureen C. Ashe
- Centre for Hip Health and Mobility, Department of Family Practice, University of British Columbia, Vancouver, BC V5Z 1M9, Canada;
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