1
|
Chagnon M, Levasseur M, Boissy P. Telehealth interventions in occupational therapy with older adults: Results from a scoping review targeting better health promotion. Aust Occup Ther J 2024; 71:190-208. [PMID: 37885381 DOI: 10.1111/1440-1630.12910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION Telehealth interventions have the potential to enhance access to care and improve efficiency while reducing the burden on patients. Although telehealth interventions are well accepted and adopted in physical therapy, their usage in occupational therapy for older adults is less common, and limited information exists regarding their setting and context. OBJECTIVE To provide an inventory and synthesis of telehealth interventions in occupational therapy for older adults. METHOD For published studies on telehealth-based occupational therapy interventions in older adults between 2000 and 2022, six databases were reviewed. Data extraction and analysis were guided by the taxonomies developed by Tulu, McColl and Law and informed by the Canadian Model of Occupational Performance and Engagement. FINDINGS Twenty-three studies on telehealth interventions in occupational therapy for older adults were identified, mostly from North American authors (n = 11; 47.8%) and randomised clinical trials (n = 9; 39.1%). Most participants had a health problem (n = 20; 87.0%), mainly stroke (n = 9; 39.1%). Interventions focussed primarily on symptom management education (n = 12; 52.2%) of community-dwelling adults with health conditions, using videoconferencing systems or applications (n = 14; 60.7%). Interventions were delivered from the healthcare centre (n = 6; 26.1%) to the person's home (n = 18; 78.3%) synchronously (n = 19; 82.6%). About one third (n = 8; 34.8%) of the studies specified the therapist's location. CONCLUSION Published studies on telehealth interventions in occupational therapy with older adults have mainly focussed on the synchronous training and education of participants using videoconferencing systems or applications. According to these studies, the scope of interventions is limited and could be expanded, for example, through occupational development and environmental modification. To better understand and describe best practices in the use of telehealth in occupational therapy, future studies should provide more details about the interventions performed, the technology used and the environmental settings of the therapist.
Collapse
Affiliation(s)
- Mathilde Chagnon
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Research Centre on Aging, Health, and Social Services Centre, University Institute of Geriatric of Sherbrooke (CSSS-IUGS), Sherbrooke, Québec, Canada
| | - Mélanie Levasseur
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Research Centre on Aging, Health, and Social Services Centre, University Institute of Geriatric of Sherbrooke (CSSS-IUGS), Sherbrooke, Québec, Canada
| | - Patrick Boissy
- Research Centre on Aging, Health, and Social Services Centre, University Institute of Geriatric of Sherbrooke (CSSS-IUGS), Sherbrooke, Québec, Canada
- Department of Surgery, Orthopedic Division, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| |
Collapse
|
2
|
Kudritzki V, Howard IM. Telehealth-based exercise in amyotrophic lateral sclerosis. Front Neurol 2023; 14:1238916. [PMID: 37564731 PMCID: PMC10410446 DOI: 10.3389/fneur.2023.1238916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/04/2023] [Indexed: 08/12/2023] Open
Abstract
The Veterans Health Administration (VHA) has served as a leader in the implementation of telerehabilitation technologies and continues to expand utilization of non-traditional patient encounters to better serve a geographically and demographically diverse population. Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease impacting Veterans at a higher rate than the civilian population and associated with high levels of disability and limited access to subspecialized care. There is growing evidence supporting exercise-based interventions as an independent or adjunctive treatment to maintain or restore function for this patient population; many of these interventions can be delivered remotely by telehealth. The recent advancements in disease-modifying therapies for neuromuscular disorders will likely increase the importance of rehabilitation interventions to maximize functional outcomes. Here, we review the evidence for specific exercise interventions in ALS and the evidence for telehealth-based exercise in neuromuscular disorders. We then use this existing literature to propose a framework for telehealth delivery of these treatments, including feasible exercise interventions and remote outcome measures, recommended peripheral devices, and an example of a current remote group exercise program offered through VHA.
Collapse
Affiliation(s)
- Virginia Kudritzki
- Rehabilitation Care Services, VA Puget Sound Healthcare System, Seattle, WA, United States
| | - Ileana M. Howard
- Rehabilitation Care Services, VA Puget Sound Healthcare System, Seattle, WA, United States
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| |
Collapse
|
3
|
Abstract
Telerehabilitation refers to the virtual delivery of rehabilitation services into the patient's home. This methodology has shown to be advantageous when used to enhance or replace conventional therapy to overcome geographic, physical, and cognitive barriers. The exponential growth of technology has led to the development of new applications that enable health care providers to monitor, educate, treat, and support patients in their own environment. Best practices and well-designed Telerehabilitation studies are needed to build and sustain a strong Telerehabilitation system that is integrated in the current health care structure and is cost-effective.
Collapse
|
4
|
Gustafsson L, Martin A, Buijsman L, Poerbodipoero S, Liddle J, Ireland D. Parallel-Forms Reliability and Clinical Utility of an Application Version of the Activity Card Sort Australia (18-64). Am J Occup Ther 2019; 72:7206205070p1-7206205070p8. [PMID: 30760399 DOI: 10.5014/ajot.2018.028688] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study examined the parallel-forms reliability of a web application (app) of the Activity Card Sort Australia for adults ages 18-64 and assessed its clinical utility. METHOD Forty-eight participants completed the app and card versions of the tool within a 2- to 3-wk interval and provided feedback via a purpose-designed survey. Intraclass correlation analysis tested parallel-forms reliability. RESULTS The app demonstrated acceptable parallel-forms reliability for overall retained activity level (r = .75, p < .001), the daily life domain (r = .77, p < .001), and the recreation and relaxation domain (r = .74, p < .001), but not for the physical activity domain (r = .59, p < .001). Clinical utility responses suggested good acceptance of both versions. CONCLUSION The results suggest that further studies are required before the app version can be used for research or in clinical settings.
Collapse
Affiliation(s)
- Louise Gustafsson
- Louise Gustafsson, BOccThy(Hons), PhD, is Professor in Occupational Therapy, School of Allied Health Sciences, Griffith University, Nathan, Queensland, Australia, and Honorary Associate Professor, School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, Queensland, Australia;
| | - Aleysha Martin
- Aleysha Martin, BOccThy(Hons), is Occupational Therapist, Mater Hospital, Brisbane, Queensland, Australia. At the time of the study, she was Student, School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, Queensland, Australia
| | - Liane Buijsman
- Liane Buijsman, BScOT(Hons), BSc, is Consultant, Heiloo, the Netherlands. At the time of the study, she was Student, Occupational Therapy Department, Amsterdam School of Higher Professional Education, Amsterdam, the Netherlands
| | - Soemitro Poerbodipoero
- Soemitro Poerbodipoero, BScOT(Hons), is Lecturer and Head of Education, Occupational Therapy Department, Amsterdam School of Higher Professional Education, Amsterdam, the Netherlands
| | - Jacki Liddle
- Jacki Liddle, BOccThy(Hons), PhD, is Research Fellow, School of Information Technology and Electrical Engineering, University of Queensland, St. Lucia, Queensland, Australia
| | - David Ireland
- David Ireland, BEng, MPhil, PhD, is Research Scientist, Australian Ehealth Research Centre, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Queensland, Australia
| |
Collapse
|
5
|
Watzlaf VJM, Zhou L, Dealmeida DR, Hartman LM. A Systematic Review of Research Studies Examining Telehealth Privacy and Security Practices used by Healthcare Providers. Int J Telerehabil 2017; 9:39-59. [PMID: 29238448 PMCID: PMC5716616 DOI: 10.5195/ijt.2017.6231] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
The objective of this systematic review was to systematically review papers in the United States that examine current practices in privacy and security when telehealth technologies are used by healthcare providers. A literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). PubMed, CINAHL and INSPEC from 2003 - 2016 were searched and returned 25,404 papers (after duplications were removed). Inclusion and exclusion criteria were strictly followed to examine title, abstract, and full text for 21 published papers which reported on privacy and security practices used by healthcare providers using telehealth. Data on confidentiality, integrity, privacy, informed consent, access control, availability, retention, encryption, and authentication were all searched and retrieved from the papers examined. Papers were selected by two independent reviewers, first per inclusion/exclusion criteria and, where there was disagreement, a third reviewer was consulted. The percentage of agreement and Cohen's kappa was 99.04% and 0.7331 respectively. The papers reviewed ranged from 2004 to 2016 and included several types of telehealth specialties. Sixty-seven percent were policy type studies, and 14 percent were survey/interview studies. There were no randomized controlled trials. Based upon the results, we conclude that it is necessary to have more studies with specific information about the use of privacy and security practices when using telehealth technologies as well as studies that examine patient and provider preferences on how data is kept private and secure during and after telehealth sessions.
Collapse
Affiliation(s)
- Valerie J M Watzlaf
- DEPARTMENT OF HEALTH INFORMATION MANAGEMENT, SCHOOL OF HEALTH AND REHABILITATION SCIENCES, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PA, USA
| | - Leming Zhou
- DEPARTMENT OF HEALTH INFORMATION MANAGEMENT, SCHOOL OF HEALTH AND REHABILITATION SCIENCES, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PA, USA
| | - Dilhari R Dealmeida
- DEPARTMENT OF HEALTH INFORMATION MANAGEMENT, SCHOOL OF HEALTH AND REHABILITATION SCIENCES, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PA, USA
| | - Linda M Hartman
- DEPARTMENT OF HEALTH INFORMATION MANAGEMENT, SCHOOL OF HEALTH AND REHABILITATION SCIENCES, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PA, USA
| |
Collapse
|
6
|
Fleming JN, Taber DJ, McElligott J, McGillicuddy JW, Treiber F. Mobile Health in Solid Organ Transplant: The Time Is Now. Am J Transplant 2017; 17:2263-2276. [PMID: 28188681 DOI: 10.1111/ajt.14225] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/24/2017] [Accepted: 02/04/2017] [Indexed: 01/25/2023]
Abstract
Despite being in existence for >40 years, the application of telemedicine has lagged significantly in comparison to its generated interest. Detractors include the immobile design of most historic telemedicine interventions and the relative lack of smartphones among the general populace. Recently, the exponential increase in smartphone ownership and familiarity have provided the potential for the development of mobile health (mHealth) interventions that can be mirrored realistically in clinical applications. Existing studies have demonstrated some potential clinical benefits of mHealth in the various phases of solid organ transplantation (SOT). Furthermore, studies in nontransplant chronic diseases may be used to guide future studies in SOT. Nevertheless, substantially more must be accomplished before mHealth becomes mainstream. Further evidence of clinical benefits and a critical need for cost-effectiveness analysis must prove its utility to patients, clinicians, hospitals, insurers, and the federal government. The SOT population is an ideal one in which to demonstrate the benefits of mHealth. In this review, the current evidence and status of mHealth in SOT is discussed, and a general path forward is presented that will allow buy-in from the health care community, insurers, and the federal government to move mHealth from research to standard care.
Collapse
Affiliation(s)
- J N Fleming
- Department of Pharmacy Services, Medical University of South Carolina, Charleston, SC
| | - D J Taber
- Department of Surgery, Medical University of South Carolina, Charleston, SC.,Department of Pharmacy, Ralph H Johnson VAMC, Charleston, SC
| | - J McElligott
- Center for Telehealth, Medical University of South Carolina, Charleston, SC
| | - J W McGillicuddy
- Department of Surgery, Medical University of South Carolina, Charleston, SC
| | - F Treiber
- Technology Center to Advance Healthful Lifestyles, College of Nursing, Medical University of South Carolina, Charleston, SC
| |
Collapse
|
7
|
Pastora-Bernal JM, Martín-Valero R, Barón-López FJ, Estebanez-Pérez MJ. Evidence of Benefit of Telerehabitation After Orthopedic Surgery: A Systematic Review. J Med Internet Res 2017; 19:e142. [PMID: 28455277 PMCID: PMC5429438 DOI: 10.2196/jmir.6836] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/10/2017] [Accepted: 03/18/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND In addition to traditional physiotherapy, studies based on telerehabilitation programs have published the results of effectiveness, validity, noninferiority, and important advantages in some neurological, cognitive, and musculoskeletal disorders, providing an opportunity to define new social policies and interventions. OBJECTIVES The aim of this systematic review is to investigate the effects of telerehabilitation after surgical procedures on orthopedic conditions as well as to describe how interventions are designed and to determine whether telerehabilitation is comparable with conventional methods of delivery. This systematic review summarizes the levels of evidence and grades of recommendation regarding telerehabilitation intervention (synchronous or asynchronous provided via the telerehabilitation medium, either in conjunction with, or in isolation of, other treatment interventions) after surgical procedures on orthopedic conditions. METHODS Study quality was assessed using the Physiotherapy Evidence Database (PEDro) scores and grade of recommendation following the recommendation of the Oxford Centre for Evidence-Based Medicine. RESULTS We found 3 studies with PEDro scores between 6 and 8, which is considered as level 1 evidence (good; 20% [3/15]), 4 studies with a score of 5, which is considered as level 2 evidence (acceptable; 27% [4/15]), and the remaining 8 studies had scores of 4 or less, which is considered (poor; 53% [8/15]). A total of 1316 participants received telerehabilitation intervention in the selected studies, where knee and hip replacement were 75% of all the studies. Strong and moderate grades of evidence (grade of recommendation A-B) were found in knee and hip replacement interventions. Studies on the upper limb were 25% of the studies, but only 1 study presented a moderate grade of evidence (grade of recommendation B) and the rest were of poor methodological quality with weak evidence (grade of recommendation C). CONCLUSIONS Conclusive evidence on the efficacy of telerehabilitation for treatment after an orthopedic surgery, regardless of pathology, was not obtained. We found strong evidence in favor of telerehabilitation in patients following total knee and hip arthroplasty and limited evidence in the upper limb interventions (moderate and weak evidence). Future research needs to be more extensive and conclusive. To the best of the authors' knowledge, this is the first attempt at evaluating the quality of telerehabilitation intervention research after surgical procedures on orthopedic conditions in a systematic review. Clinical messages and future research recommendations are included in the review.
Collapse
Affiliation(s)
| | - Rocio Martín-Valero
- Faculty of Nursery and Physiotherapy, Department of Nursery and Physiotherapy, University of Cadiz, Cadiz, Spain
| | | | | |
Collapse
|