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Ponzano M, Buren R, Adams NT, Jun J, Jetha A, Mack DE, Ginis KAM. Effect of Exercise on Mental Health and Health-related Quality of Life in Adults With Spinal Cord Injury: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil 2024:S0003-9993(24)00900-6. [PMID: 38556188 DOI: 10.1016/j.apmr.2024.02.737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES To determine the effect of exercise interventions on mental health and health-related quality of life (HRQoL) in individuals with SCI. DATA SOURCES We searched Embase, CINAHL, Medline, PsychINFO, and SPORTDiscus from inception to September 2023. STUDY SELECTION We included randomized controlled trials that (1) involved participants ≥18 years old with a SCI; (2) administered an exercise intervention; and (3) measured subjective well-being, psychological well-being, social well-being, and/or HRQoL as outcomes. We reported standardized means differences (d) with a 95% confidence interval (CI), assessed the risk of bias by using the Revised Cochrane Risk-of-bias Tool for Randomized Trials (RoB 2), and the certainty of the evidence using GRADE. DATA SYNTHESIS Nineteen studies (797 participants, mean age <65 years in every study) were included. Exercise improved overall well-being (d=0.494; 95% CI 0.268, 0.720; low certainty evidence), subjective well-being (d=0.543; 95% CI 0.270, 0.816; low certainty evidence), psychological well-being (d=0.499; 95% CI 0.193, 0.805; low certainty evidence), social well-being (d=0.452; 95% CI 0.151, 0.752; low certainty evidence), and HRQoL (d=0.323; 95% CI 0.072, 0.574; low certainty evidence). Four serious adverse events probably attributable to the interventions were reported in 3 studies. CONCLUSIONS Exercise interventions can improve well-being and HRQoL in adults with SCI <65 years of age. Additional research is needed to determine effectiveness in adults ≥65 years of age.
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Affiliation(s)
- Matteo Ponzano
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada; International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC), University of British Columbia, Vancouver, Canada.
| | - Robert Buren
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada; International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC), University of British Columbia, Vancouver, Canada
| | - Nathan T Adams
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada; International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC), University of British Columbia, Vancouver, Canada
| | - Jane Jun
- Division of Physical Medicine & Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Arif Jetha
- Institute for Work & Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Diane E Mack
- Department of Kinesiology, Brock University, St Catharines, Canada
| | - Kathleen A Martin Ginis
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada; International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC), University of British Columbia, Vancouver, Canada; Division of Physical Medicine & Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, Canada; Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, Canada
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Paul L, McDonald MT, McConnachie A, Siebert S, Coulter EH. Online physiotherapy for people with axial spondyloarthritis: quantitative and qualitative data from a cohort study. Rheumatol Int 2024; 44:145-156. [PMID: 37733042 PMCID: PMC10766789 DOI: 10.1007/s00296-023-05456-6] [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: 07/12/2023] [Accepted: 09/01/2023] [Indexed: 09/22/2023]
Abstract
Life-long exercise is essential in axial spondyloarthritis (axSpA) management; however, long-term adherence is challenging. Online exercise programmes are an alternative to face-to-face physiotherapy. (1) To measure adherence to a 12-month, individualised, online physiotherapy programme for people with axSpA, and investigate the effects on disease activity, spinal mobility, work ability, quality of life and function. (2) To investigate associations between programme adherence and outcomes. (3) To explore participants' views of the programme and factors affecting adherence. Participants were 'non-exercisers' recruited from rheumatology outpatient services. Adherence was measured using online diary entries. Outcomes included the BATH indices, health status (EQ5D), Ankylosing Spondylitis Quality of Life (ASQOL), exercise capacity (6MWT), Work, Productivity and Activity Impairment in AS (WPAI), Exercise Attitude Questionnaire (EAQ) and Exercise Motivations Inventory-2 (EMI-2) at baseline, 6 and 12 months. Interviews determined views on the intervention and factors affecting adherence. Fifty participants were recruited. Over the 52-week intervention, adherence (five times/week) ranged from 19% (± 30%) to 44% (± 35%). Significant improvements were found in disease activity (BASDAI), spinal mobility (BASMI), 6MWT, AsQoL and EQ5D-VAS at 6 and 12 months. There were no associations between adherence and baseline variables or demographics. Interviews suggested support from others, routine, and feeling the benefit positively affected adherence. Conversely, lack of motivation, life events and symptoms negatively affected adherence. A 12-month online physiotherapy programme significantly improved symptoms in people with axSpA who were not regular exercisers. Adherence reduced over the intervention period. Online exercise programmes may benefit people with axSpA; however, strategies to improve adherence are required.
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Affiliation(s)
- L Paul
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, UK
| | - M T McDonald
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, UK
| | - A McConnachie
- Robertson Centre for Biostatistics, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - S Siebert
- School of Infection and Immunity, University of Glasgow, Glasgow, UK
| | - E H Coulter
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, UK.
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Venosa M, Romanini E, Ciminello E, Cerciello S, Angelozzi M, Calvisi V. Telerehabilitation Is a Valid Option for Total Knee Arthroplasty Patients: A Retrospective Pilot Study Based on Our Experience during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:2489. [PMID: 37761686 PMCID: PMC10530780 DOI: 10.3390/healthcare11182489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/03/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION Total knee arthroplasty is an effective operation. Post-surgery rehabilitation, based on early and intensive progressive exercise programs, plays a substantial role and telerehabilitation can be an effective safe option. This retrospective study aimed to compare traditional in-presence rehabilitation and telerehabilitation for total knee arthroplasty, based on our experience during the Italian COVID-19 lockdown. MATERIALS AND METHODS We retrospectively analyzed 164 patients (94 females and 70 males) enrolled in 2020 within 2 weeks after total knee replacement to perform post-operative outpatient rehabilitation. The clinical results of 82 patients (mean age 66.8 ± 10.2 years) performing telerehabilitation with those obtained from a similar cohort of 82 patients (mean age 65.4 ± 11.8 years) performing traditional in-presence outpatient rehabilitation were compared. Clinical outcomes were examined by comparing the gait speed (Time Up and Go-TUG test), the range of motion, the pain intensity (VAS), the functional status (Oxford Knee Score-OKS and Knee injury and Osteoarthritis Outcome Score-KOOS) and the overall satisfaction (Self-administered patient satisfaction scale) 12 weeks after the beginning of the physiotherapeutic protocol. RESULTS Telerehabilitation was non-inferior to traditional in-presence rehabilitation in all of the investigated areas and no statistical difference in terms of effectiveness was detected at 12 weeks, as confirmed by the respective patient-reported outcome scores such as TUG test (reduced from 20 ± 2 s to 12 ± 1.5 s for the telerehab cohort and from 18 ± 1.5 s to 13.1 ± 2 s for the in-presence rehabilitation one), pain VAS, OKS (improved from 22 ± 1.3 to 36 ± 2.7 for the telerehab cohort and from 23 ± 2.1 to 35.1 ± 4.2 for the in-presence group), KOOS (improved from 46.2 ± 10.2 to 67.4 ± 3.8 for the telerehabilitation cohort and from 48.4 ± 8.4 to 68.3 ± 6.6 for the other group), and the Self-administered patient satisfaction scale (more than two-thirds of patients globally satisfied with the results of their surgery in both groups). CONCLUSION The telerehabilitation program was effective after total knee replacement and yielded clinical outcomes that were not inferior to conventional outpatient protocols.
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Affiliation(s)
- Michele Venosa
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Vetoio, Coppito 2, 67100 L’Aquila, Italy; (M.A.); (V.C.)
- RomaPro, Polo Sanitario San Feliciano, Via Mattia Battistini 44, 00167 Rome, Italy;
| | - Emilio Romanini
- RomaPro, Polo Sanitario San Feliciano, Via Mattia Battistini 44, 00167 Rome, Italy;
- GLOBE, Italian Working Group on Evidence-Based Orthopaedics, Via Nicola Martelli 3, 00197 Rome, Italy
| | - Enrico Ciminello
- Italian Implantable Prostheses Registry (RIPI), Italian National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy;
| | - Simone Cerciello
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy;
- Orthopaedic Department, Casa di Cura Villa Betania, Via Pio IV 42, 00165 Rome, Italy
| | - Massimo Angelozzi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Vetoio, Coppito 2, 67100 L’Aquila, Italy; (M.A.); (V.C.)
| | - Vittorio Calvisi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Vetoio, Coppito 2, 67100 L’Aquila, Italy; (M.A.); (V.C.)
- UOSD, Department of Mini-Invasive and Computer-Assisting Orthopedic Surgery, San Salvatore Hospital, Via L. Natali 1, 67100 L’Aquila, Italy
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Perceptions of a self-guided web-based exercise programme for shoulder pain after spinal cord injury: A qualitative study. Spinal Cord 2023; 61:238-243. [PMID: 36702921 PMCID: PMC10070182 DOI: 10.1038/s41393-023-00877-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 12/21/2022] [Accepted: 01/13/2023] [Indexed: 01/27/2023]
Abstract
STUDY DESIGN Qualitative study. OBJECTIVES The benefits of exercise to reduce shoulder pain in people with spinal cord injury (SCI) are well documented. Digital health interventions offer a potential solution to overcome barriers to access rehabilitation support for exercise. The aim of this project was to gain people's perspectives to inform the development of a self-guided web-based exercise intervention. Shoulder Pain Intervention delivered over the interNet (SPIN) is a self-guided web-based intervention to prescribe, monitor, and progress evidence-based exercises for people living with SCI and shoulder pain. SETTING Community in Auckland, New Zealand. METHODS The Person-Based Approach was used as the framework. Using an Interpretive Descriptive methodology, data were collected in individual and focus group interviews, exploring participants' perceptions of this intervention idea. Data were analysed using conventional content analysis. RESULTS Sixteen participants took part and asked Is it right for me?. This had three main sub-themes. Should I use it?, whether I believe it will work for me right now; Can I use it?, whether I can operate the intervention competently and confidently and Will I use it?, whether it will be responsive to my unique needs, and keep me coming back. CONCLUSIONS Participants expressed their expectations and tipping points when considering using an intervention like this. These findings will inform and guide design and development of an acceptable technology-based intervention to increase the likelihood of engagement with a self-guided web-based exercise programme. The model developed from these themes could be used to inform future self-guided intervention development.
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Giouridis N, Williams TL, Tomasone JR. Physical activity promotion to persons with spinal cord injury by health and exercise professionals: A scoping review. J Spinal Cord Med 2023; 46:126-145. [PMID: 34747675 PMCID: PMC9897751 DOI: 10.1080/10790268.2021.1977061] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Health and exercise professionals (HEPs) are ideal promoters and valued messengers of physical activity (PA) information among persons with spinal cord injury (SCI). However, little is known about what strategies used by HEPs increase PA behavior in persons with SCI, or what factors influence HEPs when promoting PA to persons with SCI. The purposes of this scoping review were to (1) ascertain the extent, range and nature of the literature, (2) identify strategies used by HEPs that are associated with an increase in PA behavior for persons with SCI, and (3) identify the facilitators and barriers to PA promotion by the HEPs. METHODS A comprehensive search was undertaken. Search terms were expanded surrounding three key terms: PA, promotion, and SCI. RESULTS Twenty-four articles representing 18 unique studies were identified. HEPs predominantly consisted of physiotherapists, occupational therapists, and leisure trainers/therapists. Most interventions were delivered by HEPs to persons with SCI in in-patient rehabilitation centres and community-based settings. Tailored exercise programs and on-going counseling support were considered essential for increasing PA behavior. HEPs' common barriers to PA promotion were perceived lack of time, education, and training. CONCLUSION A need to improve and sustain SCI-specific PA knowledge and education was identified if PA promotion is to become a structured and integral component of practice. This study provides valuable information for interventions to increase PA behavior among persons with SCI by improving PA promotion by HEPs.
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Affiliation(s)
- Nicole Giouridis
- School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada,Correspondence to: Nicole Giouridis, School of Kinesiology and Health Studies, Queen’s University, 28 Division Street, Kingston, Ontario, CanadaK7L3N6.
| | | | - Jennifer R. Tomasone
- School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada
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Feasibility of home hand rehabilitation using musicglove after chronic spinal cord injury. Spinal Cord Ser Cases 2022; 8:86. [PMID: 36347833 PMCID: PMC9643482 DOI: 10.1038/s41394-022-00552-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Study design
Randomized, controlled single-blind cross over study. This study was registered on ClinicalTrials.gov (NCT02473614).
Objectives
Examine usership patterns and feasibility of MusicGlove for at home hand rehabilitation therapy following chronic spinal cord injury.
Setting
Homes of participants.
Methods
Ten participants with chronic spinal cord injury completed two baseline assessments of hand function. After a stable baseline was determined all participants were randomized into two groups: Experimental and Control. Each group was given a recommended therapy dosage. Following this participants switched interventions.
Results
On average participants had higher levels of compliance (6.1 ± 3.5 h.), and completed more grips (15,760 ± 9,590 grips) compared to participants in previous stroke studies using the same device. Participants modulated game parameters in a manner consistent with optimal challenge principles from motor learning theory. Participants in the experimental group increased their prehension ability (1 ± 1.4 MusicGlove, 0.2 ± 0.5 Control) and performance (1.4 ± 2.2 MusicGlove, 0.4 ± 0.55 Control) on the Graded and Redefined Assessment of Strength, Sensibility, and Prehension subtests. Increases in performance on the Box and Blocks Test also favored the experimental group compared to the conventional group at the end of therapy (4.2 ± 5.9, −1.0 ± 3.4 respectively).
Conclusions
MusicGlove is a feasible option for hand therapy in the home-setting for individuals with chronic SCI. Participants completed nearly twice as many gripping movements compared to individuals from the sub-acute and chronic stroke populations, and a number far greater than the number of movements typically achieved during traditional rehabilitation.
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Andrabi MS, Mumba M, Key B, Motl R. Physical activity programs for cardiovascular outcomes in community wheelchair users: A systematic review. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:1007778. [DOI: 10.3389/fresc.2022.1007778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022]
Abstract
PurposePhysical inactivity is one of the important factors leading to chronic diseases including cardiovascular disease (CVD) in individuals with disabilities. However, not many Physical Activity (PA) interventions are available for improving the efficacy of PA and cardiovascular outcomes among community wheelchair users. Therefore, this systematic review will appraise the existing PA interventions for the community dwelling wheelchair users; we especially examined features of the PA programs that showed the improvements in PA and the CVD outcomes compared to the interventions that did not show any improvements in these outcomes among these population. The study also aimed to provide some recommendations for future research.Materials and MethodsA comprehensive and systematic search of literature published between 2015 and 2020 using the databases Scopus, Pubmed, Embase, and Cochrane CENTRAL was conducted. This review has followed the Preferred Reporting Items for Systematic Review (PRISMA) guidelines. The quality of the evidence was assessed by Using Joanna Briggs Institute's critical appraisal tool. Studies that tested the efficacy of PA interventions for community-dwelling adult wheelchair users and published in English were involved. Two reviewers reviewed the literature and any disagreements among these reviewers were resolved by a third reviewer.ResultsFourteen articles were selected for this review. Most of the studies reported improvements in PA. A few studies followed up the participants and majority of the studies have looked at the CVD outcomes.ConclusionLarge-scale studies with follow-ups, and community participatory research that evaluates the effect of PA interventions on PA and CVD outcomes among wheelchair users are needed.
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Smits M, Kim CM, van Goor H, Ludden GDS. From Digital Health to Digital Well-being: Systematic Scoping Review. J Med Internet Res 2022; 24:e33787. [PMID: 35377328 PMCID: PMC9016508 DOI: 10.2196/33787] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/27/2022] [Accepted: 02/20/2022] [Indexed: 12/14/2022] Open
Abstract
Background Digital health refers to the proper use of technology for improving the health and well-being of people and enhancing the care of patients through the intelligent processing of clinical and genetic data. Despite increasing interest in well-being in both health care and technology, there is no clear understanding of what constitutes well-being, which leads to uncertainty in how to create well-being through digital health. In an effort to clarify this uncertainty, Brey developed a framework to define problems in technology for well-being using the following four categories: epistemological problem, scope problem, specification problem, and aggregation problem. Objective This systematic scoping review aims to gain insights into how to define and address well-being in digital health. Methods We followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. Papers were identified from 6 databases and included if they addressed the design or evaluation of digital health and reported the enhancement of patient well-being as their purpose. These papers were divided into design and evaluation papers. We studied how the 4 problems in technology for well-being are considered per paper. Results A total of 117 studies were eligible for analysis (n=46, 39.3% design papers and n=71, 60.7% evaluation papers). For the epistemological problem, the thematic analysis resulted in various definitions of well-being, which were grouped into the following seven values: healthy body, functional me, healthy mind, happy me, social me, self-managing me, and external conditions. Design papers mostly considered well-being as healthy body and self-managing me, whereas evaluation papers considered the values of healthy mind and happy me. Users were rarely involved in defining well-being. For the scope problem, patients with chronic care needs were commonly considered as the main users. Design papers also regularly involved other users, such as caregivers and relatives. These users were often not involved in evaluation papers. For the specification problem, most design and evaluation papers focused on the provision of care support through a digital platform. Design papers used numerous design methods, whereas evaluation papers mostly considered pre-post measurements and randomized controlled trials. For the aggregation problem, value conflicts were rarely described. Conclusions Current practice has found pragmatic ways of circumventing or dealing with the problems of digital health for well-being. Major differences exist between the design and evaluation of digital health, particularly regarding their conceptualization of well-being and the types of users studied. In addition, we found that current methodologies for designing and evaluating digital health can be improved. For optimal digital health for well-being, multidisciplinary collaborations that move beyond the common dichotomy of design and evaluation are needed.
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Affiliation(s)
- Merlijn Smits
- Department of Surgery, Radboud University Medical Center, Nijmegen, Netherlands
| | - Chan Mi Kim
- Department of Design, Production, and Management, Faculty of Engineering Technology, University of Twente, Enschede, Netherlands
| | - Harry van Goor
- Department of Surgery, Radboud University Medical Center, Nijmegen, Netherlands
| | - Geke D S Ludden
- Department of Design, Production, and Management, Faculty of Engineering Technology, University of Twente, Enschede, Netherlands
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Goel R, Santurri L, Fruth S, Abzug JM, Geigle PR. Telerehabilitation Use With Spinal Cord Injury: Occupational Therapists' Perspective. Am J Occup Ther 2022; 76:23201. [PMID: 35157754 DOI: 10.5014/ajot.2022.045831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Telerehabilitation provides people with spinal cord injury (SCI) an alternative mode of accessing specialized health care. Further research on occupational therapy practitioners' perspectives of telerehabilitation may provide additional evidence for clinical practice implementation. OBJECTIVE To explore urban occupational therapists' perspectives on the benefits of and barriers to telerehabilitation use with SCI. DESIGN A qualitative study design using a demographic questionnaire and a single, individual semistructured interview. Thematic analyses included member checking, constant comparative analysis, triangulation, and self-description and self-reflexivity. SETTING Residential and community settings. PARTICIPANTS Six occupational therapists with a range of experience in SCI rehabilitation were recruited using purposeful sampling. RESULTS Six participants were interviewed, and four primary themes emerged: (1) communication, (2) personal factors, (3) benefits, and (4) barriers. CONCLUSIONS AND RELEVANCE Telerehabilitation offers numerous potential benefits for SCI intervention. This study provides an understanding of practitioner concerns and potential barriers to use. The results indicate that a hybrid model incorporating both in-person and distance-based treatment is likely optimal. What This Article Adds: Our results provide information that addresses practitioner concerns and recommendations for the use of telerehabilitation with people with SCI. As practitioner concerns are identified and addressed, telerehabilitation may increase in the U.S. health care system, potentially facilitating an alternative treatment delivery method for underserved populations.
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Affiliation(s)
- Ritu Goel
- Ritu Goel, DHSc, MS, OTR/L, is Occupational Therapist, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore;
| | - Laura Santurri
- Laura Santurri, PhD, MPH, CPH, is Director, Doctor of Health Science Program, and Chair, Department of Interprofessional Health & Aging Studies, College of Health Sciences, University of Indianapolis, Indianapolis, IN
| | - Stacie Fruth
- Stacie Fruth, PT, DHSc, OCS, is Director, Doctor of Physical Therapy Program, and Founding Chair, Department of Physical Therapy, Western Michigan University, Kalamazoo
| | - Joshua M Abzug
- Joshua M. Abzug, MD, is Director of Pediatric Orthopedics, University of Maryland Medical Center, and Associate Professor, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore
| | - Paula Richley Geigle
- Paula Richley Geigle, PT, MS, PhD, is Research Specialist, Charles George Department of Veterans Affairs Medical Center, Asheville, NC
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Özden F, Özkeskin M, Ak SM. Physical exercise intervention via telerehabilitation in patients with neurological disorders: a narrative literature review. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00461-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
In recent years, telerehabilitation applications have increased with the rapid development of mobile technology. Remote rehabilitation services have utmost importance in chronic neurological disorders. The aim of this narrative literature review was to discuss the physical exercise interventions via telerehabilitation in patients with neurological disorders. The literature search was conducted via PubMed using the neurological pathology terms in the MeSH (Medical Subject Headings) database. Physical exercise-based studies within the scope of neurological rehabilitation were included in the study. The contents of the studies were discussed with narrative synthesis.
Results
A total of 329 studies were obtained in the initial search. Twelve studies including cases of multiple sclerosis (MS), stroke, parkinson's disease, intracranial tumors, spinal-cord injury were interpreted. A vast majority of studies (50%) was conducted with stroke cases. On the other hand, half of the studies addressed the specific results of balance or balance-falling. The results of the studies were discussed comprehensively.
Conclusion
Physical exercise with telerehabilitation provides productive results to improve quality of life, muscle strength-endurance, hand function, balance, aerobic capacity in neurologic rehabilitation.
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Singh G, Nimmon L, Sawatzky B, Ben Mortenson W. Barriers and Facilitators to eHealth Technology Use Among Community-Dwelling Individuals With Spinal Cord Injury: A Qualitative Study. Top Spinal Cord Inj Rehabil 2022; 28:196-204. [PMID: 35521060 PMCID: PMC9009201 DOI: 10.46292/sci21-00016] [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: 11/19/2022]
Abstract
Background As eHealth technologies become a more prevalent means to access care and self-manage health, it is important to identify the unique facilitators and barriers to their use. Few studies have evaluated the use or potential use of eHealth technologies in spinal cord injury (SCI) populations. Objectives The primary objective of this study was to explore and identify barriers and facilitators to engagement with eHealth technologies among individuals with SCI. Methods A qualitative descriptive study was conducted. Data were collected via one-on-one, semi-structured interviews with a subsample of 20 community-dwelling participants enrolled in a larger clinical trial. Analysis of the transcripts was undertaken using a four-phase process of content analysis. Results Our analysis identified three barriers to engagement with eHealth technologies, including (1) overcoming a digital divide to comprehending and utilizing eHealth technologies, (2) navigating internet resources that provide too much information, and (3) interacting with these technologies despite having limited hand function. Our analysis also identified three facilitators to using eHealth technologies, including (1) having previous successful experiences with eHealth technologies, (2) being able to use voice activation features, and (3) being able to interact in an online community network. Conclusion By exploring barriers and facilitators to eHealth technology use, these findings may have a short-term impact on informing researchers and clinicians on important factors affecting engagement of individuals with SCI with telemedicine, mobile, and web applications (apps) and a long-term impact on informing future development of eHealth interventions and tools among chronic disease populations.
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Affiliation(s)
- Gurkaran Singh
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
,International Collaboration on Repair Discoveries, Vancouver, Canada
,G.F. Strong Rehabilitation Centre, Vancouver, Canada
| | - Laura Nimmon
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
,Centre for Health Education Scholarship, University of British Columbia, Vancouver, Canada
| | - Bonita Sawatzky
- International Collaboration on Repair Discoveries, Vancouver, Canada
,Department of Orthopaedics, University of British Columbia, Vancouver, Canada
| | - W. Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
,International Collaboration on Repair Discoveries, Vancouver, Canada
,G.F. Strong Rehabilitation Centre, Vancouver, Canada
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Current Approaches in Telehealth and Telerehabilitation for Spinal Cord Injury (TeleSCI). CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022; 10:77-88. [PMID: 35493027 PMCID: PMC9039273 DOI: 10.1007/s40141-022-00348-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 12/04/2022]
Abstract
Purpose of Review Telehealth and telerehabilitation in spinal cord injury (teleSCI) is a growing field that can improve access to care and improve health outcomes in the spinal cord injury population. This review provides an overview of the recent literature on the topic of teleSCI and provides insights on current evidence, future directions, and considerations when using teleSCI for clinical care. Recent Findings TeleSCI is used most often for preventive health; management of chronic pain, anxiety, and depression; and rehabilitation-related interventions. As video telehealth becomes mainstream, growth in wearable monitors, bio and neurofeedback mechanisms, and app-based care is expected. Summary TeleSCI is growing in prevalence, demonstrates positive impact on health outcomes, and requires ongoing study to identify, refine, and implement best practices.
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Ochoa C, Cole M, Froehlich-Grobe K. Feasibility of an Internet-Based Intervention to Promote Exercise for People With Spinal Cord Injury: Observational Pilot Study. JMIR Rehabil Assist Technol 2021; 8:e24276. [PMID: 34106086 PMCID: PMC8235292 DOI: 10.2196/24276] [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: 09/11/2020] [Revised: 03/29/2021] [Accepted: 04/13/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND People with spinal cord injury (SCI) are less likely to be physically active and have higher chronic disease risk than those in the general population due to physical and metabolic changes that occur postinjury. Few studies have investigated approaches to promote increased physical activity (PA) for people with SCI despite evidence that they face unique barriers, including lack of accessible transportation and exercise equipment. To address these obstacles, we adapted an evidence-based phone-delivered intervention that promoted increased PA among people with SCI into a web-based platform, titled the Workout on Wheels internet intervention (WOWii). The adapted program provides participants with weekly skill-building information and activities, basic exercise equipment, and ongoing support through weekly group videoconferencing. OBJECTIVE This pilot study was conducted to assess the feasibility of using a web-based and virtual format to deliver the WOWii program in a randomized controlled trial. METHODS We assessed the feasibility of the web-based program by delivering an abbreviated, 4-week version to 10 participants with SCI. Rates of weekly videoconference attendance, activity completion, and exercise activity as tracked by an arm-based activity monitor were recorded for all participants. RESULTS Participants averaged 3.3 of 4 (83%) weekly group videoconferences attended, 3.4 of 4 (85%) web-based module activities completed, and 2.3 of 4 (58%) weeks of using the arm-based activity monitor. The majority of the sample (9/10, 90%) synced their arm-based PA monitor at least once, and overall engagement as an average of each component across the 4 weeks was 75%. CONCLUSIONS The intervention had sufficiently high levels of engagement to be used in a full randomized controlled trial to test its effectiveness in improving levels of PA among people with SCI. The knowledge we gained from this pilot study informed improvements that were made in the full randomized controlled trial.
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Affiliation(s)
- Christa Ochoa
- Baylor Scott & White Institute for Rehabilitation, Baylor Scott & White Research Institute, Baylor Scott & White Health, Dallas, TX, United States
| | - Maria Cole
- Baylor Scott & White Institute for Rehabilitation, Baylor Scott & White Research Institute, Baylor Scott & White Health, Dallas, TX, United States
| | - Katherine Froehlich-Grobe
- Baylor Scott & White Institute for Rehabilitation, Baylor Scott & White Research Institute, Baylor Scott & White Health, Dallas, TX, United States.,Craig Hospital, Englewood, CO, United States
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Barrows D, Goldstein B. Virtual Care in the Veterans Affairs Spinal Cord Injuries and Disorders System of Care During the COVID-19 National Public Health Emergency. Phys Med Rehabil Clin N Am 2021; 32:207-221. [PMID: 33814053 DOI: 10.1016/j.pmr.2021.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Telehealth reduces disparities that result from physical disabilities, difficulties with transportation, geographic barriers, and scarcity of specialists, which are commonly experienced by individuals with spinal cord injuries and disorders (SCI/D). The Department of Veterans Affairs (VA) has been an international leader in the use of virtual health. The VA's SCI/D System of Care is the nation's largest coordinated system of lifelong care for people with SCI/D and has implemented the use of telehealth to ensure that Veterans with SCI/D have convenient access to their health care, particularly during the restrictions that were imposed by the COVID-19 pandemic.
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Affiliation(s)
- Daniel Barrows
- Spinal Cord Injuries and Disorders, National Program Office, Veterans Health Administration, 810 Vermont Avenue NW, Washington, DC 20571, USA
| | - Barry Goldstein
- Spinal Cord Injuries and Disorders, National Program Office, Veterans Health Administration, 810 Vermont Avenue NW, Washington, DC 20571, USA; Department of Rehabilitation Medicine, University of Washington, 325 9th Avenue, Box 359612, Seattle, WA 98104, USA.
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Lee S, Kim J, Kim J. Substantiating Clinical Effectiveness and Potential Barriers to the Widespread Implementation of Spinal Cord Injury Telerehabilitation: A Systematic Review and Qualitative Synthesis of Randomized Trials in the Recent Past Decade. TELEMEDICINE REPORTS 2021; 2:64-77. [DOI: http:/doi.org/10.1089/tmr.2020.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2023]
Affiliation(s)
- Seungbok Lee
- Yonsei Enabling Science Technology and Research Clinic, Yonsei University, Wonju, Republic of Korea
| | - Jeonghyun Kim
- Department of Physical Medicine and Rehabilitation, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jongbae Kim
- Yonsei Enabling Science Technology and Research Clinic, Yonsei University, Wonju, Republic of Korea
- Department of Occupational Therapy, Yonsei University College of Health Sciences, Wonju, Republic of Korea
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Lee S, Kim J, Kim J. Substantiating Clinical Effectiveness and Potential Barriers to the Widespread Implementation of Spinal Cord Injury Telerehabilitation: A Systematic Review and Qualitative Synthesis of Randomized Trials in the Recent Past Decade. TELEMEDICINE REPORTS 2021; 2:64-77. [PMID: 35720743 PMCID: PMC8989076 DOI: 10.1089/tmr.2020.0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/23/2020] [Indexed: 05/07/2023]
Abstract
Introduction: Telemedicine across many specialties in clinical practice has been established in the literature regarding technology platforms, privacy issues, cost, and clinical effectiveness. However, the lack of data in these areas applicable to spinal cord injury telerehabilitation (teleSCI) still exists. The gaps in these knowledge areas continue to hinder its widespread implementation and serve as pathways for focused efforts in teleSCI research. Objective: This systematic review aims to substantiate the clinical effectiveness and potential barriers to teleSCI implementation by verifying the statistical significance of various clinical outcomes from randomized trials published within the recent past decade. Methods: A qualitative synthesis of randomized studies, conducted across various regions, was systematically reviewed after identifying relevant records from database search engines. Applied filters in the search included publication dates (2010-2020), humans, full-text, and no language preference. The 13 studies were selected per Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram, and the risk of bias across studies was evaluated by using the Physiotherapy Evidence Database scale of quality assessment. Results: Quantitative outcome measurements demonstrated positive impact across studies: 79.1% (34/43) of all measurements were statistically significant for positive outcomes and 18.6% (8/43) yielded no effect but were significant. Primary outcomes addressed various spinal cord injury (SCI) management areas; 38.5% (5/13) of studies also assessed secondary outcomes. Interventional platforms were conventional technologies used in telemedicine. One study (7.7%) achieved data encryption; no studies presented cost-analysis data. Conclusion: The majority of studies demonstrated significant positive outcomes to validate teleSCI clinical effectiveness through conventional technology. These results further expand our understanding of teleSCI's impact and its demonstrated potential for improving SCI individuals' lives. However, heterogeneity of selected studies limits the conclusive recommendations to address potential barriers to its widespread implementation. Moreover, the development of new data is warranted to promote "buy-in" of widespread teleSCI implementation.
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Affiliation(s)
- Seungbok Lee
- Yonsei Enabling Science Technology and Research Clinic, Yonsei University, Wonju, Republic of Korea
| | - Jeonghyun Kim
- Department of Physical Medicine and Rehabilitation, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jongbae Kim
- Yonsei Enabling Science Technology and Research Clinic, Yonsei University, Wonju, Republic of Korea
- Department of Occupational Therapy, Yonsei University College of Health Sciences, Wonju, Republic of Korea
- Address correspondence to: Jongbae Kim, PhD, Yonsei Enabling Science Technology and Research Clinic, Yonsei University, 1 Yonseidae-gil, Baekun Hall Suite 131, Wonju, Gangwon-do 220-710, Republic of Korea,
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Home-based telerehabilitation software systems for remote supervising: a systematic review. Int J Technol Assess Health Care 2020; 36:113-125. [PMID: 32151291 DOI: 10.1017/s0266462320000021] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES In the past decade, with the ever-increasing growth of information and communication technologies, telerehabilitation, especially home-based rehabilitation (HBR), has been widely considered by researchers. Many software systems are developed to address HBR programs, which includes various functionalities. The aim of this study is to review the functional features of these systems designed for remote supervising of HBR programs. METHODS Scopus, PubMed, EMBASE, ISI Web of Science, Cochrane Library, IEEE Xplore Digital Library, and ProQuest databases were searched for English-language articles published between January 2008 and February 2018 to retrieve studies reported an home-based telerehabilitation software system aiming to remotely supervise HBR program. RESULTS A total of fifty studies that reported twenty-two unique systems met the inclusion criteria. Various functional features were identified including but not limited to exercise plan management, report/statistics generating, patient education, and task scheduling. Disorders or diseases addressed by these systems could mainly be grouped into five categories: musculoskeletal, neurological, respiratory, cardiovascular, and other health-related problems. Usability and acceptability, and clinical/patient outcomes were the most reported outcomes and data analysis was used by the majority of included studies to measure the outcomes. CONCLUSIONS Systems developed for supervising of HBR program are diverse. However, preliminary results of this review revealed that these systems share more or less common functionalities. However, further research is needed to determine the requirements, structure, and effectiveness of these systems in real-life settings.
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Cole M, Froehlich-Grobe K, Driver S, Shegog R, McLaughlin J. Website Redesign of a 16-Week Exercise Intervention for People With Spinal Cord Injury by Using Participatory Action Research. JMIR Rehabil Assist Technol 2019; 6:e13441. [PMID: 31845902 PMCID: PMC6938595 DOI: 10.2196/13441] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 08/21/2019] [Accepted: 10/22/2019] [Indexed: 01/20/2023] Open
Abstract
Background People with spinal cord injury (SCI) are at higher risk for numerous preventable chronic conditions. Physical activity is a protective factor that can reduce this risk, yet those with SCI encounter barriers to activity and are significantly less likely to be active. Limited evidence supports approaches to promote increased physical activity for those with SCI. Objective Building upon our previous theory- and evidence-based approach to increase participation in regular physical activity for those with SCI, this study aimed to use a participatory action research approach to translate a theory-based intervention to be delivered via the Web to individuals with SCI. Methods A total of 10 individuals with SCI were invited to participate in consumer input meetings to provide the research team with iterative feedback on an initial website designed as a platform for delivering a theory-based exercise intervention. Results A total of 7 individuals with SCI whose average age was 43.6 years (SD 13.4) and lived an average age of 12.5 years (SD 14.9) with SCI met on 2 occasions to provide their feedback of the website platform, both on the initial design and subsequently on the revamped site. Their iterative feedback resulted in redesigning the website content, format, and functionality as well as delivery of the intervention program. Conclusions The substantially redesigned website offers an easier-to-navigate platform for people with SCI with greater functionality that delivers information using a module format with less text, short video segments, and presents more resources. Preliminary testing of the site is the next step.
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Affiliation(s)
- Maria Cole
- Baylor Scott and White Institute for Rehabilitation, Dallas, TX, United States
| | | | - Simon Driver
- Baylor Scott and White Institute for Rehabilitation, Dallas, TX, United States
| | - Ross Shegog
- University of Texas Health Science Center Houston, School of Public Health, Houston, TX, United States
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Kloek CJJ, Janssen J, Veenhof C. Development of a Checklist to Assist Physiotherapists in Determination of Patients' Suitability for a Blended Treatment. Telemed J E Health 2019; 26:1051-1065. [PMID: 31804904 DOI: 10.1089/tmj.2019.0143] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: The integration of digital applications within health care is called blended care. Introduction: Despite its potential, physiotherapists experience difficulty in determining which patients are suitable for blended care. This study aimed to develop a checklist to support physiotherapists while setting up a blended treatment. Therefore, we aimed to investigate which patient characteristics predict patients' suitability for blended physiotherapy and which patient characteristics need to be taken into account while determining the ratio between therapeutic guidance and a digital application. Methods: A scoping review was conducted consisting of (1) literature search in PubMed and PEDro up to December 2017: studies were eligible if they focused on blended physiotherapy consisting of contact at least twice with a physiotherapist complemented by a digital application, and characteristics related to patients' suitability for blended physiotherapy were extracted and categorized in themes; (2) a checklist item for each theme formulated by the authors, which resulted in a first version of the Dutch Blended Physiotherapy Checklist; and (3) expert opinion and feedback on clinical relevance by six experts. The checklist was adapted accordingly. Results: The final Dutch Blended Physiotherapy Checklist consists of eight items: motivation, safety, equipment, digital skills, health literacy, self-management, time, and financial factors. Discussion: The next step is to investigate the feasibility and predictive validity of the checklist, that is, whether this checklist is actually able to predict patients' suitability for blended physiotherapy. Conclusions: This study provides the final version of the Dutch Blended Physiotherapy Checklist, which is supposed to guide physiotherapists in their clinical reasoning process while setting up a personalized, blended physiotherapy treatment.
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Affiliation(s)
- Corelien J J Kloek
- Research Group Innovation of Human Movement Care, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Joep Janssen
- Research Group Innovation of Human Movement Care, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands.,Department of Pediatrics, De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Center of Excellence for Rehabilitation Medicine, Utrecht, The Netherlands
| | - Cindy Veenhof
- Research Group Innovation of Human Movement Care, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
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20
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Stavric V, Saywell N, Kayes NM. Development of a self-guided web-based exercise intervention (SPIN) to treat shoulder pain in people living with spinal cord injury: protocol of a mixed methods study. BMJ Open 2019; 9:e031012. [PMID: 31530616 PMCID: PMC6756334 DOI: 10.1136/bmjopen-2019-031012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Chronic shoulder pain is common after spinal cord injury (SCI) and limits community mobility. This leads to loss of independence and reduced quality of life. Evidence suggests that exercises can help reduce shoulder pain. However, cost, expertise and transport barriers frequently limit access to treatment services. The objective of this study is to develop an evidence-based, acceptable, usable and persuasive self-guided web-based exercise intervention to treat shoulder pain in people living with SCI. METHODS AND ANALYSIS An iterative and phased person-based approach (PBA) will capture users' perspectives on usability and acceptability to develop guiding principles that will shape the design of the intervention. The intervention will be based on key elements identified through participant input and from evidence identified through systematic and narrative reviews, to ensure the intervention addresses participants' needs and increase the likelihood of uptake. The prototype will be iteratively refined through focus groups and think-aloud sessions. Review data will be synthesised drawing on systematic and narrative review conventions. Qualitative data will be analysed using conventional content analysis (planning phase) and directed content analysis (development phase) to inform intervention design and refinement. ETHICS AND DISSEMINATION Ethical approval has been granted by the Auckland University of Technology Ethics Committee (AUTEC) in Auckland, New Zealand. The results of the study will be published in a peer-reviewed journal and presented at relevant national and international conferences. A summary of findings will be presented to key stakeholder groups. We will progress to a definitive trial should the findings from this intervention development study indicate the intervention is acceptable and usable.
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Affiliation(s)
- Verna Stavric
- Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Nicola Saywell
- Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Nicola Maree Kayes
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
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21
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The Effect of Remote Patient Monitoring on Patients with Spinal Cord Injury: A Mini-Review. ARCHIVES OF NEUROSCIENCE 2019. [DOI: 10.5812/ans.85491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Post MWM, Leenders JMP, Tepper M, Snoek GJ, van der Woude LHV, Adriaansen JJE. Computer and internet use among people with long-standing spinal cord injury: a cross-sectional survey in the Netherlands. Spinal Cord 2019; 57:396-403. [DOI: 10.1038/s41393-018-0237-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 12/14/2018] [Accepted: 12/15/2018] [Indexed: 11/09/2022]
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Doiron-Cadrin P, Kairy D, Vendittoli PA, Lowry V, Poitras S, Desmeules F. Feasibility and preliminary effects of a tele-prehabilitation program and an in-person prehablitation program compared to usual care for total hip or knee arthroplasty candidates: a pilot randomized controlled trial. Disabil Rehabil 2019; 42:989-998. [DOI: 10.1080/09638288.2018.1515992] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Patrick Doiron-Cadrin
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montréal, Québec, Canada
- Orthopaedic Clinical Research Unit, Centre-intégré-universitaire-de-santé-et-de-services-sociaux Est-de-l’île-de Montréal, Maisonneuve-Rosemont Hospital Research Centre, University of Montreal, Montréal, Québec, Canada
| | - Dahlia Kairy
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehablitation of Greater Montreal, Montréal, Québec, Canada
| | - Pascal-André Vendittoli
- Orthopaedic Clinical Research Unit, Centre-intégré-universitaire-de-santé-et-de-services-sociaux Est-de-l’île-de Montréal, Maisonneuve-Rosemont Hospital Research Centre, University of Montreal, Montréal, Québec, Canada
- Department of Surgery, University of Montreal, Montreal, Canada
| | - Véronique Lowry
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montréal, Québec, Canada
- Orthopaedic Clinical Research Unit, Centre-intégré-universitaire-de-santé-et-de-services-sociaux Est-de-l’île-de Montréal, Maisonneuve-Rosemont Hospital Research Centre, University of Montreal, Montréal, Québec, Canada
| | - Stéphane Poitras
- School of rehabilitation sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - François Desmeules
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montréal, Québec, Canada
- Orthopaedic Clinical Research Unit, Centre-intégré-universitaire-de-santé-et-de-services-sociaux Est-de-l’île-de Montréal, Maisonneuve-Rosemont Hospital Research Centre, University of Montreal, Montréal, Québec, Canada
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Telemedicine using an iPad in the spinal cord injury population: a utility and patient satisfaction study. Spinal Cord Ser Cases 2018; 4:71. [PMID: 30131874 PMCID: PMC6082908 DOI: 10.1038/s41394-018-0105-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 06/28/2018] [Accepted: 06/30/2018] [Indexed: 01/06/2023] Open
Abstract
Study design Prospective observational. Objectives To explore participants' experience, satisfaction, and utility of telemedicine. Setting Spinal cord injury (SCI) rehabilitation clinic at a county hospital. Methods Participants in this study received telemedicine appointments for routine scheduled care and/or urgent consults with a spinal cord injury specialist via iPad on FaceTime. Demographic changes, health care utilization, and medical complications were assessed. A Program Satisfaction Survey (PSS) was completed after a 6-month enrollment. Results Telemedicine visits included general follow-ups (51.25%), "multiple issues" (24.38%), skin (6.88%), bowel and bladder (5.63%), spasms (3.13%), and pain (3.13%). The PSS was collected (n = 45) and revealed positive results in perceived health, satisfaction with equipment/ease of use, and satisfaction with the program. Analysis of anecdotal comments revealed themes such as efficiency, convenience, and reduced barriers provided by telemedicine visits. Conclusions This study shows the feasibility and acceptance of a telemedicine intervention via iPad for individuals with SCI through positive PSS ratings and the wide variety of clinical topics addressed. Sponsorship Craig H. Neilsen Foundation.
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Demographics and rates of surgical arthroscopy and postoperative rehabilitative preferences of arthroscopists from the Arthroscopy Association of North America (AANA). J Orthop 2018; 15:591-595. [PMID: 29881200 DOI: 10.1016/j.jor.2018.05.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 05/06/2018] [Indexed: 11/21/2022] Open
Abstract
Survey of 869 arthroscopists regarding joint-specific arthroscopic procedures and postoperative rehabilitative preferences revealed comparable support for use of supervised physical therapy (SPT) and home exercise programs (HEPs) but stronger preference for joint-specific HEP applications (wrist, knee). Among respondents utilizing HEPs, modality of delivery (verbal/handout/web-based) didn't differ by joint, yet only 2.9% utilized web-based HEPs. This is the first known study to identify postoperative rehabilitation preferences. With 1.77 million estimated arthroscopic procedures annually (mean: 325.4 procedures/respondent), this study highlights under-utilization of web-based HEPs. Reliable, web-based HEPs can improve post-arthroscopic outcomes for patients, arthroscopic surgeons, and rehabilitative specialists while being cost efficient.
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27
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Irgens I, Rekand T, Arora M, Liu N, Marshall R, Biering- Sørensen F, Alexander M. Telehealth for people with spinal cord injury: a narrative review. Spinal Cord 2018. [DOI: 10.1038/s41393-017-0033-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Web-based physiotherapy for people with axial spondyloarthritis (WEBPASS) - a study protocol. BMC Musculoskelet Disord 2016; 17:360. [PMID: 27553492 PMCID: PMC4995794 DOI: 10.1186/s12891-016-1218-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 08/13/2016] [Indexed: 11/10/2022] Open
Abstract
Background Evidence suggests people with axial spondyloarthritis (axial SpA) should exercise up to five times per week but lack of time, symptoms, cost and distance are barriers to regular exercise in axial SpA. Personalised exercise programmes delivered via the internet might support people with axial SpA to reach these exercise targets. The aim of this study is to investigate the effect of, and adherence to, a 12 month personalised web-based physiotherapy programme for people with axial SpA. Methods Fifty people with axial SpA will be recruited to this prospective, interventional cohort study. Each participant will be assessed by a physiotherapist and an individualised exercise programme set up on www.webbasedphysio.com. Participants will be asked to complete their programme five times per week for 12 months. With the exception of adherence, data will be collected at baseline, 6 and 12 months. Discussion The primary outcome measure is adherence to the exercise programme over each four week cycle (20 sessions maximum per cycle) and over the 12 months. Secondary measures include function (BASFI), disease activity (BASDAI), work impairment (WPAI:SpA), quality of life (ASQoL, EQ5D), attitude to exercise (EMI-2, EAQ), spinal mobility (BASMI), physical activity and the six minute walk test. Participants will also be interviewed to explore their adherence, or otherwise, to the intervention. This study will determine the adherence and key clinical outcomes of a targeted web-based physiotherapy programme for axial SpA. This data will inform clinical practice and the development and implementation of similar programmes. Trial registration ClinicalTrials.gov: NCT02666313, 20th January 2016
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