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Ogedengbe TO, Kreidy C, Gürke N, Twahirwa BN, Boateng MA, Eslahi M, Khodayari F, Nemargut JP, Martiniello N, Wittich W. Feasibility of telerehabilitation to address the orientation and mobility needs of individuals with visual impairment: perspectives of current guide dog users. Disabil Rehabil 2024:1-11. [PMID: 38907578 DOI: 10.1080/09638288.2024.2368058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 06/11/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVE To assess guide dog users' perspectives on the feasibility of telerehabilitation for their O&M needs. METHOD An online survey gathered insights from 56 guide dog (GD) users (Mean age = 59, Mean GD used = 4, Mean duration of use = 22 years). Thirteen GD users further participated in interviews or focus groups to explore survey responses. Data were analyzed using content analysis. FINDINGS Most (40) were blind, and 16 had low vision, with intermediate (25) and advanced (25) communication technology proficiency. Most GD users (46) underwent residential training, and 10 received one-on-one visits. Qualitative analysis revealed acceptance of telerehabilitation services, citing accessibility as an advantage. However, GD users expressed concerns about safety, potential loss of behavioral observation, and social contact loss. Success depended on the type of technology, service type, and personal attributes. CONCLUSION While feasible, telerehabilitation services may not be universally suitable for all training stages. Flexibility and applicability in service design are necessary to accommodate individual preferences and experience levels.
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Affiliation(s)
- Tosin Omonye Ogedengbe
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, Québec, Canada
| | - Chantal Kreidy
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, Québec, Canada
| | - Nora Gürke
- Vrije Universiteit Amsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam, Noord-Holland, Netherlands
| | | | - Mark A Boateng
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | - Mina Eslahi
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | | | - Joseph P Nemargut
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, Québec, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, Québec, Canada
- Centre de Réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Natalina Martiniello
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, Québec, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, Québec, Canada
- Centre de Réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Walter Wittich
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, Québec, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, Québec, Canada
- Centre de Réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montréal, Québec, Canada
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Ouendi N, Avril E, Dervaux B, Pudlo P, Wallard L. Effectiveness of Telerehabilitation Programs in Elderly with Hip or Knee Arthroplasty: A Systematic Review. Telemed J E Health 2024. [PMID: 38574249 DOI: 10.1089/tmj.2023.0622] [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: 04/06/2024] Open
Abstract
Background: Lower limb osteoarthritis (OA) often generates musculoskeletal pain causing functional impairment and decreasing mobility, autonomy, and quality of life. Patients with OA are commonly prescribed specific care for total hip arthroplasty or total knee arthroplasty (THA or TKA), when patients present symptoms that are refractory to nondrug treatments. Currently, when patients are discharged from orthopedic surgery, they are either referred to a rehabilitation department, or sent directly home with assistance such as remote monitoring by teleconsultation or a mobile application. In recent years, there has been an evolution in digital health and in particular telerehabilitation. To determine utility and effectiveness, the aim of this systematic review was to highlight and evaluate different telerehabilitation programs using new information and communication technologies. Methods: Five databases, ScienceDirect, PubMed, Web of Sciences, Scopus, and Google scholar, were searched until 30 June 30, 2023. All studies written in English and meeting our inclusion criteria were included. Databases were screened for "Total Hip Arthroplasty," "Total Knee Arthroplasty," "Total Hip Replacement," "Total Knee Replacement," "Rehabilitation," "Physical Activity," "Physiotherapy," "Telerehabilitation," "Telecommunication*," "Senior*," and "Elderly" in accordance with PRISMA-ScR guideline. Results: Fourteen articles were selected according to inclusion criteria. Telerehabilitation was offered in seven different ways (video call, applications smartphones, website, etc.). Assessments included were mainly quality of life questionnaires, perceived effort after exercises, field surveys on the tool experience, and physical tests to assess motor functions. Conclusion: This review highlights the importance and relevance of evaluating the contributions and limits of new health technologies to improve patient monitoring and thus enable better remote clinical care.
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Affiliation(s)
- Nawel Ouendi
- Laboratoire LAMIH - UMR CNRS 8201, Département de Recherche Sciences de l'Homme et du Vivant, Univ Polytechnique Hauts-de-France, Valenciennes, France
- Pôle SSR - Maison Sport Santé - Institut Jean Stablinski, Centre Hospitalier de Valenciennes, Valenciennes, France
| | - Eugénie Avril
- Laboratoire LAMIH - UMR CNRS 8201, Département de Recherche Sciences de l'Homme et du Vivant, Univ Polytechnique Hauts-de-France, Valenciennes, France
| | - Benjamin Dervaux
- Pôle SSR - Maison Sport Santé - Institut Jean Stablinski, Centre Hospitalier de Valenciennes, Valenciennes, France
| | - Philippe Pudlo
- Laboratoire LAMIH - UMR CNRS 8201, Département de Recherche Sciences de l'Homme et du Vivant, Univ Polytechnique Hauts-de-France, Valenciennes, France
| | - Laura Wallard
- Laboratoire LAMIH - UMR CNRS 8201, Département de Recherche Sciences de l'Homme et du Vivant, Univ Polytechnique Hauts-de-France, Valenciennes, France
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Ott KK, Schein RM, Straatmann J, Schmeler MR, Dicianno BE. Development of a Home-Based Telerehabilitation Service Delivery Protocol for Wheelchair Seating and Mobility Within the Veterans Health Administration. Mil Med 2021; 187:e718-e725. [PMID: 33647955 DOI: 10.1093/milmed/usab091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/06/2021] [Accepted: 02/22/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION The provision of seating and wheeled mobility devices is a complex process that requires trained professionals and multiple appointments throughout the service delivery process. However, this can be inconvenient and burdensome for individuals with mobility limitations or for individuals who live in rural areas. Rural areas often present unique difficulties regarding the provision of healthcare services including lengthy travel times to medical facilities and lack of specialized providers and medical technology. The purpose of this article is to provide a comprehensive overview of the development and implementation of a service delivery protocol for a home-based telerehabilitation assessment for wheelchair seating and mobility. MATERIALS AND METHODS The telerehabilitation team consists of a trained wheelchair seating and mobility therapist and a telehealth clinical technician (TCT). In order to determine veterans that are appropriate for a home-based telerehabilitation assessment, a three-phase pre-assessment screening process was conducted by the therapist and TCT, including consult, chart, and phone review. Veterans that met all of the predetermined eligibility criteria were recommended for a telerehabilitation wheelchair assessment. The TCT traveled to the veteran's residence with necessary evaluation and safety equipment and connected with the therapist remotely using the VA Video Connect platform. Assessment and veteran data were collected during the initial evaluation and then during a 21-day follow-up. RESULTS Forty-three veterans were successfully seen via telerehabilitation for a seating and wheeled mobility assessment between November, 2017 and July, 2018. The average travel distance between the veteran's residence and the clinic was 34.1 miles. The total telerehabilitation encounter times ranged from 45 min to 145 min. CONCLUSIONS The implementation of this service delivery protocol for wheelchair seating and mobility assessments demonstrated the benefits of using telehealth services including reaching rural veterans, reducing distance traveled, maximizing efficiency of provider schedules, and conducting realistic assessments in veterans' home environments. Success can be attributed to being able to deliver best practice remotely and to the rapport of the TCT with the providers. Cultivating provider buy-in, selecting appropriate outcome measures, and restructuring workflows were additional lessons learned. The VA Video Connect platform is an accessible tool that can be easily learned by both veterans and providers and used beyond initial wheelchair seating evaluations for improved access to follow-up healthcare services.
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Affiliation(s)
- Kaila K Ott
- Department of Rehabilitation Science & Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15206, USA
| | - Richard M Schein
- Department of Rehabilitation Science & Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15206, USA
| | - Joseph Straatmann
- Department of Rehabilitation Science & Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15206, USA
| | - Mark R Schmeler
- Department of Rehabilitation Science & Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15206, USA
| | - Brad E Dicianno
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA 15206, USA.,Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Kaufmann Medical Building, Pittsburgh, PA 15213, USA
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Matsumoto ME, Wilske GC, Tapia R. Innovative Approaches to Delivering Telehealth. Phys Med Rehabil Clin N Am 2021; 32:451-465. [PMID: 33814069 DOI: 10.1016/j.pmr.2020.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Mary E Matsumoto
- Department of Physical Medicine and Rehabilitation, Minneapolis VA Health Care System, 1 Veterans Drive, Mail Stop 117, Minneapolis, MN 55417, USA; Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA.
| | - Grace C Wilske
- Department of Physical Medicine and Rehabilitation, Minneapolis VA Health Care System, 1 Veterans Drive, Mail Stop 117, Minneapolis, MN 55417, USA
| | - Rebecca Tapia
- South Texas Veterans Healthcare System, 7400 Merton Minter Boulevard, San Antonio, TX 78229, USA; Department of Rehabilitation Medicine, UT Health San Antonio, San Antonio, TX, USA
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Hale-Gallardo JL, Kreider CM, Jia H, Castaneda G, Freytes IM, Cowper Ripley DC, Ahonle ZJ, Findley K, Romero S. Telerehabilitation for Rural Veterans: A Qualitative Assessment of Barriers and Facilitators to Implementation. J Multidiscip Healthc 2020; 13:559-570. [PMID: 32669850 PMCID: PMC7335893 DOI: 10.2147/jmdh.s247267] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 05/07/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose Telerehabilitation (TR) is increasingly being used to meet the rehabilitation needs of individuals living in rural areas. Nevertheless, reports on TR implementation for rural patients remain limited. As part of a broader evaluation, this study investigated barriers and facilitators to the implementation of a national TR program to meet the needs of rural Veterans Health Administration (VHA) patients. Methods This study applied a qualitative approach to the RE-AIM framework to investigate barriers and facilitators impacting TR implementation. We conducted in-depth, semi-structured interviews with ten program managers and medical directors within the VHA at three time points during the first 18 months of implementation. Interviews were analyzed using thematic analysis. Results Three themes were identified describing key cultural, infrastructural and logistical, and environmental barriers impacting the reach, adoption, and implementation of TR. Within the themes, facilitators for TR were also identified to include, allowing providers flexibility in implementing TR, mentorship and development of creative approaches to TR training, overcoming infrastructural and logistical TR barriers through championing, and continuous sharing of lessons learned in a community of practice. Discussion This study explicates salient barriers and facilitators encountered during the first 18 months of implementation of a TR program within a national healthcare system in the United States. Implementing TR to meet the rehabilitation needs of Veterans in resource-limited rural environments requires creative approaches and flexibility, as well as perseverance and consistent championing in order to overcome cultural challenges. This, in combination with infrastructural challenges, such as lack of broadband, adds greater complexity to meeting the needs of rural patients. This study provides new and in-depth understanding of the processes by which TR is implemented in a large healthcare system and points to practical real-world lessons in implementing TR for rural patients.
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Affiliation(s)
- Jennifer L Hale-Gallardo
- Department of Veterans Affairs, North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA
| | - Consuelo M Kreider
- Department of Veterans Affairs, Veterans Rural Health Resource Center-Gainesville, Office of Rural Health, Gainesville, Florida, USA.,Department of Occupational Therapy, University of Florida, Gainesville, Florida, USA
| | - Huanguang Jia
- Department of Veterans Affairs, North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA
| | - Gail Castaneda
- Department of Veterans Affairs, Veterans Rural Health Resource Center-Gainesville, Office of Rural Health, Gainesville, Florida, USA
| | - I Magaly Freytes
- Department of Veterans Affairs, North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA
| | - Diane C Cowper Ripley
- Department of Veterans Affairs, Veterans Rural Health Resource Center-Gainesville, Office of Rural Health, Gainesville, Florida, USA
| | - Zaccheus J Ahonle
- Department of Occupational Therapy, University of Florida, Gainesville, Florida, USA
| | - Kimberly Findley
- Department of Veterans Affairs, North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA
| | - Sergio Romero
- Department of Veterans Affairs, North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA.,Department of Veterans Affairs, Veterans Rural Health Resource Center-Gainesville, Office of Rural Health, Gainesville, Florida, USA
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Graham F, Boland P, Grainger R, Wallace S. Telehealth delivery of remote assessment of wheelchair and seating needs for adults and children: a scoping review. Disabil Rehabil 2019; 42:3538-3548. [DOI: 10.1080/09638288.2019.1595180] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Fiona Graham
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Pauline Boland
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Rebecca Grainger
- Department of Medicine, University of Otago, Wellington, New Zealand
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Pekçetin S, Özdinç S, Ata H, Can HB, Elter K. Effect of telephone-supported ergonomic education on pregnancy-related low back pain. Women Health 2018; 59:294-304. [PMID: 29920177 DOI: 10.1080/03630242.2018.1478364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study investigated the effect of telephone-supported ergonomic education on pregnancy-related low back pain. This study was performed at Trakya University Hospital in Edirne, Turkey between December 15, 2016 and April 4, 2017. One hundred ten pregnant women were included in the study and randomly assigned to one of two groups. Sixty pregnant women received one face-to-face session of ergonomic education followed by three weekly sessions of telephone-supported ergonomic education (intervention group). Fifty pregnant women received only one session of standard face-to-face ergonomic education. Before and after the intervention, low back pain was evaluated using the Visual Analog Scale. Pain-related disability was evaluated with the Oswestry Disability Index, and health-related quality of life was evaluated with the SF-36. Telephone-supported ergonomic education was more effective than standard ergonomic education and can be used as an effective solution for pregnancy-related low back pain.
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Affiliation(s)
- Serkan Pekçetin
- a Health Sciences Occupational Therapy Department, Trakya University , Edirne , Turkey
| | - Sevgi Özdinç
- b Physical Therapy and Rehabilitation Department, Trakya University , Edirne , Turkey
| | - Hilal Ata
- b Physical Therapy and Rehabilitation Department, Trakya University , Edirne , Turkey
| | - Hilal Başak Can
- b Physical Therapy and Rehabilitation Department, Trakya University , Edirne , Turkey
| | - Koray Elter
- c Obstetrics and Gynecology Department, Trakya University , Edirne , Turkey
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Graham F, Boland P, Grainger R, Wallace S. Telehealth delivery of remote assessment of wheelchair and seating needs for adults and children: A scoping review (Preprint). JMIR Rehabil Assist Technol 2018. [DOI: 10.2196/rehab.9914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Reinkensmeyer DJ, Blackstone S, Bodine C, Brabyn J, Brienza D, Caves K, DeRuyter F, Durfee E, Fatone S, Fernie G, Gard S, Karg P, Kuiken TA, Harris GF, Jones M, Li Y, Maisel J, McCue M, Meade MA, Mitchell H, Mitzner TL, Patton JL, Requejo PS, Rimmer JH, Rogers WA, Zev Rymer W, Sanford JA, Schneider L, Sliker L, Sprigle S, Steinfeld A, Steinfeld E, Vanderheiden G, Winstein C, Zhang LQ, Corfman T. How a diverse research ecosystem has generated new rehabilitation technologies: Review of NIDILRR's Rehabilitation Engineering Research Centers. J Neuroeng Rehabil 2017; 14:109. [PMID: 29110728 PMCID: PMC5674748 DOI: 10.1186/s12984-017-0321-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 10/26/2017] [Indexed: 01/14/2023] Open
Abstract
Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a "total approach to rehabilitation", combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970's, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program.
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Affiliation(s)
| | | | | | - John Brabyn
- The Smith-Kettlewell Eye Research Institute, San Francesco, USA
| | | | | | | | | | - Stefania Fatone
- Northwestern University Prosthetics-Orthotics Center, Evanston, USA
| | - Geoff Fernie
- Toronto Rehabilitation Institute, Toronto, Canada
| | - Steven Gard
- Northwestern University Prosthetics-Orthotics Center, Evanston, USA
| | | | | | | | | | - Yue Li
- Toronto Rehabilitation Institute, Toronto, Canada
| | | | | | | | | | | | - James L. Patton
- Rehabilitation Institute of Chicago, University of Illinois at Chicago, Chicago, USA
| | | | - James H. Rimmer
- Lakeshore FoundationUniversity of Alabama-Birmingham, Birmingham, USA
| | | | - W. Zev Rymer
- Rehabilitation Institute of Chicago, Chicago, USA
| | | | | | | | | | - Aaron Steinfeld
- Robotics Institute, Carnegie Mellon University, Pittsburgh, USA
| | | | | | | | | | - Thomas Corfman
- National Institute on Disability, Independent Living, and Rehabilitation Research, Washington, DC, USA
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Choi J, Hergenroeder AL, Burke L, Dabbs AD, Morrell M, Saptono A, Parmanto B. Delivering an in-Home Exercise Program via Telerehabilitation: A Pilot Study of Lung Transplant Go (LTGO). Int J Telerehabil 2016; 8:15-26. [PMID: 28775798 PMCID: PMC5536726 DOI: 10.5195/ijt.2016.6201] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
We evaluated the feasibility, safety, system usability, and intervention acceptability of Lung Transplant Go (LTGO), an 8-week in-home exercise intervention for lung transplant recipients using a telerehabilitation platform, and described changes in physical function and physical activity from baseline to post-intervention. The intervention was delivered to lung transplant recipients in their home via the Versatile and Integrated System for TeleRehabilitation (VISYTER). The intervention focused on aerobic and strengthening exercises tailored to baseline physical function. Participants improved walk distance (6-minute walk distance), balance (Berg Balance Scale), lower body strength (30-second chair stand test) and steps walked (SenseWear Armband®). No adverse events were reported. Participants rated the program highly positively in regard to the technology and intervention. The telerehabilitation exercise program was feasible, safe, and acceptable. Our findings provide preliminary support for the LTGO intervention to improve physical function and promote physical activity in lung transplant recipients.
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Affiliation(s)
- Jiyeon Choi
- DEPARTMENT OF ACUTE & TERTIARY CARE, SCHOOL OF NURSING, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PENNSYLVANIA, USA
| | - Andrea L Hergenroeder
- DEPARTMENT OF PHYSICAL THERAPY, SCHOOL OF HEALTH AND REHABILITATION SCIENCE, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PENNSYLVANIA, USA
| | - Lora Burke
- DEPARTMENT OF HEALTH & COMMUNITY SYSTEMS, SCHOOL OF NURSING, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PENNSYLVANIA, USA
| | - Annette Devito Dabbs
- DEPARTMENT OF ACUTE & TERTIARY CARE, SCHOOL OF NURSING, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PENNSYLVANIA, USA
| | - Matthew Morrell
- DIVISION OF PULMONARY ALLERGY AND CRITICAL CARE MEDICINE, DEPARTMENT OF MEDICINE, UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE & SCHOOL OF NURSING, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PENNSYLVANIA, USA
| | - Andi Saptono
- DEPARTMENT OF HEALTH INFORMATION MANAGEMENT, SCHOOL OF HEALTH AND REHABILITATION SCIENCE, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PENNSYLVANIA, USA
| | - Bambang Parmanto
- DEPARTMENT OF HEALTH INFORMATION MANAGEMENT, SCHOOL OF HEALTH AND REHABILITATION SCIENCE, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PENNSYLVANIA, USA
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Agostini M, Moja L, Banzi R, Pistotti V, Tonin P, Venneri A, Turolla A. Telerehabilitation and recovery of motor function: a systematic review and meta-analysis. J Telemed Telecare 2015; 21:202-13. [PMID: 25712109 DOI: 10.1177/1357633x15572201] [Citation(s) in RCA: 152] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Accepted: 11/15/2014] [Indexed: 11/17/2022]
Abstract
Recent advances in telecommunication technologies have boosted the possibility to deliver rehabilitation via the internet (i.e. telerehabilitation). Several studies have shown that telerehabilitation is effective to improve clinical outcomes in disabling conditions. The aim of this review was to determine whether telerehabilitation was more effective than other modes of delivering rehabilitation to regain motor function, in different populations of patients.We searched PubMed, Embase and the Cochrane library retrieving 2360 records. Twelve studies were included involving different populations (i.e. neurological, total knee arthroplasty (TKA), cardiac) of patients. Inconclusive finding were found on the effect of telerehabilitation for neurological patients (SMD = 0.08, CI 95% = -0.13, 0.29), while both for cardiac (SMD = 0.24, CI 95% = 0.04, 0.43) and TKA patients (Timed Up and Go test: MD = -5.17, CI 95% = -9.79, -0.55) the results were in favour of telerehabilitation.Conclusive evidence on the efficacy of telerehabilitation for treatment of motor function, regardless of pathology, was not reached. Nevertheless, a strong positive effect was found for patients following orthopaedic surgery, suggesting that the increased intensity provided by telerehabilitation is a promising option to be offered to patients. More and higher quality research is needed in this field especially with neurological patients.
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Affiliation(s)
- Michela Agostini
- Foundation IRCCS San Camillo Hospital, Laboratory of Kinematics and Robotics, Neurorehabilitation Department, via Alberoni 70, 30126, Venice, Italy
| | - Lorenzo Moja
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; Clinical Epidemiology Unit, IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - Rita Banzi
- IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Via La Masa 19, 20156 Milan, Italy
| | - Vanna Pistotti
- IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Via La Masa 19, 20156 Milan, Italy
| | - Paolo Tonin
- Foundation IRCCS San Camillo Hospital, Laboratory of Kinematics and Robotics, Neurorehabilitation Department, via Alberoni 70, 30126, Venice, Italy
| | - Annalena Venneri
- Department of Neuroscience, The University of Sheffield. Sheffield, UK Foundation IRCCS San Camillo Hospital, Laboratory of Neuroimaging, via Alberoni 70, 30126, Venice, Italy
| | - Andrea Turolla
- Foundation IRCCS San Camillo Hospital, Laboratory of Kinematics and Robotics, Neurorehabilitation Department, via Alberoni 70, 30126, Venice, Italy Department of Neuroscience, The University of Sheffield. Sheffield, UK
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Abstract
Rehabilitation medicine is the medical specialty that integrates rehabilitation as its core therapeutic modality in disability management. More than a billion people worldwide are disabled, and the World Health Organization has developed the International Classification of Functioning, Disability and Health as a framework through which disability is addressed. Herein, we explore paradigm shifts in neurorehabilitation, with a focus on restoration, and provide overviews on developments in neuropharmacology, rehabilitation robotics, virtual reality, constraint-induced therapy and brain stimulation. We also discuss important issues in rehabilitation systems of care, including integrated care pathways, very early rehabilitation, early supported discharge and telerehabilitation. Finally, we highlight major new fields of rehabilitation such as spasticity management, frailty and geriatric rehabilitation, intensive care and cancer rehabilitation.
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Affiliation(s)
- Yee Sien Ng
- Department of Rehabilitation Medicine, Singapore General Hospital, Outram Road, Singapore 169608.
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Gregory P, Alexander J, Satinsky J. Clinical telerehabilitation: applications for physiatrists. PM R 2011; 3:647-56; quiz 656. [PMID: 21777864 DOI: 10.1016/j.pmrj.2011.02.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 02/17/2011] [Accepted: 02/20/2011] [Indexed: 11/26/2022]
Abstract
Telemedicine offers an innovative approach to increase access to rehabilitation medicine services for patients who live in areas where physiatrists are scarce or absent. This article reviews the current status of telerehabilitation services delivered through real-time videoconferencing to provide support, assessment, and interventions to individuals with impairments or disabilities. A literature review demonstrates various uses of telerehabilitation by physical therapists, occupational therapists, speech and language pathologists, audiologists, recreational therapists, neuropsychologists, nurses, other physician specialists, and physiatrists. We also provide more in-depth examples of 2 current programs that involve physiatrists: One furnishes telerehabilitation services to adult stroke survivors, and the other addresses the special health care needs of children with developmental disabilities. We discuss the benefits of using telemedicine via real-time videoconferencing to care for individuals with disabilities, outline the challenges of successfully implementing a physiatric telerehabilitation program, and finish with a list of potential applications for physiatrists interested in incorporating telemedicine into their practice. Further investigation of the use of telehealth technologies to deliver physiatric services, care coordination, and education is needed. We recommend that our professional societies develop and publish guidelines to facilitate development and use of telerehabilitation technologies to increase access to physiatric services.
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Affiliation(s)
- Patricia Gregory
- Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Tousignant M, Boissy P, Moffet H, Corriveau H, Cabana F, Marquis F, Simard J. Patients' satisfaction of healthcare services and perception with in-home telerehabilitation and physiotherapists' satisfaction toward technology for post-knee arthroplasty: an embedded study in a randomized trial. Telemed J E Health 2011; 17:376-82. [PMID: 21492030 DOI: 10.1089/tmj.2010.0198] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE We measured the satisfaction of both patients and healthcare professionals with the technologies and services provided during in-home telerehabilitation as an alternative to conventional rehabilitation after discharge from total knee arthroplasty surgery. METHODS This study was embedded in a larger controlled trial where 48 community-living older adults who received total knee arthroplasty were recruited prior to discharge from acute care following surgery and randomly assigned to treatment arms (Tele and Comparison). The participants' satisfaction with the services was assessed at the end of the intervention for both groups using the Healthcare Satisfaction Questionnaire. For the Tele group, the patients' perception of in-home telehealth was assessed before treatment and after completion of teletreatments. The satisfaction of the healthcare professionals with the technology during the telerehabilitation services was noted at the end of each treatment session using a technical quality subjective appreciation questionnaire. RESULTS Both groups of patients (Tele and Comparison) were satisfied with the services received and no significant difference was observed between them. Moreover, the physiotherapists' satisfaction with regard to goal achievement, patient-therapist relationship, overall session satisfaction, and quality and performance of the technological platform was high. CONCLUSIONS As patient satisfaction is important in maintaining motivation and treatment compliance and the satisfaction of healthcare professionals must be high in order for new treatments to become mainstream in clinics, the results show that in-home telerehabilitation seems to be a promising alternative to traditional face-to-face treatments.
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Affiliation(s)
- Michel Tousignant
- Sherbrooke Geriatric University Institute, University of Sherbrooke, Sherbrooke, Québec, Canada .
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Schein RM, Schmeler MR, Saptono A, Brienza D. Patient satisfaction with telerehabilitation assessments for wheeled mobility and seating. Assist Technol 2011; 22:215-22. [PMID: 21306067 DOI: 10.1080/10400435.2010.518579] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Wheeled mobility and seating assessments for individuals with mobility impairments living in rural or distant locations are problematic due to the lack of expertise and available resources. The objective of this study was to measure satisfaction based on one's evaluation and prescription as well as comfort level when being evaluated by telerehabilitation (TR). Patient satisfaction data from real-time interactive TR clinical consultations between an expert practitioner located at least 125 miles away and four remote wheelchair clinics set up by the research team were collected and evaluated. The results revealed that there was a statistically significant difference between participants' pre- and postevaluation scores, t(39) = -13.92, p < .05, as well as pre- and postprescription scores, t(39) = -13.15, p < .05. In addition, all mean scores were significantly higher than the scale midpoint of3.5 on a TR survey. The study's findings are consistent with those of previous telemedicine satisfaction studies. Overall, the results indicate a high level of patient satisfaction using TR.
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Affiliation(s)
- Richard M Schein
- Department of Rehabilitation Science and Technology, University of Pittsburgh, 5044 Forbes Tower at Atwood, Pittsburgh, PA 15260, USA.
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Parmanto B, Saptono A, Pramana G, Pulantara W, Schein RM, Schmeler MR, McCue MP, Brienza DM. VISYTER: versatile and integrated system for telerehabilitation. Telemed J E Health 2010; 16:939-44. [PMID: 21034239 DOI: 10.1089/tmj.2010.0033] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The versatile and integrated system for telerehabilitation (VISYTER) is a software platform for developing various telerehabilitation applications. VISYTER has been designed to take into account the environments and requirements of rehabilitation services. The requirements considered in the platform design include minimal equipment beyond what is available in many rehabilitation settings, minimal maintenance, and ease of setup and operation. In addition, the platform has been designed to be able to adjust to different bandwidths, ranging from the very fast new generation of Internet to residential broadband connections. VISYTER is a secure integrated system that combines high-quality videoconferencing with access to electronic health records and other key tools in telerehabilitation such as stimuli presentation, remote multiple camera control, remote control of the display screen, and an eye contact teleprompter. The software platform is suitable for supporting low-volume services to homes, yet scalable to support high-volume enterprise-wide telehealth services. The VISYTER system has been used to develop a number of telerehabilitation applications, including a remote wheelchair prescription, adult autistic assessments, and international physical therapy teleconsultations. An evaluation of VISYTER for delivering a remote wheelchair prescription was conducted on 48 participants. Results of the evaluation indicate a high level of satisfaction from patients with the use of VISYTER. The versatility and cost-effectiveness of the platform has the potential for a wide range of telerehabilitation applications and potentially may lower the technical and economic barriers of telemedicine adoption.
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Affiliation(s)
- Bambang Parmanto
- Department of Health Information Management, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA.
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Telerehabilitation Wheeled Mobility and Seating Assessments Compared With In Person. Arch Phys Med Rehabil 2010; 91:874-8. [DOI: 10.1016/j.apmr.2010.01.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 01/21/2010] [Accepted: 01/23/2010] [Indexed: 11/22/2022]
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Saptono A, Schein RM, Parmanto B, Fairman A. Methodology for analyzing and developing information management infrastructure to support telerehabilitation. Int J Telerehabil 2009; 1:39-46. [PMID: 25945161 PMCID: PMC4296783 DOI: 10.5195/ijt.2009.6012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The proliferation of advanced technologies led researchers within the Rehabilitation Engineering Research Center on Telerehabilitation (RERC-TR) to devise an integrated infrastructure for clinical services using the University of Pittsburgh (PITT) model. This model describes five required characteristics for a telerehabilitation (TR) infrastructure: openness, extensibility, scalability, cost-effectiveness, and security. The infrastructure is to deliver clinical services over distance to improve access to health services for people living in underserved or remote areas. The methodological approach to design, develop, and employ this infrastructure is explained and detailed for the remote wheelchair prescription project, a research task within the RERC-TR. The availability of this specific clinical service and personnel outside of metropolitan areas is limited due to the lack of specialty expertise and access to resources. The infrastructure is used to deliver expertise in wheeled mobility and seating through teleconsultation to remote clinics, and has been successfully deployed to five rural clinics in Western Pennsylvania.
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Affiliation(s)
- Andi Saptono
- Department of Health Information Management at the University of Pittsburgh
| | - Richard M Schein
- Department of Rehabilitation Science and Technology at the University of Pittsburgh
| | - Bambang Parmanto
- Department of Health Information Management at the University of Pittsburgh
| | - Andrea Fairman
- Department of Rehabilitation Science and Technology at the University of Pittsburgh
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Schmeler MR, Schein RM, McCue M, Betz K. Telerehabilitation clinical and vocational applications for assistive technology: research, opportunities, and challenges. Int J Telerehabil 2009; 1:59-72. [PMID: 25945163 PMCID: PMC4296780 DOI: 10.5195/ijt.2009.6014] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Rehabilitation service providers in rural or underserved areas are often challenged in meeting the needs of their complex patients due to limited resources in their geographical area. Recruitment and retention of the rural clinical workforce are beset by the ongoing problems associated with limited continuing education opportunities, professional isolation, and the challenges inherent in coordinating rural community healthcare. People with disabilities who live in rural communities also face challenges accessing healthcare. Traveling long distances to a specialty clinic for necessary expertise may be troublesome due to inadequate or unavailable transportation, disability specific limitations, and financial limitations. Distance and lack of access are just two threats to quality of care that now being addressed by the use of videoconferencing, information exchange, and other telecommunication technologies that facilitate telerehabilitation. This white paper illustrates and summarizes clinical and vocational applications of telerehabilitation. We provide definitions related to the fields of telemedicine, telehealth, and telerehabilitation, and consider the impetus for telerehabilitation. We review the telerehabilitation literature for assistive technology applications; pressure ulcer prevention; virtual reality applications; speech-language pathology applications; seating and wheeled mobility applications; vocational rehabilitation applications; and cost-effectiveness. We then discuss external telerehabilitation influencers, such as the positions of professional organizations. Finally, we summarize clinical and policy issues in a limited context appropriate to the scope of this paper.
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Affiliation(s)
- Mark R Schmeler
- Department of Rehabilitation Science and Technology, University of Pittsburgh
| | - Richard M Schein
- Department of Rehabilitation Science and Technology, University of Pittsburgh
| | - Michael McCue
- Department of Rehabilitation Science and Technology, University of Pittsburgh
| | - Kendra Betz
- Prosthetics and Sensory Aids Service, Veterans Health Administration
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Abstract
Rehabilitation service providers in rural or underserved areas are often challenged in meeting the needs of their complex patients due to limited resources in their geographical area. Recruitment and retention of the rural clinical workforce are beset by the ongoing problems associated with limited continuing education opportunities, professional isolation, and the challenges inherent to coordinating rural community healthcare. People with disabilities who live in rural communities also face challenges accessing healthcare. Traveling long distances to a specialty clinic for necessary expertise is troublesome due to inadequate or unavailable transportation, disability specific limitations, and financial limitations. Distance and lack of access are just two threats to quality of care that now being addressed by the use of videoconferencing, information exchange, and other telecommunication technologies that facilitate telerehabilitation. This white paper illustrates and summarizes clinical and vocational applications of telerehabilitation. We provide definitions related to the fields of telemedicine, telehealth, and telerehabilitation, and consider the impetus for telerehabilitation. We review the telerehabilitation literature for assistive technology applications, pressure ulcer prevention, virtual reality applications, speech-language pathology applications, seating and wheeled mobility applications, vocational rehabilitation applications, and cost-effectiveness. We then discuss external telerehabilitation influencers, such as the positions of professional organizations. Finally, we summarize clinical and policy issues in a limited context appropriate to the scope of this paper.
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Affiliation(s)
- Bambang Parmanto
- Department of Health Information Management, University of Pittsburgh
| | - Andi Saptono
- Department of Health Information Management, University of Pittsburgh
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