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Sun J, Xu Y, Zhu J, Zhu B, Gao W. Efficacy and safety of continuous nursing in improving functional recovery after total hip or knee arthroplasty in older adults: A systematic review. Int J Nurs Sci 2024; 11:286-294. [PMID: 38707686 PMCID: PMC11064567 DOI: 10.1016/j.ijnss.2024.03.013] [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: 08/28/2023] [Revised: 02/15/2024] [Accepted: 03/08/2024] [Indexed: 05/07/2024] Open
Abstract
Objective This systematic review was conducted to evaluate the efficacy and safety of continuous nursing care for the recovery of joint function in older adults with total hip or knee arthroplasty. Methods Randomized controlled trials and cohort studies of continuous nursing in older patients after joint replacement were searched from the database of Cochrane Library, Web of Science, PubMed, and Embase from their establishment to October 25, 2023. After literature screening, two researchers completed data extraction, and the risk of bias was assessed using the Cochrane risk-of-bias tool. The risk analysis included in cohort studies was based on the Newcastle-Ottawa Scale (NOS). Results The study included a total of 15 articles, comprising 34,186 knee and hip replacement patients. In this review, the effects of continuous nursing on the recovery of joint function of knee replacement and hip replacement in older adults were classified and discussed. Continuous nursing interventions targeted for total hip replacement could greatly increase the range of joint mobility, enhance muscle strength during hip movements like flexion, extension, and abduction, maintain joint stability, relieve pain, improve daily activities, and lower the risk of complications. For older patients with knee arthroplasty, continuous nursing programs could markedly improve knee motion range, joint flexion, joint stability, daily activities, and pain management. Despite the implementation of interventions, the incidence of complications caused by total knee replacement did not decrease. Out of all the studies reviewed, only one used a theoretical framework for interventions provided to patients during the postoperative period of hip arthroplasty. The overall quality of the included studies was very high. Conclusion Continuous nursing can effectively improve the joint function of older patients after joint replacement. However, its effectiveness in terms of clinical outcomes, patient satisfaction, and medical cost of associated continuous nursing needs to be further clarified. In addition, continuous nursing has no significant advantage in the safety of postoperative complications and readmission rates in older adults after knee joint replacement. To enhance the efficacy and safety of continuous nursing effectively, it is crucial to refine the continuous nursing program in the future, thereby elevating the quality of nursing services.
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Affiliation(s)
- Jing Sun
- School of Nursing, Jiangsu Vocational College of Medicine, Yancheng, China
- Department of Nursing, Faculty of Nursing, Lincoln University College, Kuala Lumpur, Malaysia
| | - Yirong Xu
- School of Nursing, Jiangsu Vocational College of Medicine, Yancheng, China
- Department of Nursing, Faculty of Nursing, Lincoln University College, Kuala Lumpur, Malaysia
| | - Juan Zhu
- School of Nursing, Jiangsu Vocational College of Medicine, Yancheng, China
- Department of Nursing, Faculty of Nursing, Lincoln University College, Kuala Lumpur, Malaysia
| | - Bei Zhu
- School of Nursing, Jiangsu Vocational College of Medicine, Yancheng, China
- Department of Nursing, Faculty of Nursing, Lincoln University College, Kuala Lumpur, Malaysia
| | - Wei Gao
- School of Nursing, Jiangsu Vocational College of Medicine, Yancheng, China
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Bramanti A, Ciurleo R, Vecchione C, Turolla A, Piramide N, Ciccarelli M, Piramide E, Garofano M, Senatore M, Calabrese M. Telerehabilitation: A Solution for Patients After Hip Fracture? Transl Med UniSa 2024; 26:30-37. [PMID: 38560615 PMCID: PMC10980289 DOI: 10.37825/2239-9747.1048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/01/2024] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
- Hip fracture is the most common cause of hospitalization in frail geriatric subjects due to osteoporosis and recurrent falls. The clinical practice guidelines for rehabilitation after surgery in patients with hip fractures recommend to start treatment early. However, the outbreak of SARS-CoV-2 pandemic between December 2019 and January 2020 forced to lockdown. Thus, telerehabilitation seemed the best solution to remote assistance. In this scenario, the aim of our study is to assess the effects of telerehabilitation and to clarify and rearrange the knowledge about its usability and feasibility in patients after hip fracture in emergency conditions, such as the pandemic of SARS-CoV-2. Three databases were systematically searched from caption to December 2023, considering only articles published in peer-reviewed journals, with the use of three macro-areas: 'telerehabilitation', 'remote rehabilitation' and 'hip fracture'. In the present review, 26 articles were considered eligible and 10 were included. Heterogeneous results were found due to the different characteristics of the patients recruited in the studies, designs and type of the studies, and reporting/conducting of the research. Also, the typologies of telerehabilitation provided were various. In conclusion, this review demonstrated that telerehabilitation is safe, effective and well tolerated from patients and seems to be not inferior to the conventional physiotherapy. It also plays a positive role in psychological rehabilitation, in the prevention of complications and in the maintenance of achieved goals. However, further studies are needed to guide the clinical practice in providing the better posology and typology of telerehabilitation.
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Affiliation(s)
- Alessia Bramanti
- Department of Medicine, Surgery and Dentistry “Medical School of Salerno”, University of Salerno,
Italy
| | | | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry “Medical School of Salerno”, University of Salerno,
Italy
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna,
Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna,
Italy
| | | | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry “Medical School of Salerno”, University of Salerno,
Italy
| | | | - Marina Garofano
- Department of Medicine, Surgery and Dentistry “Medical School of Salerno”, University of Salerno,
Italy
- Department of Medicine, Surgery and Dentistry, University of Cagliari,
Italy
| | | | - Mariaconsiglia Calabrese
- Department of Medicine, Surgery and Dentistry “Medical School of Salerno”, University of Salerno,
Italy
- Rehabilitation Department, A.O.U. “San Giovanni di Dio e Ruggi d’Aragona”, 84125, Salerno,
Italy
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Molina-Garcia P, Mora-Traverso M, Prieto-Moreno R, Díaz-Vásquez A, Antony B, Ariza-Vega P. Effectiveness and cost-effectiveness of telerehabilitation for musculoskeletal disorders: A systematic review and meta-analysis. Ann Phys Rehabil Med 2024; 67:101791. [PMID: 38128150 DOI: 10.1016/j.rehab.2023.101791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 07/25/2023] [Accepted: 08/21/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Internet-based telerehabilitation could be a valuable option for the treatment of musculoskeletal disorders, with the advantage of providing rehabilitation from anywhere. However, there is no solid and updated evidence demonstrating its effectiveness on relevant clinical and cost outcomes. OBJECTIVE This systematic review aims to determine the clinical and cost-effectiveness of internet-based telerehabilitation during the recovery of musculoskeletal disorders. METHODS Medline, Web of Science, Scopus and Cochrane databases were systematically searched from inception to June 2023. Trials investigating the effects of internet-based telerehabilitation in any musculoskeletal disorder were selected. Nonoriginal articles and grey literature were excluded. Two independent reviewers conducted the study selection and data extraction. Random effect meta-analyses (standardized mean difference) and further sensitivity analyses were performed. RESULTS We selected 37 clinical trials (33 randomized and 4 non-randomized) and 5 health economics studies, which included a total of 4,288 participants. Telerehabilitation was more favourable than control treatments in improving all studied clinical outcomes, although the effectiveness varied depending on the type of musculoskeletal disorder. The standard mean differences (SMD) ranged from 0.24 to 0.91. For physical function, the primary outcome, superior effectiveness was found only in people with hip fractures (SMD, 0.87; 95 % CI, 0.34 to 1.41). The effects for joint replacement, osteoarthritis, and spine pain were similar to those of control treatments. However, the favourable outcomes for telerehabilitation became insignificant when compared specifically to face-to-face rehabilitation. Some results displayed publication bias and a lack of robustness, necessitating cautious interpretation. In terms of health economics studies, telerehabilitation was 89.55$ (95 % CI 4.6 to 174.5) cheaper per individual than conventional treatments. CONCLUSIONS Telerehabilitation should be considered in the recovery process of musculoskeletal disorders when optimal face-to-face rehabilitation is not feasible. Moreover, telerehabilitation reduces costs and time. PROSPERO NUMBER CRD42022322425.
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Affiliation(s)
| | - Marta Mora-Traverso
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain
| | - Rafael Prieto-Moreno
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain; Biomedical Research Unit, Torrecárdenas University Hospital, 04009 Almería, Spain; Department of Education, Faculty of Education Sciences, SPORT Research Group (CTS-1024) and CERNEP Research Center, University of Almería, Almería, Spain
| | | | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania 7000, Australia
| | - Patrocinio Ariza-Vega
- Instituto de Investigación Biosanitaria ibs.GRANDA, Granada, Spain; PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain; Department of Physiotherapy, Faculty of Health Science, University of Granada, Granada, Spain
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Wang L, Wang X, Zhang R, He C. Emerging trends and prospects in telerehabilitation for hip fracture: Bibliometric and visualization study. Digit Health 2024; 10:20552076241255465. [PMID: 38798887 PMCID: PMC11128182 DOI: 10.1177/20552076241255465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Background Telerehabilitation provide distant physical rehabilitation services and help overcome the barriers associated with face-to-face interventions for hip fractures. This study aims to analyse the progress of the application of telerehabilitation in hip fracture and reveal its research profile, hotspots and development trends. Methods The articles and reviews related to telerehabilitation in hip fracture were retrieved from 1992 to 2024. A bibliometric visualization and comparative analysis of countries, institutions, journals, authors, references and keywords were conducted using Java-based CiteSpace and VOSviewer. Results A total of 79 documents were obtained. Spain was the most academically influential country. The University of Granada was the most prolific institution. The author Ariza-vega P listed first in terms of publications and citations. Most publications were published in high academic impact journals. The major frontier keywords were "older adults," "functional recovery," "reliability," "mortality," "rehabilitation," "mobility" and "quality of life." The most popular keywords from 2020 to 2024 were "geriatric medicine," "family caregiver" and "digital health." Conclusions The historical and prospective perspective in telerehabilitation following hip fracture were presented. A primary focus in the early years was the impact of telerehabilitation on functional independence for hip fracture patients. Future outcomes are expected to include patient satisfaction, health-related quality of life and psychiatric symptoms. Exercise was also designed to eliminate travel burdens and strengthen self-efficacy, and improve the physical and psychosocial function of hip fracture patients. This work will provide a fundamental reference as well as a directional guide for future research.
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Affiliation(s)
- Liqiong Wang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Xiangxiu Wang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Ruishi Zhang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Chengqi He
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
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Gatica-Rojas V, Cartes-Velásquez R. Telerehabilitation in Low-Resource Settings to Improve Postural Balance in Older Adults: A Non-Inferiority Randomised Controlled Clinical Trial Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6726. [PMID: 37754586 PMCID: PMC10531484 DOI: 10.3390/ijerph20186726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 09/28/2023]
Abstract
Background: Several exercise methods with virtual reality devices have been used in treatments for older adults and patients with neurodegenerative diseases, although the mechanisms continue to be elucidated. The aim of this study is to establish the feasibility and effectiveness of a rehabilitation programme using low-cost virtual reality aimed at improving postural balance in older adults. It also seeks to compare low-cost virtual reality under two delivery modalities, telerehabilitation (TR) in elderly centres and face-to-face (FtF) in rehabilitation centres. Methods: The study is set up as a non-inferiority two-arm parallel triple-blind randomised controlled clinical trial. Sixteen persons aged 65 to 75-years-old will be included. Eighteen Wii therapy sessions (25-30 min) will be provided through both FtF (control group, n = 8) and TR (exposure group, n = 8), both with a Nintendo Wii balance board. Data will be collected at baseline (week 0), during the Wii therapy sessions (weeks 2, 4, and 6), and during the follow-up (weeks 8 and 10). The primary outcome will be the area of centre-of-pressure (CoP) sway; secondary outcomes will be medial-lateral and anterior-posterior velocity and standard deviation of CoP; and tertiary outcomes will be clinical measures: single-leg stand, timed up-and-go tests, Barthel Index, and Tinetti's scale. Statistical analyses will be performed using SPSS 20.00 for Windows. The trial adheres to the Declaration of Helsinki and the Chilean laws of rights and duties of the patient and research in humans. Ethical approval was obtained from the Ethics Committee of the University of Talca. Written informed consent will be obtained from participants. Discussion: In this trial, older adults from a Chilean city with a large rural and underserved population share will be included to test the feasibility and effectiveness of a rehabilitation programme using low-cost VR aimed at improving postural balance to generate evidence to support decision makers generating public health policy. Trial registration: Australian New Zeeland Clinical Trials Registration (ACTRN12621001380886).
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Affiliation(s)
- Valeska Gatica-Rojas
- Telerehabilitation Technology Centre and Neurosciences in Human Movement, Faculty of Health Sciences, Universidad de Talca, Av. Lircay S/N, Talca 3460000, Chile
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