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VanPuymbrouck L, Friedman C. Early Career Occupational Therapists' Experiences during the COVID-19 Pandemic. Occup Ther Health Care 2024; 38:530-549. [PMID: 36794316 DOI: 10.1080/07380577.2023.2175291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 01/28/2023] [Indexed: 02/17/2023]
Abstract
Occupational therapists entering the clinical workforce during the COVID-19 pandemic experienced levels of uncertainty and stress. This study's aim was to explore the clinical experiences and concerns of early-career occupational therapists entering the workforce during the COVID-19 pandemic (n = 27). We administered an open-ended online survey and analyzed the data using inductive thematic analysis. Resulting themes included: safety, exposure, and transmission; implementation and enforcement of safety protocols; quality of care; and impact of the pandemic on overall health highlighting the issues that need to be addressed to be more prepared for future practice in an evolving environment.
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Affiliation(s)
| | - Carli Friedman
- CQL | The Council on Quality and Leadership, Towson, MD, USA
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2
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Silva MFD, Farias MN, Lopes RE. Terapia ocupacional e meio rural: uma revisão de escopo. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2023. [DOI: 10.1590/2526-8910.ctoar256533471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Resumo O mundo rural é um território de extrema importância para a sociedade como um todo; não obstante, tende ainda a ser visto como algo separado desta e, muitas vezes marginalizado em relação ao meio urbano. Além disso, é tido como um espaço atrasado, desatualizado e rústico em alguns contextos, como no brasileiro. A falta de acesso a bens sociais acaba por limitar as perspectivas da pessoa que vive nesse território, diminuindo sua autonomia e oportunidade de escolhas com relação à sua própria vida. Tanto no âmbito mundial quanto nacional, a terapia ocupacional, em suas diferentes subáreas, tem buscado contribuir para a resolução de problemáticas que envolvem contextos e sujeitos diversos que ocupam e vivem no meio rural. Assim, o objetivo primário deste estudo foi realizar uma revisão de escopo que abrangesse publicações nacionais e estrangeiras, procurando apreender, sistematizar e divulgar a produção científica na interface da terapia ocupacional com o mundo rural, analisando-a criticamente, de modo a perceber suas potencialidades e fragilidades, considerando as diversas ruralidades e contextos mundo afora. Foram encontrados resultados dos cinco continentes com dados necessários para essa sistematização e para uma síntese dessa produção. Tais resultados foram estudados, analisados e distribuídos em seis categorias configuradas a partir dos assuntos específicos abordados. Conclui-se que estudos relevantes foram realizados na interface terapia ocupacional-mundo rural, voltando-se a fatores que influenciam a atuação profissional nesses territórios, ao mesmo tempo em que propõem métodos, estratégias e programas de prática e formação para superar importantes desafios.
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Affiliation(s)
| | - Magno Nunes Farias
- Universidade Federal de São Carlos, Brasil; Universidade de Brasília, Brasil
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3
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Silva MFD, Farias MN, Lopes RE. Occupational therapy and rural environment: a scoping review. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2023. [DOI: 10.1590/2526-8910.ctoar256533472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Abstract The rural world is a territory of extreme importance for society as a whole; nevertheless, it still tends to be seen as something separate from it and often marginalized in relation to the urban environment. In addition, it is seen as a backward, outdated and rustic space in some contexts, such as the Brazilian one. The lack of access to social goods ends up limiting the perspectives of people living in this territory, reducing their autonomy and opportunity to make choices about their own lives. Both worldwide and nationally, occupational therapy, in its different subareas, has sought to contribute to the resolution of problems involving different contexts and subjects who occupy and live in rural areas. Thus, the primary objective of this study was to carry out a scope review that covered national and foreign publications, seeking to apprehend, systematize and disseminate scientific production in the interface of occupational therapy with the rural world, critically analyzing it, in order to perceive its potential and weaknesses, considering the different ruralities and contexts around the world. Results from five continents were found with data necessary for this systematization and for a synthesis of this production. Such results were studied, analyzed and distributed in six categories configured from the specific subjects addressed. It is concluded that relevant studies were carried out in the occupational therapy-rural world interface, focusing on factors that influence professional performance in these territories, while proposing methods, strategies and practice, and training programs to overcome important challenges.
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Affiliation(s)
| | - Magno Nunes Farias
- Universidade Federal de São Carlos, Brasil; Universidade de Brasília, Brasil
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4
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Leone E, Eddison N, Healy A, Royse C, Chockalingam N. Exploration of implementation, financial and technical considerations within allied health professional (AHP) telehealth consultation guidance: a scoping review including UK AHP professional bodies' guidance. BMJ Open 2021; 11:e055823. [PMID: 34969656 PMCID: PMC8718347 DOI: 10.1136/bmjopen-2021-055823] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic has resulted in a shift to remote consultations, but telehealth consultation guidelines are lacking or inconsistent. Therefore, a scoping review was performed to chart the information in the articles exploring telehealth for the UK allied health professionals (AHPs) and compare them with the UK AHP professional bodies' guidelines. DESIGN Scoping review following Aksey and O' Malley methodological framework. DATA SOURCES CINHAL and MEDLINE were searched from inception to March 2021 using terms related to 'telehealth', 'guidelines' and 'AHPs'. Additionally, the UK AHP professional bodies were contacted requesting their guidelines. STUDY SELECTION Articles exploring telehealth for patient consultations, written in English and published in peer-reviewed journal or guidelines available from UK AHP professional bodies/their websites were considered eligible for review. DATA EXTRACTION One reviewer extracted data concerning three overarching domains: implementation, financial and technological considerations. RESULTS 2632 articles were identified through database searches with 21 articles eligible for review. Eight guidelines were obtained from the UK AHP professional bodies with a total of 29 included articles/guidelines. Most articles were published in the last two years; there was variety in telehealth terminology, and most were developed for occupational therapists, physiotherapists and speech and language therapists. Information was lacking about the assessment of telehealth use and effectiveness, barriers and limitations, the logistical management, the family's and caregiver's roles and the costs. There was lack of clarity on the AHPs' registration requirements, costs and coverage, and legal aspects. CONCLUSION This study identified gaps in current guidelines, which showed similarities as well as discrepancies with the guidance for non-AHP healthcare professionals and revealed that the existing guidelines do not adequately support AHPs delivering telehealth consultations. Future research and collaborative work across AHP groups and the world's leading health institutions are suggested to establish common guidelines that will improve AHP telehealth services.
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Affiliation(s)
- Enza Leone
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, UK
| | - Nicola Eddison
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, UK
- Orthotic Service, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Aoife Healy
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, UK
| | - Carolyn Royse
- Dorset County Hospital NHS Foundation Trust, Dorchester, Dorset, UK
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, UK
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5
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Little LM, Pickett KA, Proffitt R, Cason J. Keeping Pace With 21 st Century Healthcare: A Framework for Telehealth Research, Practice, and Program Evaluation in Occupational Therapy. Int J Telerehabil 2021; 13:e6379. [PMID: 34345350 PMCID: PMC8287707 DOI: 10.5195/ijt.2021.6379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The use of telehealth to deliver occupational therapy services rapidly expanded during the COVID-19 pandemic. There are frameworks to evaluate services delivered through telehealth; however, none are specific to occupational therapy. Therefore, occupational therapy would benefit from a framework to systematically evaluate components of telehealth service delivery and build evidence to demonstrate the distinct value of occupational therapy. The PACE Framework outlines four priority domains to address areas of need: (1) Population and Health Outcomes; (2) Access for All Clients; (3) Costs and Cost Effectiveness; and (4) Experiences of Clients and Occupational Therapy Practitioners. This article describes the development and expert reviewer evaluation of the PACE Framework. In addition, the PACE Framework's domains, subdomains, and outcome measure examples are described along with future directions for implementation in occupational therapy research, practice, and program evaluation.
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Affiliation(s)
| | | | | | - Jana Cason
- Spalding University, Louisville, KY, USA
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6
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Mehta SP, Kendall KM, Reasor CM. Virtual assessments of knee and wrist joint range motion have comparable reliability with face-to-face assessments. Musculoskeletal Care 2020; 19:208-216. [PMID: 33107154 DOI: 10.1002/msc.1525] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND There has been increased usage of virtual telerehabilitation approach during the COVID-19 pandemic. It is crucial to establish reliability of conducting virtual assessments for musculoskeletal conditions. OBJECTIVES This research determined the intra- and interrater reliability of measuring knee and wrist range of motion (ROM) assessed virtually and obtained face-to-face (F2F) using a goniometer (UG) for a student and an experienced examiner. METHOD Knee and wrist joint ROM for 54 healthy participants was assessed virtually and F2F by a student examiner and an experienced physical therapist. Intra- (virtual vs. UG assessment) and inter-rater (virtual or UG assessment between examiners) reliabilities were examined for all ROM using Intraclass correlation coefficient (ICC). The ICC values were considered good (>0.75) or excellent (>0.90). Bland and Altman plots determined the limits of agreement (LOA) in assessing joint ROM. RESULTS/FINDINGS Student examiner had good reliability in virtually estimating knee extension (ICC = 0.79), wrist flexion (ICC = 0.82) and wrist extension (ICC = 0.78), whereas the experienced examiner had excellent reliability in virtually estimating all knee and wrist ROM (ICC > 0.90). The LOA in assessing knee and wrist ROM for the student examiner were wider indicating higher disagreement between virtual and UG-obtained ROM in some cases. CONCLUSIONS Virtual estimation of knee and wrist ROM is a reliable technique, however experience level impacts the precision of measurement. It is suggested that the same examiner conducts all the ROM assessments throughout the clinical course of a patient receiving virtual interventions for knee or wrist pathologies.
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Affiliation(s)
- Saurabh P Mehta
- School of Physical Therapy, Marshall University, Huntington, West Virginia, USA.,Dept. of Orthopedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, USA
| | - Kaitlyn M Kendall
- School of Physical Therapy, Marshall University, Huntington, West Virginia, USA
| | - Charlotte M Reasor
- School of Physical Therapy, Marshall University, Huntington, West Virginia, USA
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Maresca G, Maggio MG, De Luca R, Manuli A, Tonin P, Pignolo L, Calabrò RS. Tele-Neuro-Rehabilitation in Italy: State of the Art and Future Perspectives. Front Neurol 2020; 11:563375. [PMID: 33101176 PMCID: PMC7554582 DOI: 10.3389/fneur.2020.563375] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/26/2020] [Indexed: 11/20/2022] Open
Abstract
Current research suggests that the management of neurological diseases, both in adults and children, requires an ever increasing commitment of resources for the national healthcare system (NHS). In Italy, due to the aging of the population, increase in chronicity and morbidity of pathologies, and presence of islands and rural areas, health needs to be supported by innovative technologies. Telemedicine is a method of providing healthcare services at distance, remotely connecting health professionals and patients (or two professionals). In Italy, telemedicine is under development, and the NHS has not yet exploited and independently developed all the possibilities that telemedicine offers. Tele-rehabilitation consists in the use of information and communication technologies for the remote support of rehabilitation services. By allowing “home care,” it represents a valid support during the home rehabilitation process. This review is aimed at evaluating the role of telerehabilitation in Italy, with regard to the motor and cognitive rehabilitation programs applied to neurological pathologies, in both pediatric and adult patients. We screened the studies published between 2010 and 2019 on PubMed, Scopus, Cochrane, and Web of Sciences databases. Using the PICO model, the search combined the terms “telerehabilitation”; “neurological disorders”; “neurodegenerative disease,” “motor telerehabilitation”; “cognitive rehabilitation.” This review showed that telerehabilitation is a promising healthcare tool, as it guarantees continuity of care over time (after discharge) and in space (from hospital to patient's home), especially in patients with stroke. Furthermore, it allows to increase the frequency and intensity of rehabilitation programs, provide individualized rehabilitation treatment in comfortable and familiar environment for patient, monitor and evaluate patients' needs and progress, stimulate patient motivation and achieve better patient satisfaction, verify the results achieved by the patients, and potentially reduce the service costs. Unfortunately, almost all neurorehabilitation studies are characterized by small samples and wide variability of results, and would benefit from standardized procedures, aims and targets. Future telerehabilitation trials should include cost-effectiveness analysis associated with clinical outcomes to better assess the validity of this promising tool.
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Affiliation(s)
| | | | | | | | - Paolo Tonin
- S. Anna Institute, Research in Advanced Neurorehabilitation, Crotone, Italy
| | - Loris Pignolo
- S. Anna Institute, Research in Advanced Neurorehabilitation, Crotone, Italy
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8
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Krishnan J, Chung KC. Access to Hand Therapy Following Surgery in the United States: Barriers and Facilitators. Hand Clin 2020; 36:205-213. [PMID: 32307051 DOI: 10.1016/j.hcl.2020.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Hand therapy is a time-sensitive and essential postoperative service for patients undergoing reparative or corrective procedures in the hand and plays an important role in achieving best functional outcomes. In the United States, therapy is an independent service from a payer's standpoint. Access is affected by global and distinct factors in health care. This article presents views on certain aspects of health care that aide in and those that impede access to hand therapy for patients in the United States, and concludes with a brief glimpse into some ongoing efforts to improve access for patients.
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Affiliation(s)
- Jasmine Krishnan
- Michigan Medicine, Rehabilitation Services, Domino's Farms, Lobby A, Plastic Surgery Suite, Room 1108, 24 Frank Lloyd Wright Drive, SPC 5735, Ann Arbor, MI 48106, USA.
| | - Kevin C Chung
- Michigan Medicine, Section of Plastic Surgery, University of Michigan Medical School, 1500 East Medical Center Drive, 2130 Taubman Center, SPC 5340, Ann Arbor, MI 48109-5340, USA
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9
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Sarsak HI. Telerehabilitation services: a successful paradigm for occupational therapy clinical services? ACTA ACUST UNITED AC 2020. [DOI: 10.15406/ipmrj.2020.05.00237] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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10
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Kamwesiga JT, Eriksson GM, Tham K, Fors U, Ndiwalana A, von Koch L, Guidetti S. A feasibility study of a mobile phone supported family-centred ADL intervention, F@ce™, after stroke in Uganda. Global Health 2018; 14:82. [PMID: 30111333 PMCID: PMC6094578 DOI: 10.1186/s12992-018-0400-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 07/26/2018] [Indexed: 02/08/2023] Open
Abstract
Background There is a lack of evidence-based health services to reduce the impact of stroke in low-income countries at a personal, family or community level. The aim was to evaluate the feasibility of: i) a mobile phone supported family-centred intervention (F@ce™), and ii) the study design for evaluating the effects of the intervention on the perceived impact of stroke; perceived participation in everyday life; and self-efficacy in everyday activities amongst persons with stroke and their families in Uganda. Methods The study comprised a pre-post design with an intervention group (IG) receiving the F@ce™ and a control group (CG). The inclusion criteria’s were: a) confirmed stroke diagnosis, b) access to and ability to use a mobile phone, c) ability to communicate in English and/or Luganda, d) > 18 years, e) residents in Kampala, and f) a Modified Rankin Scale level 2 to 4. The aim of the F@ceTM was to increase functioning in daily activities for persons living with the consequences of stroke, and participation in everyday life for persons with stroke and their families. The F@ce™ was an eight-week family-centred intervention, which entailed goal setting and problem-solving strategies, daily reminders and self-rated follow-ups of performance by short message service (SMS). Data were collected in the participants’ home environment at baseline and after eight weeks. Data on acceptability of the F@ce™ and study procedures were collected by log-books and the responses of the SMS follow ups on the server. The primary outcomes were performance and satisfaction of valued daily activities in everyday life using the Canadian Occupational Performance Measure (COPM), self-efficacy in performance of activities in daily life. Results The IG comprised n = 13 and the CG n = 15. There were differences between the IG and CG in changes between baseline and follow-up in the primary outcomes COPM (performance component) and self-efficacy in favour of F@ce™. Overall with minor modifications the intervention and the study design were feasible for all participants involved. Conclusion The results support the need for further research to rigorously evaluate the effects of F@ce™ since the intervention appears to be feasible for persons with stroke and their family members. Electronic supplementary material The online version of this article (10.1186/s12992-018-0400-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Julius T Kamwesiga
- Division of Occupational therapy, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Uganda Allied Health Examinations Board, Kampala, Uganda
| | - Gunilla M Eriksson
- Division of Occupational therapy, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Neuroscience, Rehabilitation medicine, Uppsala University, Uppsala, Sweden
| | - Kerstin Tham
- Division of Occupational therapy, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Malmö University, Malmö, Sweden
| | - Uno Fors
- Department of Computer and Systems Sciences (DSV), Stockholm University, Stockholm, Sweden
| | | | - Lena von Koch
- Division of Occupational therapy, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Susanne Guidetti
- Division of Occupational therapy, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
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Telehealth, Wearable Sensors, and the Internet: Will They Improve Stroke Outcomes Through Increased Intensity of Therapy, Motivation, and Adherence to Rehabilitation Programs? J Neurol Phys Ther 2018. [PMID: 28628594 DOI: 10.1097/npt.0000000000000183] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Stroke, predominantly a condition of older age, is a major cause of acquired disability in the global population and puts an increasing burden on health care resources. Clear evidence for the importance of intensity of therapy in optimizing functional outcomes is found in animal models, supported by neuroimaging and behavioral research, and strengthened by recent meta-analyses from multiple clinical trials. However, providing intensive therapy using conventional treatment paradigms is expensive and sometimes not feasible because of social and environmental factors. This article addresses the need for cost-effective increased intensity of practice and suggests potential benefits of telehealth (TH) as an innovative model of care in physical therapy. SUMMARY OF KEY POINTS We provide an overview of TH and present evidence that a web-supported program, used in conjunction with constraint-induced therapy (CIT), can increase intensity and adherence to a rehabilitation regimen. The design and feasibility testing of this web-based program, "LifeCIT," is presented. We describe how wearable sensors can monitor activity and provide feedback to patients and therapists. The methodology for the development of a wearable device with embedded inertial and mechanomyographic sensors, algorithms to classify functional movement, and a graphical user interface to present meaningful data to patients to support a home exercise program is explained. RECOMMENDATIONS FOR CLINICAL PRACTICE We propose that wearable sensor technologies and TH programs have the potential to provide most-effective, intensive, home-based stroke rehabilitation.
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Levy CE, Silverman E, Jia H, Geiss M, Omura D. Effects of physical therapy delivery via home video telerehabilitation on functional and health-related quality of life outcomes. ACTA ACUST UNITED AC 2016; 52:361-70. [PMID: 26230650 DOI: 10.1682/jrrd.2014.10.0239] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 02/12/2015] [Indexed: 11/05/2022]
Abstract
This study examined functional outcomes, health-related quality of life (HRQoL), and satisfaction in a group of Veterans who received physical therapy via an in-home video telerehabilitation program, the Rural Veterans TeleRehabilitation Initiative (RVTRI). A retrospective, pre-post study design was used. Measures obtained from 26 Veterans who received physical therapy in the RVTRI program between February 22, 2010, and April 1, 2011, were analyzed. Outcomes were the Functional Independence Measure (FIM); Quick Disabilities of the Arm, Shoulder, and Hand measure; Montreal Cognitive Assessment (MoCA); and the 2-minute walk test (2MWT). HRQoL was assessed using the Veterans RAND 12-Item Health Survey (VR-12), and program satisfaction was evaluated using a telehealth satisfaction scale. Average length of participation was 99.2 +/- 43.3 d and Veterans, on average, received 15.2 +/- 6.0 therapeutic sessions. Significant improvement was shown in the participants' FIM (p < 0.001, r = 0.63), MoCA (p = 0.01, r = 0.44), 2MWT (p = 0.006, r = 0.73), and VR-12 (p = 0.02, r = 0.42). All Veterans reported satisfaction with their telerehabilitation experiences. Those enrolled in the RVTRI program avoided an average of 2,774.7 +/- 3,197.4 travel miles, 46.3 +/- 53.3 hr of driving time, and $1,151.50 +/- $1,326.90 in travel reimbursement. RVTRI provided an effective real-time, home-based, physical therapy.
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Cahill SM, McGuire B, Krumdick ND, Lee MM. Rural Practitioners’ Involvement in Response to Intervention. JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 2015. [DOI: 10.1080/19411243.2015.1040943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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14
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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: 157] [Impact Index Per Article: 17.4] [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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15
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Baker NA, Jacobs K. The feasibility and accuracy of using a remote method to assess computer workstations. HUMAN FACTORS 2014; 56:784-788. [PMID: 25029902 DOI: 10.1177/0018720813503985] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The objective was to test the accuracy of using remote methods (tele-ergonomics) to identify potential mismatches between workers and their computer workstations. BACKGROUND Remote access to ergonomic assessments and interventions using two-way interactive communications, tele-ergonomics, increases the ability to deliver computer ergonomic services. However, this mode of delivery must first be tested for accuracy. METHOD In this single group study, the computer workstations of 30 participants who reported mild to moderate discomfort were remotely assessed using photographs taken by a research assistant and the self-report Computer Workstation Checklist (CWC) completed by the study participant. Mismatches identified remotely by an ergonomics expert were compared to results obtained from an onsite computer workstation visit completed by the same expert. RESULTS We accurately identified 92% of mismatches. The method was more sensitive (0.97) than specific (0.88), indicating that experts using the remote method were likely to overidentify mismatches. CONCLUSION These results suggest that an expert using the self-reported CWC combined with workstation photographs can accurately identify mismatches between workers and their computer workstations. APPLICATION Remote assessment is a promising method to improve access to computer workstation ergonomic assessments.
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Abstract
BACKGROUND Telerehabilitation is an alternative way of delivering rehabilitation services. Information and communication technologies are used to facilitate communication between the healthcare professional and the patient in a remote location. The use of telerehabilitation is becoming more viable as the speed and sophistication of communication technologies improve. However, it is currently unclear how effective this model of delivery is relative to rehabilitation delivered face-to-face. OBJECTIVES To determine whether the use of telerehabilitation leads to improved ability to perform activities of daily living amongst stroke survivors when compared with (1) in-person rehabilitation (when the clinician and the patient are at the same physical location and rehabilitation is provided face-to-face); or (2) no rehabilitation. Secondary objectives were to determine whether use of telerehabilitation leads to greater independence in self care and domestic life and improved mobility, health-related quality of life, upper limb function, cognitive function or functional communication when compared with in-person rehabilitation and no rehabilitation. Additionally, we aimed to report on the presence of adverse events, cost-effectiveness, feasibility and levels of user satisfaction associated with telerehabilitation interventions. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register (November 2012), the Cochrane Effective Practice and Organization of Care Group Trials Register (November 2012), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 11, 2012), MEDLINE (1950 to November 2012), EMBASE (1980 to November 2012) and eight additional databases. We searched trial registries, conference proceedings and reference lists. SELECTION CRITERIA Randomised controlled trials (RCTs) of telerehabilitation in stroke. We included studies that compared telerehabilitation with in-person rehabilitation or no rehabilitation. In addition, we synthesised and described the results of RCTs that compared two different methods of delivering telerehabilitation services without an alternative group. We included rehabilitation programmes that used a combination of telerehabilitation and in-person rehabilitation provided that the greater proportion of intervention was provided via telerehabilitation. DATA COLLECTION AND ANALYSIS Two review authors independently identified trials on the basis of prespecified inclusion criteria, extracted data and assessed risk of bias. A third review author moderated any disagreements. The review authors contacted investigators to ask for missing information. MAIN RESULTS We included in the review 10 trials involving a total of 933 participants. The studies were generally small, and reporting quality was often inadequate, particularly in relation to blinding of outcome assessors and concealment of allocation. Selective outcome reporting was apparent in several studies. Study interventions and comparisons varied, meaning that in most cases, it was inappropriate to pool studies. Intervention approaches included upper limb training, lower limb and mobility retraining, case management and caregiver support. Most studies were conducted with people in the chronic phase following stroke. PRIMARY OUTCOME no statistically significant results for independence in activities of daily living (based on two studies with 661 participants) were noted when a case management intervention was evaluated. SECONDARY OUTCOMES no statistically significant results for upper limb function (based on two studies with 46 participants) were observed when a computer programme was used to remotely retrain upper limb function. Evidence was insufficient to draw conclusions on the effects of the intervention on mobility, health-related quality of life or participant satisfaction with the intervention. No studies evaluated the cost-effectiveness of telerehabilitation. No studies reported on the occurrence of adverse events within the studies. AUTHORS' CONCLUSIONS We found insufficient evidence to reach conclusions about the effectiveness of telerehabilitation after stroke. Moreover, we were unable to find any randomised trials that included an evaluation of cost-effectiveness. Which intervention approaches are most appropriately adapted to a telerehabilitation approach remain unclear, as does the best way to utilise this approach.
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Affiliation(s)
- Kate E Laver
- Flinders UniversityDepartment of Rehabilitation and Aged CareRepatriation General HospitalsDaws Road, Daw ParkAdelaideAustralia5041
| | - Daniel Schoene
- Neuroscience Research AustraliaFalls and Balance Research GroupPO Box 1165RandwickSydneyAustraliaNSW 2031
| | - Maria Crotty
- Flinders University, Repatriation General HospitalDepartment of Rehabilitation and Aged CareDaws RoadDaw ParkAustralia5042
| | - Stacey George
- Flinders UniversityDepartment of Rehabilitation, Aged and Extended CareDaws RoadDaw ParkAustralia5041
| | - Natasha A Lannin
- Alfred Clinical School, La Trobe UniversityFaculty of Health ScienceLevel 4, The Alfred Centre59 Commercial RoadPrahranAustralia3004
| | - Catherine Sherrington
- The George Institute for Global Health, Sydney Medical School, University of SydneyMusculoskeletal DivisionPO Box M201Missenden RoadSydneyAustralia2050
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Zylstra SE. Evidence for the Use of Telehealth in Pediatric Occupational Therapy. JOURNAL OF OCCUPATIONAL THERAPY SCHOOLS AND EARLY INTERVENTION 2013. [DOI: 10.1080/19411243.2013.860765] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Laver KE, Schoene D, Crotty M, George S, Lannin NA, Sherrington C. Telerehabilitation services for stroke. Cochrane Database Syst Rev 2012. [DOI: 10.1002/14651858.cd010255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Tang J, Mandrusiak A, Russell T. The feasibility and validity of a remote pulse oximetry system for pulmonary rehabilitation: a pilot study. Int J Telemed Appl 2012; 2012:798791. [PMID: 23049549 PMCID: PMC3462379 DOI: 10.1155/2012/798791] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 08/09/2012] [Accepted: 08/23/2012] [Indexed: 01/17/2023] Open
Abstract
Pulmonary rehabilitation is an effective treatment for people with chronic obstructive pulmonary disease. However, access to these services is limited especially in rural and remote areas. Telerehabilitation has the potential to deliver pulmonary rehabilitation programs to these communities. The aim of this study was threefold: to establish the technical feasibility of transmitting real-time pulse oximetry data, determine the validity of remote measurements compared to conventional face-to-face measures, and evaluate the participants' perception of the usability of the technology. Thirty-seven healthy individuals participated in a single remote pulmonary rehabilitation exercise session, conducted using the eHAB telerehabilitation system. Validity was assessed by comparing the participant's oxygen saturation and heart rate with the data set received at the therapist's remote location. There was an 80% exact agreement between participant and therapist data sets. The mean absolute difference and Bland and Altman's limits of agreement fell within the minimum clinically important difference for both oxygen saturation and heart rate values. Participants found the system easy to use and felt confident that they would be able to use it at home. Remote measurement of pulse oximetry data for a pulmonary rehabilitation exercise session was feasible and valid when compared to conventional face-to-face methods.
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Affiliation(s)
- Jonathan Tang
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia 4072, Brisbane, QLD 4072, Australia
| | - Allison Mandrusiak
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia 4072, Brisbane, QLD 4072, Australia
| | - Trevor Russell
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia 4072, Brisbane, QLD 4072, Australia
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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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Woo C, Guihan M, Frick C, Gill CM, Ho CH. What's happening now! Telehealth management of spinal cord injury/disorders. J Spinal Cord Med 2011; 34:322-31. [PMID: 21756573 PMCID: PMC3127362 DOI: 10.1179/2045772311y.0000000003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
CONTEXT Spinal cord injury and/or disorders (SCI/D) is a costly chronic condition. Impaired mobility, and lengthy travel distances to access specialty providers are barriers that can have adverse impact on expenses and quality of care. Although ample opportunities for use of telehealth technologies exist between medical facilities, and from clinical to home settings, field experience has largely been focused on home telehealth services to promote better patient self-management skills and improve clinical outcomes. FINDINGS This paper provides an overview of published literature on use of telehealth technologies with the SCI/D population. Presentation of case studies describe telehealth as a potential strategy for addressing disparities in providing quality care, and explore comprehensive management of multiple health issues in individuals with SCI/D. Experiences of providers in both private sector health-care systems and VHA medical facilities are described. Development of telehealth clinical protocols and adaptive devices that can be integrated with equipment to accommodate for the functional limitations in the SCI/D population are discussed as necessary for expansion of use of telehealth services. Rigorous research studies are lacking. As use of this technology spreads and issues surrounding implementation are addressed, we look forward to increased research to assess and evaluate its efficacy in the SCI/D population. CONCLUSION/CLINICAL RELEVANCE Telehealth in the home setting appears to be able to help persons with SCI/D remain in the community. As the use of telehealth increases, research will be necessary in both clinical and home settings to assess its efficacy in improving outcomes in the SCI/D population.
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Affiliation(s)
- Christine Woo
- National SCI/D Telehealth Program Coordinator, Cleveland SCI/D Clinical and Research Telehealth Programs, Cleveland, OH
| | - Marylou Guihan
- VA Medical Center, Hines, IL,Correspondence to: Marylou Guihan, VA Medical Center, Hines, IL 60141, USA.
| | | | - Carol M. Gill
- Chief of Spinal Cord Injury/Disorders Service Veterans Affairs, East Orange, NJ
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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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Tousignant M, Moffet H, Boissy P, Corriveau H, Cabana F, Marquis F. A randomized controlled trial of home telerehabilitation for post-knee arthroplasty. J Telemed Telecare 2011; 17:195-8. [PMID: 21398389 DOI: 10.1258/jtt.2010.100602] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We compared the effectiveness of home telerehabilitation with conventional rehabilitation following knee replacement surgery (total knee arthroplasty, TKA). Forty-eight patients (mean age 66 years) who received TKA were recruited prior to discharge from hospital after surgery and were randomly assigned to telerehabilitation or usual care. Telerehabilitation sessions (16 per participant over two months) were conducted by trained physiotherapists using videoconferencing to the patient's home via an Internet connection (512 kbit/s upload speed). Disability and function were measured using standardized outcome measures in face-to-face evaluations at three times (prior to and at the end of treatment, and four months after the end of treatment). Clinical outcomes improved significantly for all subjects in both groups between endpoints. Some variables showed larger improvements in the usual care group two months post-discharge from therapy than in the telerehabilitation group. Home telerehabilitation is at least as effective as usual care, and has the potential to increase access to therapy in areas with high speed Internet services.
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Affiliation(s)
- Michel Tousignant
- Research Centre on Aging, Sherbrooke Geriatric University Institute, Faculty of Medicine, University of Sherbrooke, 1036 Belvédère Sud, Québec J1H 4C4, Canada.
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Baker NA, Jacobs K. Tele-Ergonomics: A Novel Approach to Computer Workstation Ergonomic Assessment and Modification. ACTA ACUST UNITED AC 2010. [DOI: 10.1177/154193121005400909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
U.S. healthcare reform demands that ergonomically trained health professionals reassess how they deliver their services. One innovative strategy to deliver ergonomic assessment and modification is tele-ergonomics. This practice-oriented paper will describe the process of developing the Telerehabilitation Computer Ergonomics System ( tele-CES). The tele-CES will be a valid and reliable systematic program using existing previously validated ergonomic instruments. This program will allow ergonomically trained health professionals to: 1) remotely assess the computer workstation, which will eliminate several barriers to access experienced by computer operators; and 2) based on the assessment, generate explicit participant-specific workstation modification recommendations. These recommendations will be easily implemented; reduce pain, discomfort, and fatigue; and eliminate barriers to productivity. The tele-CES will be developed as a collaboration between ergonomically trained health professionals in multiple locations in the US, telerehabilitation experts, and consumers. This system will reduce the personal cost of obtaining expert ergonomic assessments and interventions and provide an evidence-based and systematic program of completing ergonomic assessments remotely.
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Russell T, Truter P, Blumke R, Richardson B. The Diagnostic Accuracy of Telerehabilitation for Nonarticular Lower-Limb Musculoskeletal Disorders. Telemed J E Health 2010; 16:585-94. [DOI: 10.1089/tmj.2009.0163] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Affiliation(s)
- Trevor Russell
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Piers Truter
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Robert Blumke
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Bradley Richardson
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
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McCue M, Fairman A, Pramuka M. Enhancing quality of life through telerehabilitation. Phys Med Rehabil Clin N Am 2010; 21:195-205. [PMID: 19951786 DOI: 10.1016/j.pmr.2009.07.005] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Telerehabilitation is an emerging method of delivering rehabilitation services that uses technology to serve clients, clinicians, and systems by minimizing the barriers of distance, time, and cost. The driving force for telerehabilitation has been as an alternative to face-to-face rehabilitation approaches to reduce costs, increase geographic accessibility, or act as a mechanism to extend limited resources. A rationale for telerehabilitation is the potential to enhance outcomes beyond what may result from face-to-face interventions by enabling naturalistic, in vivo interventions. There is considerable support for the value of interventions delivered in the natural environment, ranging from addressing efficacy concerns by addressing problems of generalization, to increasing patient participation, including environmental context in rehabilitation, and increasing patient satisfaction. Further clinical and research exploration should explore telerehabilitation as a tool for the delivery of rehabilitation services in vivo.
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Affiliation(s)
- Michael McCue
- Department of Rehabilitation Science and Technology, University of Pittsburgh, 5040 Forbes Tower, 3600 Forbes Avenue, Pittsburgh, PA 15260, USA.
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Hermann VH, Herzog M, Jordan R, Hofherr M, Levine P, Page SJ. Telerehabilitation and Electrical Stimulation: An Occupation-Based, Client-Centered Stroke Intervention. Am J Occup Ther 2010; 64:73-81. [DOI: 10.5014/ajot.64.1.73] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. We examined the efficacy of a remotely based arm rehabilitation regimen. A 62-year-old man participated in occupation-based, task-specific practice of activities of daily living (ADLs) >3 years after stroke. The entire regimen was administered over the Internet using personal computer–based cameras and free network meeting software.
METHOD. Fugl-Meyer Assessment (FM), Action Research Arm Test (ARA), and Canadian Occupational Performance Measure (COPM) were administered before intervention. One week after treatment, FM, ARA, and COPM were readministered.
RESULTS. The participant exhibited reduced impairment and reduced functional limitation. He also expressed enhanced satisfaction with his ability to perform ADLs and rated his ADL performance better after intervention. The participant could now drive using both hands, use eating utensils, and catch and throw a ball.
CONCLUSION. Data suggest feasibility and efficacy of a remotely based, inexpensive approach using functional electrical stimulation for affected arm rehabilitation after stroke.
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Affiliation(s)
- Valerie Hill Hermann
- Valerie Hill Hermann, MS, OTR/L, is Research Occupational Therapist, Department of Rehabilitation Sciences, University of Cincinnati Academic Medical Center (UCAMC), and Member, Neuromotor Recovery and Rehabilitation Laboratory (NMRRL) at Drake Rehabilitation Center, Cincinnati, OH
| | - Mandy Herzog
- Mandy Herzog, OTR/L, was a student in the Occupational Therapy Program at Xavier University, Cincinnati, OH, at the time that this study was conducted
| | - Rachel Jordan
- Rachel Jordan, OTR/L, was a student in the Occupational Therapy Program at Xavier University, Cincinnati, OH, at the time that this study was conducted
| | - Maura Hofherr
- Maura Hofherr, OTR/L, was a student in the Occupational Therapy Program at Xavier University, Cincinnati, OH, at the time that this study was conducted
| | - Peter Levine
- Peter Levine, PTA, is Senior Research Assistant, UCACM, and Co-director, NMRRL
| | - Stephen J. Page
- Stephen J. Page, PhD, FAHA, is Associate Professor, Departments of Rehabilitation Sciences, Physical Medicine and Rehabilitation, and Neurosciences; Director, NMRRL; and Member, Greater Cincinnati/Northern Kentucky Stroke Team, University of Cincinnati Academic Medical Center, 3202 Eden Avenue, Suite 310, Cincinnati, OH 45267-0394;
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Cason J. A pilot telerehabilitation program: delivering early intervention services to rural families. Int J Telerehabil 2009; 1:29-38. [PMID: 25945160 PMCID: PMC4296778 DOI: 10.5195/ijt.2009.6007] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The enTECH Telerehabilitation Program explored the use of telerehabilitation as an alternative service delivery model for early intervention therapy services. Utilizing the Kentucky Telehealth Network, two families living in rural Kentucky received occupational therapy services over a 12-week period. Following program implementation, qualitative data was collected using participant journals and interviews. Data analysis identified three thematic categories related to the program: benefits/strengths, challenges/weaknesses, and recommendations for program improvement. Results of the program evaluation indicated that telerehabilitation has the potential to cost-effectively meet the therapeutic needs of children living in rural areas where provider shortages exist. The enTECH Telerehabilitation Program serves as a model for how telerehabilitation can be used to deliver early intervention services to ameliorate health disparities and improve access to rehabilitation services.
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Affiliation(s)
- Jana Cason
- Auerbach School of Occupational Therapy, Spalding University, Louisville, KY
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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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Tousignant M, Boissy P, Corriveau H, Moffet H, Cabana F. In-home telerehabilitation for post-knee arthroplasty: a pilot study. Int J Telerehabil 2009; 1:9-16. [PMID: 25945158 PMCID: PMC4296777 DOI: 10.5195/ijt.2009.5997] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The purpose of this study was to investigate the efficacy of in-home telerehabilitation as an alternative to conventional rehabilitation services following knee arthroplasty. Five community-living elders who had knee arthroplasty were recruited prior to discharge from an acute care hospital. A pre/post-test design without a control group was used for this pilot study. Telerehabilitation sessions (16) were conducted by two trained physiotherapists from a service center to the patient's home using H264 videoconference CODECs (Tandberg 550 MXP) connected at 512 Kb\s. Disability (range of motion, balance and lower body strength) and function (locomotor performance in walking and functional autonomy) were measured in face-to-face evaluations prior to and at the end of the treatments by a neutral evaluator. The satisfaction of the health care professional and patient was measured by questionnaire. Results are as follows. One participant was lost during follow-up. Clinical outcomes improved for all subjects and improvements were sustained two months post-discharge from in-home telerehabilitation. The satisfaction of the participants with in-home telerehabilitation services was very high. The satisfaction of the health care professionals with the technology and the communication experience during the therapy sessions was similar or slightly lower. In conclusion, telerehabilitation for post-knee arthroplasty is a realistic alternative for dispensing rehabilitation services for patients discharged from an acute care hospital.
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Prinz L, Cramer M, Englund A. Telehealth: A policy analysis for quality, impact on patient outcomes, and political feasibility. Nurs Outlook 2008; 56:152-8. [DOI: 10.1016/j.outlook.2008.02.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2007] [Indexed: 12/01/2022]
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Miller PA, Huijbregts M, French E, Taylor D, Reinikka K, Berezny L, Fry S, Grunin A, Harvey M. Videoconferencing a stroke assessment training workshop: effectiveness, acceptability, and cost. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2008; 28:256-69. [PMID: 19058246 DOI: 10.1002/chp.192] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
INTRODUCTION Videoconferencing (VC) is becoming a common method for the delivery of continuing education (CE) to clinicians in remote locations. The purpose of this study was to compare the effectiveness, acceptability, and costs of a full-day training workshop (TW) delivered through two different formats: face-to-face (FTF) and VC. The TW was designed to teach administration and scoring guidelines for the Chedoke-McMaster Stroke Assessment, an outcome measure used by rehabilitation professionals. METHODS The TW was delivered simultaneously in FTF and VC formats to a total of five remote communities on two separate occasions. Participants completed a test of scoring competency at the beginning (pretest) and end (posttest) of the TW as well as a feedback questionnaire. A cost comparison was also undertaken. RESULTS Forty-four physical and occupational therapists participated. No significant between-group differences were found in posttest scoring competency related to delivery format (FTF or VC): (F(1,38) = 0.6, MSE = 3.6, p > 0.4), or for the two workshops: (F(1,38) = 1.4, MSE = 3.6, p > 0.2). Despite technical difficulties, participant experience was rated as "good" to "excellent." The VC method offered considerable cost savings to participants and their organizations, at a minimum of $7,437 (Canadian). CONCLUSION Clinicians participating in the TW via VC performed as well as those in the FTF group on the competency test. Videoconferencing improves access to CE, is well received by participants, and provides a cost-effective method of course delivery. Further evaluation of other CE events delivered through VC is indicated.
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Affiliation(s)
- Patricia A Miller
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
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