The continuous development in telecommunication tech­nologies has created opportunities for health professionals to optimise healthcare delivery by adopting digital tools into rehabilitation programs (i.e., telerehabilitation). These tech­nological advances, along with the demographic and social characteristics of each country, have made the implementa­tion of telerehabilitation a disparate process across regions. We have gathered the experience of four countries (Australia, Chile, Brazil, and Colombia) in two different regions (Ocea­nia and South America) to recompile the history pre- and post-Covid-19 outbreak until January of 2021, the barriers to, and facilitators of telerehabilitation, and outline the future challenges for these countries.

The world is rapidly urbanizing, which may influence physical activity (PA) levels - although little evidence is available for low- and middle-income countries. We evaluated associations between urbanization and total PA, as well as work-, leisure-, home-, and transport-specific PA, for 138,206 adults (35-70 years) living in 698 communities across 22 countries within the Prospective Urban and Rural Epidemiology (PURE) study. The 1-week total PA long-form International PA Questionnaire (IPAQ) was administered at baseline (2003-2015) and we used satellite-derived population density and impervious surface area to quantify levels of urbanization for 5 and 10 years prior to PA measurements. Generalized linear mixed effects models were used to examine associations between urbanization measures and PA, controlling for individual, household and community factors. Higher community baseline levels of population density (-12.4%, 95% CI: -16.0%, -8.7% per IQR) and impervious surface area (-29.2%, 95% CI: -37.5%, -19.7% per IQR), as well as 5-year population density change (-17.2%, 95% CI: -25.7%, -7.7 per IQR) was associated with lower total PA. Important differences in the associations between urbanization metrics and PA were observed between PA domains, country income levels, urban and rural status, and gender. These findings provide new information on the complex associations between urbanization and PA.

Caracterización de las propiedades diagnósticas de médicos generales del Servicio de Salud

La Rehabilitación Cardíaca disminuye las complicaciones de la cirugía cardíaca y es mundialmente reconocida. A pesar de esto, en Chile su desarrollo ha sido lento y el reporte de experiencias bajo. Objetivo: Describir la progresión de acuerdo los pasos de rehabilitación y días postoperatorios en pacientes de rehabilitación cardíaca fase I en un hospital público de Temuco, Chile. Metodología: Se analizó una serie de casos de pacientes en rehabilitación cardíaca fase I, participantes de un protocolo basado en hitos motores de seis pasos: movilización en cama (P1); sedente borde cama (P2); marcha de 35 mts (P3); marcha hasta 100 mts (P4); marcha hasta 200 metros más subir/bajar un piso de escaleras (P5); marcha de 300 metros más subir/bajar dos pisos de escaleras (P6). Resultados: Se incluyeron 243 pacientes (1.033 sesiones) con una media de 65.9 años (DS 9.5), mediana de hospitalización 6 días. Del total de atenciones realizadas el día 1, en 53% de ellas se alcanzó el P1; en el día 2, en un 51% se alcanzó el P2 y en un 42% un paso ≥P3; en el día 3, en 44.78% se alcanzó paso ≥P4; en el día 4, en 37.75% se alcanzó ≥P4. En los días 5-7, aproximadamente 50% logró ≥P5. Conclusión: La progresión de los pasos es proporcional al día postcirugía y es más rápida en hombres. Al momento del alta, 75% de los pacientes alcanza una independencia funcional que les permite caminar dos cuadras y subir/bajar un piso de escaleras.