A pilot study of a telehealth intervention for persons with spinal cord dysfunction

Houlihan, Bethlyn; Jette, Alan M.; Friedman, Robert H.; Paasche‐Orlow, Michael K.; Ni, Pengsheng; Wierbicky, Jane; Williams, Katie; Ducharme, Stanley; Zazula, Judi; Cuevas, Penelope H.; Rosenblum, David S.; Williams, Stuart J.

doi:10.1038/sc.2013.45

Cited by 43 publications

(61 citation statements)

References 21 publications

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“…The frequency-magnitude product score of different individual items were summed to create total CHIEF score and averaged to create mean of the subscale scores (Physical/Structural, Attitudes/Support, Services/Assistance, Policies, and Work/School). CHIEF has been used to investigate perceived environmental barriers in people with spinal cord injuries [28,29], traumatic brain injuries [30], and stroke [31,32]. …”

Section: Methodsmentioning

confidence: 99%

Relationship of perceived environmental barriers and disability in community-dwelling elderly in Taiwan – a population-based study

et al. 2014

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BackgroundTo identify the relationship between perceived environmental barriers and disability in community-dwelling elderly.MethodsCross-sectional study in two community service centers in Tainan. We enrolled 200 community-dwelling residents, aged above 65 years, who had resided in the same community for at least 12 months. Basic activity of daily living (BADL) and instrumental activity of daily living (IADL) were assessed using the Hierarchy of Care Required (HCR). There were 59 participants in BADL disability and 109 in IADL disability. Perceived environmental barriers were assessed using the Craig Hospital Inventory of Environmental Factors (CHIEF). We used multinomial logistic regression to examine the relationship of perceived environmental barriers and disability.ResultsThe presence of perceived environmental barriers was related to BADL disability (OR = 4.39, 95% CI = 1.01-19.11) and IADL disability (IADL with difficulty in 1–2 tasks: OR = 9.93, 95% CI = 3.22-30.56; IADL with difficulty in more than 2 tasks: OR = 8.40, 95% CI = 1.83-38.51). The presence of physically/structurally perceived environmental barriers was related to BADL disability (OR = 4.90, 95% CI = 1.01-23.86) and IADL disability (IADL with difficulty in 1–2 tasks: OR = 4.61, 95% CI = 1.27-16.76; IADL with difficulty in more than 2 tasks: OR = 17.05, 95% CI = 2.82-103.30).ConclusionsPerceived environmental barriers are related to disability in community-dwelling elderly.

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Section: Methodsmentioning

confidence: 99%

Relationship of perceived environmental barriers and disability in community-dwelling elderly in Taiwan – a population-based study

et al. 2014

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“…An emerging modality for telehealth is the use of applications or automated telephone call/messaging programs to provide educational material, instructions, and reminders so that patients can more effectively engage in rehabilitation programs. This modality has been piloted successfully in SCI, where the implementation of automated call programs resulted in reduction of pressure ulcers [52] and improved weight management [53]. Pilot studies also have begun to test the impact of Web‐based applications on symptom management in TBI [54,55], skin care in spina bifida [56,57], mobility in stroke [58], and multidisciplinary care in patients with chronic disability [59].…”

Section: Outpatient Neurorehabilitationmentioning

confidence: 99%

Telehealth in Physical Medicine and Rehabilitation: A Narrative Review

Tenforde

Hefner

Kodish-Wachs

et al. 2017

PM&R

152

127

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Telehealth refers to health care interactions that leverage telecommunication devices to provide medical care outside the traditional face-to-face, in-person medical encounter. Technology advances and research have expanded use of telehealth in health care delivery. Physical medicine and rehabilitation providers may use telehealth to deliver care to populations with neurologic and musculoskeletal conditions, commonly treated in both acute care and outpatient settings. Patients with impaired mobility and those living in locations with reduced access to care may particularly benefit. Video-teleconferencing has been shown to be effective for management of burn patients during acute rehabilitation, including reduced health care use expenses and less disruptions to care. Telehealth can facilitate developing interprofessional care plans. Patients with neurologic conditions including stroke, spinal cord injury, traumatic brain injury, and amyotrophic lateral sclerosis may use telehealth to monitor symptoms and response to treatment. Telehealth also may facilitate occupational and physical therapy programs as well as improve weight management and skin care in patients with chronic conditions. Other applications include imaging review in sports medicine, symptom management and counseling in concussion, traumatic brain injury, and pain management programs. Limitations of telehealth include barriers in establishing relationship between medical provider and patient, ability to perform limited physical examination, and differences in payment models and liability coverage. The expansion of telehealth services is expected to grow and has potential to improve patient satisfaction by delivering high quality and value of care.

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“…Recent telerehabilitation studies have addressed different approaches: feasibility and efficacy, patients’ and professionals’ satisfaction, and cost analysis studies. This includes neurological diseases [7-10], stroke patients [11-13], intensive care unit [14], breast cancer [15], COPD [16], and musculoskeletal disorders [17-22]. Although trials supporting the role of telerehabilitation continue to emerge, implementation has been slow [23].…”

Section: Introductionmentioning

confidence: 99%

Evidence of Benefit of Telerehabitation After Orthopedic Surgery: A Systematic Review

et al. 2017

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BackgroundIn addition to traditional physiotherapy, studies based on telerehabilitation programs have published the results of effectiveness, validity, noninferiority, and important advantages in some neurological, cognitive, and musculoskeletal disorders, providing an opportunity to define new social policies and interventions.ObjectivesThe aim of this systematic review is to investigate the effects of telerehabilitation after surgical procedures on orthopedic conditions as well as to describe how interventions are designed and to determine whether telerehabilitation is comparable with conventional methods of delivery. This systematic review summarizes the levels of evidence and grades of recommendation regarding telerehabilitation intervention (synchronous or asynchronous provided via the telerehabilitation medium, either in conjunction with, or in isolation of, other treatment interventions) after surgical procedures on orthopedic conditions.MethodsStudy quality was assessed using the Physiotherapy Evidence Database (PEDro) scores and grade of recommendation following the recommendation of the Oxford Centre for Evidence-Based Medicine.ResultsWe found 3 studies with PEDro scores between 6 and 8, which is considered as level 1 evidence (good; 20% [3/15]), 4 studies with a score of 5, which is considered as level 2 evidence (acceptable; 27% [4/15]), and the remaining 8 studies had scores of 4 or less, which is considered (poor; 53% [8/15]). A total of 1316 participants received telerehabilitation intervention in the selected studies, where knee and hip replacement were 75% of all the studies. Strong and moderate grades of evidence (grade of recommendation A–B) were found in knee and hip replacement interventions. Studies on the upper limb were 25% of the studies, but only 1 study presented a moderate grade of evidence (grade of recommendation B) and the rest were of poor methodological quality with weak evidence (grade of recommendation C).ConclusionsConclusive evidence on the efficacy of telerehabilitation for treatment after an orthopedic surgery, regardless of pathology, was not obtained. We found strong evidence in favor of telerehabilitation in patients following total knee and hip arthroplasty and limited evidence in the upper limb interventions (moderate and weak evidence). Future research needs to be more extensive and conclusive. To the best of the authors’ knowledge, this is the first attempt at evaluating the quality of telerehabilitation intervention research after surgical procedures on orthopedic conditions in a systematic review. Clinical messages and future research recommendations are included in the review.

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A pilot study of a telehealth intervention for persons with spinal cord dysfunction

Cited by 43 publications

References 21 publications

Relationship of perceived environmental barriers and disability in community-dwelling elderly in Taiwan – a population-based study

Relationship of perceived environmental barriers and disability in community-dwelling elderly in Taiwan – a population-based study

Telehealth in Physical Medicine and Rehabilitation: A Narrative Review

Evidence of Benefit of Telerehabitation After Orthopedic Surgery: A Systematic Review

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