Clinical Effectiveness of Home‐Based Telerehabilitation Program for Geriatric Hip Fracture Following Total Hip Replacement

Abstract

Objective To compare the effectiveness of a six‐month home‐based telerehabilitation based on the Internet‐based rehabilitation management system coupled with conventional outpatient care in elderly patients with hip fractures following total hip replacement (THR). Methods Elderly patients (aged over 65 years) with first hip fractures who underwent THR between March 2018 and September 2018 in Tianjin Hospital were enrolled in this study. Patients were divided into two groups: telerehabilitation group (n = 43) and telephone group (n = 42). A Internet‐based telerehabilitation management system was established and applied on patients in the telerehabilitation group. For patients in the telephone group, the rehabilitation intervention was administered through conventional outpatient care (telephone along with outpatient follow‐up). Data from the Harris hip scale (HHS), functional independence measure (FIM), self‐rating anxiety scale (SAS), and postoperative complications at 1, 3, and 6 months after surgery were collected and compared between the two groups. Results A total of 85 elderly patients completed the 6‐month follow‐up assessment. Results showed that the HHS score was significantly higher in the telerehabilitation group than in the telephone group at 1 month (66.35 ± 4.63 vs 63.48 ± 4.49), 3 months (76.33 ± 4.52 vs 71.81 ± 3.84), and 6 months (84.23 ± 3.13 vs 77.29 ± 4.95) after surgery (P < 0.001). The FIM score was significantly higher in the telerehabilitation group than in the telephone group at 1 month (89.00 ± 5.63 vs 73.35 ± 8.70), 3 months (100.16 ± 4.56 vs 92.81 ± 5.17), and 6 months (111.70 ± 3.13 vs 98.64 ± 5.12) after surgery (P < 0.001). The SAS score was significantly lower in the telerehabilitation group than in the telephone group at 1 month (42.40 ± 3.07 vs 46.21 ± 3.53), 3 months (36.77 ± 2.26 vs 40.24 ± 1.66), and 6 months (29.26 ± 1.63 vs 33.81 ± 2.62) after surgery (P < 0.001). The overall complication rate was significantly lower in the telerehabilitation group than in the telephone group (14% vs 40.5%) (P < 0.05). Conclusion Internet‐based rehabilitation management system can not only promote the physical rehabilitation of patients, but also play a positive role in psychological rehabilitation and the prevention of complications, which provides new ideas and methods for clinical rehabilitation.

Telerehabilitation After Hip-Fracture Surgery

“…They confirmed the improvement of functional recovery of hip fractures thus enhancing the ability to perform activities of daily living and somatic integration by the Internet-based rehabilitation management system applied to postoperative home rehabilitation of hip fractures [15]. Another study comparing the efficacy of telephone and telerehabilitation groups is by Wu et al [16]. In Wu`s study "Familyoriented postoperative rehabilitation management system for geriatric hip fracture includes video communication, application and working portal of doctors" was used as a telerehabilitation method [16].…”

“…Also, @ctivehip telerehabilitation is used in another study and showed better results compared to the home-in-person rehabilitation [20]. More Interactive rehabilitation setting with microcontrollers to check patient's fever, blood pressure, glucose level, and blood oxygen levels was used in a study showing improvement of the physical rehabilitation of patients and also play a positive role in psychological rehabilitation and the prevention of complications compared to group delivering rehabilitation by phone [16]. The same telerehabilitation system with microcontrollers is used in Zhang`s study compared to telephone rehabilitation and same conclusion with improving in the functional recovery of the hip joint and enhancing perform of the daily activities [15].…”

“…Another study comparing the efficacy of telephone and telerehabilitation groups is by Wu et al [16]. In Wu`s study "Familyoriented postoperative rehabilitation management system for geriatric hip fracture includes video communication, application and working portal of doctors" was used as a telerehabilitation method [16]. They compared functional and psychological scores and concluded that telerehabilitation can improve the patient's physical function and play a positive role in psychological rehabilitation [16].…”

“…In Wu`s study "Familyoriented postoperative rehabilitation management system for geriatric hip fracture includes video communication, application and working portal of doctors" was used as a telerehabilitation method [16]. They compared functional and psychological scores and concluded that telerehabilitation can improve the patient's physical function and play a positive role in psychological rehabilitation [16]. In Jørgensen`s study, from 33 patients, only 2 patients accepted to be involved, and this low involvement of the study was explained with "immediately after hospital discharge was found unfeasible in a geriatric population hospitalized due to acute illness."…”

Emerging trends and prospects in telerehabilitation for hip fracture: Bibliometric and visualization study

“…Therefore, telerehabilitation appears to be particularly beneficial to elderly patients with hip fractures. 42 …”