Effectiveness of a tele-rehabilitation intervention to improve performance and reduce morbidity for people post hip fracture - study protocol for a randomized controlled trial

Abstract

Background Most surviving hip-fracture patients experience reduced mobility and lose some of their functional ability, which increases the risk of complications and rehospitalization. Post-discharge transitional programs to reduce readmissions and disabilities have shown some success. Telerehabilitation refers to the use of technologies to provide rehabilitation services to people in their homes. Considering the need for long-term follow-up care for people with hip fracture, in-home telerehabilitation could increase independence, decrease hospital stays and reduce the burden for caregivers. The objective of this study is to investigate the effectiveness of an intervention program based on telerehabilitation on activities of daily living (ADL), quality of life (QOL), depression and burden on caregivers compared to face-to-face home visits and usual care of community-dwelling older adults after hip fracture. Methods/design This will be a three-armed randomized control trial (RCT) including pre/post intervention and follow-up. The trial will include 90 older people with hip fractures who will be randomly assigned to a telerehabilitation group ( N = 30), face-to-face visits (N = 30) and a control group. The aim of the intervention is to improve the transition from rehabilitation units to community dwelling. It will include 10 videoconferencing/ face-to-face sessions from an occupational therapist in the presence of the primary caregiver. Each session will be utilized to guide the participants to achieve their self-identified goals, focusing on problem-solving for daily life situations and on the ability to implement the discussed strategies for a variety of activities. Outcome measures include Functional Independence Measure (FIM) for evaluation of ADL, SF-12 for evaluation of Health-related QOL, The Geriatric Depression Scale (GDS) and The Zarit Caregiver Burden Scale. Data will be analyzed using Repeated measures MANOVA. Discussion The current study will enable the cost-effectiveness examination of a suggested rehabilitation service based on available technology. The proposed intervention will increase accessibility of in-home rehabilitation services, improve function and health, and reduce economic burden. Trial registration NCT03376750 (12/15/2017).

Evaluation of Admission Diagnoses of the Patients Admitted to the Physical Rehabilitation and Medicine Outpatient Clinic at COVID-19 Pandemic

“…Son yıllarda kronik birçok hastalıkta tele-rehabilitasyon yönteminin etkinliğini değerlendiren çalışmalar yapılmıştır. 11,12 Yapılan çalışmalarda tele-rehabilitasyon yönteminin, kas-iskelet sistemi problemlerine uygun bir yöntem olduğu belirtilmiştir. 13 Pandemi sebebiyle tele-rehabilitasyon uygulaması birçok alanda genişletilmiştir.…”

Postacute Management of Older Adults Suffering an Osteoporotic Hip Fracture: A Consensus Statement From the International Geriatric Fracture Society

“…For those patients who encounter challenges leaving their homes, telemedicine appears to be a feasible option where available. 147 Medication changes might happen while in a PAC facility and it is important that the new list of medications is communicated to the patient's health care providers in the community. If the patient is unable to leave the house, it might be helpful to seek for a primary care provider who can provide home visits and establish home delivery pharmacy services.…”

“…For those patients who encounter challenges leaving their homes, telemedicine appears to be a feasible option where available. 147 …”

Current Telerehabilitation Approaches in Orthopaedic Physiotherapy

“…Web tabanlı video egzersiz platformlarının bazıları, hasta ile klinisyenin görüntülü olarak iletişim kurabildikleri ve egzersiz eğitimlerini bu şekilde gerçekleştirebildikleri video konferans teknolojisine sahiptir. 34 2018 yılında gerçekleştirilen bir projede, telerehabilitasyon kavramı içinde uzaktan değerlendirmelerin bazılarının, video konferans sistemleri aracılığı ile gerçekleştirildiği vurgulanmıştır. 35 Yakın zamanda gerçekleştirilmiş bir vaka serileri çalışmasında, video konferans uygulamasının kronik mekanik bel ağrılı 3 hastada tedavinin uzun süreli olarak devam ettirilebilmesi hususunda faydalı olabileceği ancak daha fazla araştırma yapılmasını gerektirdiği gösterilmiştir.…”