Neuro-telehealth for fragile patients in a tertiary referral neurological institute during the COVID-19 pandemic in Milan, Lombardy

Pareyson, Davide; Pantaleoni, Chiara; Eleopra, Roberto; Filippis, Giuseppe De; Moroni, Isabella; Freri, Elena; Zibordi, Federica; Bulgheroni, Sara; Pagliano, Emanuela; Sarti, Daniela; Silvani, Antonio; Grazzi, Licia; Tiraboschi, Pietro; Didato, Giuseppe; Anghileri, Elena; Bersano, Anna; Valentini, Laura; Piacentini, Sylvie; Muscio, Cristina; Leonardi, Matilde; Mariotti, Caterina; Eoli, Marica; Nuzzo, Sara; Tagliavini, Fabrizio; Giorgi, Francesca De; Task, Force Besta-Telehealth

doi:10.1007/s10072-021-05252-9

Cited by 24 publications

(20 citation statements)

References 31 publications

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“…In particular, the Foundation IRCCS Neurological Institute 'C. Besta' in Milan, which had initially been conceived as a hub for non-COVID patients with neurological pathologies, in order to ensure continuity of care for all patients already followed, has reorganized and converted its activities to remote [1]. Specifically for children, this decision forced specialists to temporarily suspend all the rehabilitation protocols [2,3] necessitating alternative methods to guarantee, initially at least, the supervision of regular home exercises and activities for children with different types of special needs.…”

Section: Introductionmentioning

confidence: 99%

“…Several clinical centres that experimented with telemedicine and telerehabilitation pathways during the COVID-19 lockdown (first phase) have carried out research on the perception and satisfaction of stakeholders in telerehabilitation [3,13]. During the first phase of the pandemic (from March to September 2020 period) Pareyson and colleagues [1] administered a big survey to parents, caregivers and patients of the Foundation IRCCS Neurological Institute 'C. Besta' in Milan and showed that satisfaction about the telehealth and telerehabilitation was very high.…”

Section: Introductionmentioning

confidence: 99%

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Telerehabilitation and Wellbeing Experience in Children with Special Needs during the COVID-19 Pandemic

Sarti¹,

Salvatore²,

Pagliano³

et al. 2021

Children

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Social distancing due to the COVID-19 pandemic represented a golden opportunity to implement telerehabilitation for clinical groups of children. The present study aims to show the impact that telerehabilitation had on the experience of well-being of children with special needs being treated at the Foundation IRCCS Neurological Institute ‘C. Besta’ in Milan (Specific Learning Disorders and Cerebral Palsy diagnosis); it aims to do so by comparing it with experiences of those who did not undertake telerehabilitation despite the diagnosis during the pandemic, and with typically developing children. Results show that the three groups differed in the Support, Respect and Learning dimensions of well-being experience. Post hoc comparisons revealed that children with Specific Learning Disorders and Cerebral Palsy scored higher than normotypical children in Support and in Respect scales. Furthermore, children who experienced telerehabilitation showed the highest scores on the Learning scale in comparison with the other two groups. These results support the importance of reorganizing care and assistance by integrating telemedicine, which seems to have fostered a positive experience of well-being in people with special needs, particularly in the perception of a supportive environment that respects psychological needs.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Telerehabilitation and Wellbeing Experience in Children with Special Needs during the COVID-19 Pandemic

Sarti¹,

Salvatore²,

Pagliano³

et al. 2021

Children

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View full text Add to dashboard Cite

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“…Less than 10% of the studies were multinational, which also decreases the potential for comparison between different countries and, potentially, their generalizability. There were many publications focusing on guidance and recommendations about what to do in terms of alleviating and mitigating the disruption of the neurological services [29,30], but little consensus on which items should be included in studies systematically evaluating this topic and how the results should be presented. An important lesson from this review is that future studies should clearly define how representative of the studied population and territory the data is, as well as, if possible, how the situation was before the pandemic.…”

Section: Discussionmentioning

confidence: 99%

Disruptions of neurological services, its causes and mitigation strategies during COVID-19: a global review

et al. 2021

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Background The COVID-19 pandemic leads to disruptions of health services worldwide. To evaluate the particular impact on neurological services a rapid review was conducted. Methods Studies reporting the provision of neurological services during the pandemic and/or adopted mitigation strategies were included in this review. PubMed and World Health Organization’s (WHO) COVID-19 database were searched. Data extraction followed categories used by WHO COVID-19 pulse surveys and operational guidelines on maintaining essential health services during COVID-19. Findings The search yielded 1101 articles, of which 369 fulfilled eligibility criteria, describing data from 210,419 participants, being adults (81%), children (11.4%) or both (7.3%). Included articles reported data from 105 countries and territories covering all WHO regions and World Bank income levels (low income: 1.9%, lower middle: 24.7%, upper middle: 29.5% and high income; 44.8%). Cross-sectoral services for neurological disorders were most frequently disrupted (62.9%), followed by emergency/acute care (47.1%). The degree of disruption was at least moderate for 75% of studies. Travel restrictions due to lockdowns (81.7%) and regulatory closure of services (65.4%) were the most commonly reported causes of disruption. Authors most frequently described telemedicine (82.1%) and novel dispensing approaches for medicines (51.8%) as mitigation strategies. Evidence for the effectiveness of these measures is largely missing. Interpretation The COVID-19 pandemic affects all aspects of neurological care. Given the worldwide prevalence of neurological disorders and the potential long-term neurological consequences of COVID-19, service disruptions are devastating. Different strategies such as telemedicine might mitigate the negative effects of the pandemic, but their efficacy and acceptability remain to be seen.

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“…Furthermore, these results confirmed the telemedicine potential for the rehabilitation of LDs, which was previously highlighted in several studies conducted during the COVID-19 pandemic. Numerous papers reported on the results obtained in telemedicine satisfaction questionnaires that were completed by adult patients and children's caregivers and that highlighted an overall good level of satisfaction concerning the remodeling of services [29]. Telerehabilitation for LDs has made it possible to maintain therapeutic continuity for younger patients.…”

Section: Discussionmentioning

confidence: 99%

“…An Italian example of the reorganization of LD practices imposed by COVID-19 was recently described in an article by Sarti and colleagues [28]. More precisely, the Language and Learning Disorders Service of the Fondazione IRCCS Istituto Neurologico Carlo Besta of Milan, Italy [29] reformulated the children's rehabilitation plan by integrating telemedicine in order to ensure continuity of care for patients. The reorganization involved children with Specific Learning Disorders (SLDs) and preschoolers with Language and Speech Disorders.…”

Section: Introductionmentioning

confidence: 99%

Dyslexia Telerehabilitation during the COVID-19 Pandemic: Results of a Rhythm-Based Intervention for Reading

et al. 2021

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The COVID-19 outbreak necessitated a reorganization of the rehabilitation practices for Learning Disorders (LDs). During the lockdown phase, telerehabilitation offered the possibility to continue training interventions while enabling social distancing. Given such an advantage of telerehabilitation methods for LDs, clinical research is still needed to test the effectiveness of diverse teletraining approaches by comparing their outcomes with those of face-to-face interventions. To compare the effectiveness of telerehabilitation vs. in-presence rehabilitation of dyslexia, a rhythm-based intervention for reading, called Rhythmic Reading Training (RRT), was tested in a small-scale clinical trial during the lockdown phase of the COVID-19 pandemic. Thirty children aged 8–13 with a diagnosis of developmental dyslexia were assigned to either a telerehabilitation or an in-presence rehabilitation setting and received RRT for 10 biweekly sessions of 45 min, supervised by a trained practitioner. The results showed that both telerehabilitation and in-presence rehabilitation were effective in improving reading and rapid automatized naming in children with dyslexia and that the effects were comparable between settings. Therefore, RRT was found to be effective in spite of the administration method (remote or in-presence). These results confirm the potential of telemedicine for the rehabilitation of LDs. Clinical Trial ID: NCT04995471.

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Neuro-telehealth for fragile patients in a tertiary referral neurological institute during the COVID-19 pandemic in Milan, Lombardy

Cited by 24 publications

References 31 publications

Telerehabilitation and Wellbeing Experience in Children with Special Needs during the COVID-19 Pandemic

Telerehabilitation and Wellbeing Experience in Children with Special Needs during the COVID-19 Pandemic

Disruptions of neurological services, its causes and mitigation strategies during COVID-19: a global review

Dyslexia Telerehabilitation during the COVID-19 Pandemic: Results of a Rhythm-Based Intervention for Reading

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