Scope, context and quality of telerehabilitation guidelines for physical disabilities: a scoping review

Anil, Krithika; Freeman, Jennifer; Buckingham, Sarah; Demain, Sara; Gunn, Hilary; Jones, Ray; Logan, Angela; Marsden, Jonathan; Sein, Kim; Kent, Bridie

doi:10.1136/bmjopen-2021-049603

Cited by 17 publications

(16 citation statements)

References 32 publications

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“…Moreover, findings include information specific to movement considerations and safety considerations for patients with physical disabilities or impairments impacting cognitive functioning. A 2021 scoping review of telerehabilitation guidelines regarding patients with physical disabilities found only three studies providing specific provider guidance; however, the guidance was specific to use of the telerehabilitation technology (42). These researchers concluded a notable lack of movement-specific related clinical telerehabilitation guidance.…”

Section: Discussionmentioning

confidence: 99%

Providers' Shift to Telerehabilitation at the U.S. Veterans Health Administration During COVID-19: Practical Applications

Kreider

Hale–Gallardo

Kramer

et al. 2022

Front. Public Health

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Telerehabilitation provides Veteran patients with necessary rehabilitation treatment. It enhances care continuity and reduces travel time for Veterans who face long distances to receive care at a Veterans Health Administration (VHA) medical facility. The onset of the COVID-19 pandemic necessitated a sudden shift to telehealth–including telerehabilitation, where a paucity of data-driven guidelines exist that are specific to the practicalities entailed in telerehabilitation implementation. This paper explicates gains in practical knowledge for implementing telerehabilitation that were accelerated during the rapid shift of VHA healthcare from out-patient rehabilitation services to telerehabilitation during the COVID-19 pandemic. Group and individual interviews with 12 VHA rehabilitation providers were conducted to examine, in-depth, the providers' implementation of telerehabilitation. Thematic analysis yielded nine themes: (i) Willingness to Give Telerehabilitation a Chance: A Key Ingredient; (ii) Creativity and Adaptability: Critical Attributes for Telerehabilitation Providers; (iii) Adapting Assessments; (iv) Adapting Interventions; (v) Role and Workflow Adaptations; (vi) Appraising for Self the Feasibility of the Telerehabilitation Modality; (vii) Availability of Informal, In-Person Support Improves Feasibility of Telerehabilitation; (viii) Shifts in the Expectations by the Patients and by the Provider; and (ix) Benefit and Anticipated Future of Telerehabilitation. This paper contributes an in-depth understanding of clinical reasoning considerations, supportive strategies, and practical approaches for engaging Veterans in telerehabilitation.

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Section: Discussionmentioning

confidence: 99%

Providers' Shift to Telerehabilitation at the U.S. Veterans Health Administration During COVID-19: Practical Applications

Kreider

Hale–Gallardo

Kramer

et al. 2022

Front. Public Health

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“…The decision to select UK-based practitioners was a pragmatic one, as the tool kit will include specific guidance on aspects such as information governance and digital platforms used in the United Kingdom. Nevertheless, many of the issues identified are likely to be of relevance to other countries, as suggested by our scoping review [17].…”

Section: Limitationsmentioning

confidence: 91%

“…Findings from our scoping review [17] and consultation with experts informed the survey questions. The expert consultation process involved informal discussions (email and verbal) with specialists in rehabilitation and physical disabilities, including health and social care practitioners and academics within, and external to, the project team.…”

Section: Design and Developmentmentioning

confidence: 99%

“…Our recent global scoping review found that specific published guidance, training, and support on how to undertake remote assessments in people with physical disabilities is limited [17]. Professional bodies and clinical networks highlight large variations in the approaches taken, expressing concerns about potential inequity and inefficiency [4,18,19].…”

Section: Introductionmentioning

confidence: 99%

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Telerehabilitation for People With Physical Disabilities and Movement Impairment: A Survey of United Kingdom Practitioners

Buckingham¹,

Anil²,

Demain³

et al. 2022

JMIRx Med

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Background Telerehabilitation is a feasible and potentially effective alternative to face-to-face rehabilitation. However, specific guidance, training, and support for practitioners who undertake remote assessments in people with physical disabilities and movement impairment are limited. Objective The aims of this survey of United Kingdom–based health and social care practitioners were to explore experiences, assess training needs, and collate ideas on best practices in telerehabilitation for physical disabilities and movement impairment. The aim will be to use the findings to inform a practical tool kit and training package for telerehabilitation use. Methods UK rehabilitation practitioners were invited to complete an online questionnaire from November to December 2020. Opportunity and snowball sampling were used to recruit participants from professional and educational networks, special interest groups, and via social media. Closed questionnaire items were analyzed using descriptive statistics. Qualitative inductive analysis using NVivo was used for open responses. Results There were 247 respondents, of which 177 (72%) were physiotherapists and occupational therapists. Most (n=207, 84%) had used video-based consultations (typically supported by telephone and email), and the use of this method had increased in frequency since the COVID-19 pandemic. Practitioners perceived telerehabilitation positively overall and recognized benefits for patients including a reduced infection risk, convenience and flexibility, and reduced travel and fatigue. Common obstacles were technology related (eg, internet connection), practical (eg, difficulty positioning the camera), patient related (eg, health status), practitioner related (eg, lack of technical skills), and organizational (eg, lack of access to technology). Support from family members or carers was a major facilitator for successful remote consultations. Of the 207 respondents who had used video-based consultations, 103 (50%) had assessed physical impairments using this method, 107 (52%) had assessed physical function, and 121 (59%) had used patient-reported outcome measures. Although practitioners generally felt confident in delivering video-based consultations, they felt less proficient in undertaking remote physical assessments, expressing concerns about validity, reliability, and safety. Only 46 of the 247 (19%) respondents had received any training in telerehabilitation or video consultations, and some felt they were “feeling their way in the dark.” Practitioners desired training and guidance on physical assessment tools suitable for remote use, when to use video-based consultations or alternative methods, governance issues, digital platforms, and signposting to digital skills training for themselves and their patients. Conclusions In response to the COVID-19 pandemic, practitioners rapidly adopted telerehabilitation for people with physical disabilities and movement impairment. However, there are technical, practical, and organizational obstacles to overcome, and a clear need for improved guidance and training in remote physical assessments. The findings of this survey will inform the development of a tool kit of resources and a training package for the current and future workforce in telerehabilitation.

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“…Telerehabilitation could indeed complement the current rehabilitation services, allowing healthcare professionals to support and treat patients in remote locations using telecommunications technology, guaranteeing people access to medical expertise in a quick, flexible and efficient manner, without having to travel, resulting in less burden and great satisfaction. However, the current level of evidence supporting this kind of intervention in clinical practice is still relatively limited [ 14 ]. Considering that the actual extent of the implementation of telerehabilitation during the current COVID-19 pandemic is still unclear, this review aims to summarize and analyze the different solutions that have been proposed to remotely support patients with a variety of health conditions in their rehabilitation process during the COVID-19 pandemic, highlighting the effectiveness and feasibility of such interventions.…”

Section: Introductionmentioning

confidence: 99%

Using Telehealth to Guarantee the Continuity of Rehabilitation during the COVID-19 Pandemic: A Systematic Review

Brigo

Rintala

Kossi

et al. 2022

IJERPH

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COVID-19 has abruptly disrupted healthcare services; however, the continuity of rehabilitation could be guaranteed using mobile technologies. This review aims to analyze the feasibility and effectiveness of telehealth solutions proposed to guarantee the continuity of rehabilitation during the COVID-19 pandemic. The PubMed, Cochrane Library, Web of Science and PEDro databases were searched; the search was limited to randomized controlled trials, observational and explorative studies published up to 31 May 2022, assessing the feasibility and effectiveness of telerehabilitation during the COVID-19 pandemic. Twenty studies were included, for a total of 224,806 subjects: 93.1% with orthopedic complaints and 6.9% with non-orthopedic ones. The main strategies used were video and audio calls via commonly available technologies and free videoconferencing tools. Based on the current evidence, it is suggested that telerehabilitation is a feasible and effective solution, allowing the continuity of rehabilitation while reducing the risk of infection and the burden of travel. However, it is not widely used in clinical settings, and definitive conclusions cannot be currently drawn. Telerehabilitation seems a feasible and safe option to remotely deliver rehabilitation using commonly available mobile technologies, guaranteeing the continuity of care while respecting social distancing. Further research is, however, needed to strengthen and confirm these findings.

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Scope, context and quality of telerehabilitation guidelines for physical disabilities: a scoping review

Cited by 17 publications

References 32 publications

Providers' Shift to Telerehabilitation at the U.S. Veterans Health Administration During COVID-19: Practical Applications

Providers' Shift to Telerehabilitation at the U.S. Veterans Health Administration During COVID-19: Practical Applications

Telerehabilitation for People With Physical Disabilities and Movement Impairment: A Survey of United Kingdom Practitioners

Using Telehealth to Guarantee the Continuity of Rehabilitation during the COVID-19 Pandemic: A Systematic Review

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