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1.
Support Care Cancer ; 32(10): 636, 2024 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-39235650

RESUMEN

PURPOSE: Specialised group-based exercise rehabilitation is beneficial for cancer survivors but access to these services is limited. Telerehabilitation provides an opportunity to expand reach, but we do not know about the experiences of those who participate in this way. This study explored participant experiences of an exercise-based telerehabilitation program for people with cancer. METHOD: A qualitative study using semi-structured interviews was completed. Twenty-two cancer survivors were purposively sampled from the experimental group of a randomised controlled trial evaluating exercise-based cancer telerehabilitation delivered in groups using synchronous videoconferencing. Interviews were audio-recorded and transcribed verbatim. Data were coded independently by two reviewers and analysed inductively by thematic analysis. RESULTS: 'A feeling of connection' was the overarching theme. Participants perceived they connected with the health service, expert health professionals, and peers through participating in the telerehabilitation program. These connections provided a personalised rehabilitation experience and improved perceptions of physical and emotional well-being. Two subthemes suggested connection was facilitated by (1) the acceptability of telerehabilitation and (2) enhanced accountability to exercise. Participants felt disconnected when they were unable to participate in the program due to cancer treatment and side effects (e.g. fatigue), feeling unwell, and co-morbidities. CONCLUSION: We identified that telerehabilitation facilitated connections that enhanced the reach of exercise to cancer survivors. Our findings support using telerehabilitation to deliver specialised group-based exercise programs alongside more traditional models of care to increase participation in exercise among people with cancer.


Asunto(s)
Supervivientes de Cáncer , Neoplasias , Investigación Cualitativa , Telerrehabilitación , Humanos , Femenino , Masculino , Persona de Mediana Edad , Supervivientes de Cáncer/psicología , Anciano , Neoplasias/rehabilitación , Neoplasias/psicología , Adulto , Terapia por Ejercicio/métodos , Comunicación por Videoconferencia , Entrevistas como Asunto
2.
J Pak Med Assoc ; 74(9): 1723-1726, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39279090

RESUMEN

Mobile Health (mHealth) applications are transforming stroke rehabilitation, through personalized care and datadriven insights. These applications employ AI-driven algorithms, tele-rehabilitation, wearable technologies, and gamification to enhance recovery process. The objective of this mini review is to explore the transformative role of Mobile Health (mHealth) applications in stroke rehabilitation, highlighting its capacity to transcend geographical barriers and establish extensive support networks connecting stroke survivors, caregivers, and healthcare professionals. Particularly in developing countries like Pakistan, where healthcare resources may be limited, mHealth offers a viable solution to bridge the gap in stroke care. By facilitating access to rehabilitation services, mHealth can significantly improve outcomes for stroke survivors in these regions. This integration of mobile technology with stroke rehabilitation not only promises personalized and more effective rehabilitation but also presents a unique blend of technology and compassion. This evolution in healthcare holds the potential to redefine stroke recovery, marking a significant milestone in the journey towards more inclusive, efficient, and compassionate care solutions.


Asunto(s)
Aplicaciones Móviles , Rehabilitación de Accidente Cerebrovascular , Telemedicina , Humanos , Rehabilitación de Accidente Cerebrovascular/métodos , Pakistán , Telerrehabilitación , Dispositivos Electrónicos Vestibles , Accidente Cerebrovascular/terapia
3.
Integr Cancer Ther ; 23: 15347354241256314, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39223789

RESUMEN

OBJECTIVE: To compare the effects between telerehabilitation and in-person rehabilitation on physical function, pain and quality of life in patients with breast cancer after surgery. DESIGN: Randomized, controlled, and parallel study that involved post-surgical oncological breast surgery patients who were female and aged between 18 and 70 years. The study was conducted in an outpatient environment, and the participants were randomized using a computer system. Population was divided into 2 groups: G1 (n = 20), who received face-to-face care, and G2 (n = 24), who received telerehabilitation. Participants were followed for 15 and 45 days postoperatively. The study's primary outcomes were based on 44 patients (n = 44). Values of changes in quality of life, range of motion (ROM), muscle strength, and upper limb functionality were compared for both groups during the 15 to 45 day postoperative. RESULTS: Both groups exhibited progressive improvements in range of motion, muscle strength, functionality, and quality of life over time (15- and 45-days post-operatively [PO]), indicating a positive response to treatment. Patients in G2 demonstrated more significant improvements in range of motion and muscle strength, as well as better functionality and quality of life compared to G1, particularly after 45 days PO. Additionally, G2 exhibited a more significant reduction in fatigue after 45 days PO. CONCLUSIONS: Telerehabilitation is a viable option with good usability, and has been shown to produce results similar to in-person physiotherapy in most cases, and even superior in some. Long-term intervention studies are needed for the development of telerehabilitation.


Asunto(s)
Neoplasias de la Mama , Calidad de Vida , Rango del Movimiento Articular , Telerrehabilitación , Humanos , Femenino , Neoplasias de la Mama/cirugía , Neoplasias de la Mama/rehabilitación , Persona de Mediana Edad , Adulto , Rango del Movimiento Articular/fisiología , Anciano , Fuerza Muscular/fisiología , Adolescente , Adulto Joven
4.
JMIR Mhealth Uhealth ; 12: e56580, 2024 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-39240210

RESUMEN

Background: Physical therapy has demonstrated efficacy in managing nonspecific low back pain (NLBP) among patients. Nevertheless, the prevalence of NLBP poses a challenge, as the existing medical infrastructure may be insufficient to care for the large patient population, particularly in geographically remote regions. Telerehabilitation emerges as a promising method to address this concern by offering a method to deliver superior medical care to a greater number of patients with NLBP. Objective: The purpose of this study is to demonstrate the physical and psychological effectiveness of a user-centered telerehabilitation program, consisting of a smartphone app and integrated sensors, for patients with NLBP. Methods: This was a single-center, prospective, randomized controlled trial for individuals with NLBP for a duration exceeding 3 months. All participants were assigned randomly to either the telerehabilitation-based exercise group (TBEG) or the outpatient-based exercise group (OBEG). All participants completed a 30-minute regimen of strength and stretching exercises 3 times per week, for a total of 8 weeks, and were required to complete assessment questionnaires at 0, 2, 4, and 8 weeks. The TBEG completed home-based exercises and questionnaires using a telerehabilitation program, while the OBEG completed them in outpatient rehabilitation. The Oswestry Disability Index (ODI) served as the primary outcome measure, assessing physical disability. Secondary outcomes included the Numeric Pain Rating Scale, Fear-Avoidance Beliefs Questionnaire, and 36-item Short-Form Health Survey. Results: In total, 54 of 129 eligible patients were enrolled and randomly assigned to the study. The completion of all the interventions and assessments in the TBEG and OBEG was 89% (24/27) and 81% (22/27). The findings indicate that no statistical significance was found in the difference of ODI scores between the TBEG and the OBEG at 2 weeks (mean difference -0.91; odds ratio [OR] 0.78, 95% CI -5.96 to 4.14; P=.72), 4 weeks (mean difference -3.80; OR 1.33, 95% CI -9.86 to -2.25; P=.21), and 8 weeks (mean difference -3.24; OR 0.92, 95% CI -8.65 to 2.17; P=.24). The improvement of the ODI in the TBEG (mean -16.42, SD 7.30) and OBEG (mean -13.18, SD 8.48) was higher than 10 after an 8-week intervention. No statistically significant differences were observed between the 2 groups at the 8-week mark regarding the Fear-Avoidance Beliefs Questionnaire (mean difference 8.88; OR 1.04, 95% CI -2.29 to 20.06; P=.12) and Numeric Pain Rating Scale (mean difference -0.39; OR 0.44, 95% CI -2.10 to 1.31; P=.64). In the subgroup analysis, there was no statistically significant difference in outcomes between the 2 groups. Conclusions: Telerehabilitation interventions demonstrate comparable therapeutic efficacy for individuals with NLBP when compared to conventional outpatient-based physical therapy, yielding comparable outcomes in pain reduction and improvement in functional limitations.


Asunto(s)
Terapia por Ejercicio , Dolor de la Región Lumbar , Telerrehabilitación , Humanos , Dolor de la Región Lumbar/psicología , Dolor de la Región Lumbar/rehabilitación , Masculino , Femenino , Estudios Prospectivos , Persona de Mediana Edad , Adulto , Terapia por Ejercicio/métodos , Terapia por Ejercicio/psicología , Encuestas y Cuestionarios , Resultado del Tratamiento , Dimensión del Dolor/métodos
5.
J Orthop Sports Phys Ther ; 54(9): 594-607, 2024 09.
Artículo en Inglés | MEDLINE | ID: mdl-39207737

RESUMEN

OBJECTIVES: To explore (1) initial feelings of people with knee osteoarthritis who are unexpectedly offered telerehabilitation, and (2) if their experiences met their expectations, and their willingness to use telerehabilitation in the future. DESIGN: Mixed-methods study of 122 people with knee osteoarthritis who were randomized to receive physiotherapist-delivered telerehabilitation in a clinical trial. METHODS: At enrollment in the trial, participants were unaware care would be delivered via telerehabilitation. At completion, quantitative (Likert scales, analyzed descriptively) and qualitative (open-text, underwent content/thematic analysis) questions asked participants about their initial feelings when randomized to telerehabilitation, if experiences met expectations, and willingness to use telerehabilitation in the future. RESULTS: Data were collected between October 2021 to March 2023. At enrollment, 44 (36% of 122) participants initially felt negative toward telerehabilitation (doubts about effectiveness, physiotherapist can't see/touch, believe in-person is better, can't communicate effectively, not good with technology), 18 (15%) were neutral, and 60 (49%) felt positive. After experiencing telerehabilitation, 43 (72%) people who were initially positive and 27 (61%) who were initially negative believed telerehabilitation exceeded their expectations (easier than expected, surprised by benefits/effectiveness, strong rapport with physiotherapist, convenience). Twenty-eight (23% of 122) people were not at all or slightly willing to use telerehabilitation in future (prefer hands-on, doesn't allow adequate assessment/observation, prefer in-person, don't like telerehabilitation). CONCLUSION: One in 2 people were positive about telerehabilitation from the outset, and 6 in 10 people who initially felt negative about telerehabilitation found that their experiences were better than expected. One in 4 people were unwilling to use telerehabilitation in the future, even after they had experienced it. J Orthop Sports Phys Ther 2024;54(9):1-14. Epub 11 June 2024. doi:10.2519/jospt.2024.12383.


Asunto(s)
Osteoartritis de la Rodilla , Telerrehabilitación , Humanos , Femenino , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla/rehabilitación , Osteoartritis de la Rodilla/psicología , Anciano , Dolor Crónico/rehabilitación , Dolor Crónico/psicología , Emociones , Aceptación de la Atención de Salud/psicología
6.
NeuroRehabilitation ; 55(1): 103-115, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39213097

RESUMEN

BACKGROUND: It is important to investigate satisfaction and perception of the effectiveness of telerehabilitation and its outcomes post-COVID-19 pandemic. OBJECTIVE: Evaluate the patients' and healthcare providers' level of satisfaction with telerehabilitation and perception of its efficacy and describe how it became an established resource in a network of rehabilitation hospitals post-pandemic. METHODS: The online survey about their experience with telerehabilitation was completed by 2,755 patients (322 new patients and 2,433 existing patients), and 668 providers from 26 different specialties. RESULTS: Most patients and providers rated remote care as effective. There were no differences in scores between existing patients and new patients and the majority reported that their expectations were met. Most patients described their remote consults as good as or better than in-person, while providers mostly preferred in-person sessions. Despite most modalities having returned to in-person practice, there is still a significant percentage of telerehabilitation consults. CONCLUSION: Three years after the start of the pandemic, despite a return to in-person treatment, we see a telerehabilitation culture being constructed as a resource to supplement the rehabilitation process, with potential for establishing this model in a network of rehabilitation hospitals.


Asunto(s)
COVID-19 , Personal de Salud , Satisfacción del Paciente , Telerrehabilitación , Humanos , COVID-19/rehabilitación , COVID-19/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Estudios de Seguimiento , Adulto , Personal de Salud/psicología , Anciano , Encuestas y Cuestionarios , Actitud del Personal de Salud
7.
Physiother Res Int ; 29(4): e2120, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39192801

RESUMEN

BACKGROUND AND PURPOSE: In the evolving landscape of healthcare, telerehabilitation is emerging as a pivotal modality, especially in delivering services to vulnerable populations. With the increasing reliance on digital health solutions, there is a pressing need for physiotherapists to be adequately trained in telerehabilitation. This training is essential for them to adapt to new technologies and methodologies, ensuring effective and efficient patient care. The aim of this study was to evaluate the effect of a telerehabilitation educational intervention on physiotherapists' knowledge and perceptions in Bucaramanga and its metropolitan area. METHODS: A group of 27 physiotherapists underwent an educational intervention focused on telerehabilitation. Before- and after-intervention assessments were conducted to gauge their perceptions and knowledge. RESULTS: Participants generally held a positive perception of telerehabilitation both before and after the intervention [Before Median (Md) and interquartile range (IQR): Md = 2.5 (IQR = 2.1-3); after: Md = 2.7 (IQR = 2.4-3.1), p = 0.256]. A significant increase in their knowledge after-intervention was observed [Before: Md = 55.5 (IQR = 33.3-66.6)]; after: Md = 77.7 (IQR = 66.6-88.8), p = <0.001, emphasizing the potential benefits of targeted educational interventions. CONCLUSIONS: The educational intervention significantly improved physiotherapists' knowledge of telerehabilitation, underscoring the importance of professional training in this domain. While perceptions remained consistently positive, the notable increase in knowledge suggests that such educational programs are crucial for enhancing the adoption and effective use of telerehabilitation in physiotherapy practice.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Fisioterapeutas , Telerrehabilitación , Humanos , Fisioterapeutas/educación , Masculino , Femenino , Adulto , Persona de Mediana Edad
8.
Rev Colomb Psiquiatr (Engl Ed) ; 53(2): 149-157, 2024.
Artículo en Inglés, Español | MEDLINE | ID: mdl-39127543

RESUMEN

INTRODUCTION: Social distancing measures due to the COVID-19 pandemic prevented many children with neurodevelopmental disorders from accessing face-to-face treatments. Telerehabilitation grew at this time as an alternative therapeutic tool. In this study we analysed remote cognitive rehabilitation in neurodevelopmental disorders. METHODS: This was a prospective, quasi-experimental (before-after) study that included 22 patients (mean age 9.41 years) with neurodevelopmental disorders who had telerehabilitation for over six months. RESULTS: After six months of telerehabilitation, a statistically significant improvement was found with a large effect size in these areas: attention (sustained, selective and divided), executive functions (verbal and visual working memory, categorisation, processing speed), visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia) and language (comprehensive and expressive). On the Weiss Functional Impairment Scale, all areas (family, learning and school, self-concept, activities of daily living, risk activities) improved with statistical significance. We found a positive correlation between the number of sessions and the improvement observed in executive functions (visual working memory, processing speed), attention (sustained attention, divided attention) and visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia). We did not find statistical significance between the family structure and the number of sessions carried out. A high degree of perception of improvement and satisfaction was observed in the parents. CONCLUSIONS: Telerehabilitation is a safe alternative tool which, although it does not replace face-to-face therapy, can achieve significant cognitive and functional improvements in children with neurodevelopmental disorders.


Asunto(s)
COVID-19 , Trastornos del Neurodesarrollo , Telerrehabilitación , Humanos , COVID-19/rehabilitación , Trastornos del Neurodesarrollo/rehabilitación , Masculino , Femenino , Niño , Estudios Prospectivos , Adolescente , Función Ejecutiva , Preescolar , Atención , Actividades Cotidianas , Resultado del Tratamiento
9.
Int J Med Inform ; 191: 105578, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-39096592

RESUMEN

BACKGROUND: Measuring satisfaction with telerehabilitation provides a way to evaluate and improve the effectiveness of both the technology used and the rehabilitation provided. On the other hand, valid and reliable tools are needed to evaluate satisfaction of patients receiving physiotherapy via telerehabilitation. AIMS: The purpose of the current study was to develop Telerehabilitation Satisfaction Questionnaire (TrSQ) and evaluate its validity and reliability. METHODS: Sixty-three patients with stroke, Multiple Sclerosis, or Parkinson's disease participated in this study. Content validity was reviewed by a panel experienced in telerehabilitation. Construct validity of the model was investigated using and Confirmatory Factor Analysis (CFA) and Explanatory Factor Analysis (EFA). Test-retest reliability and Internal consistency were used to evaluate the reliability of the TrSQ. RESULTS: A one-factor structure was determined based on EFA. The structure fitted well in terms of the fit indices according to the confirmatory factor analysis results (x2/df = 1.016, p = 0.442, IFI=0.997, CFI=0.997, and RMSEA=0.016). The questionnaire was proven to have an acceptable reliability level (Cronbach's alpha = 0.858) and it was found that all items were necessary. Finally, an 11-item version was obtained and tested twice on 30 patients. The questionnaire was shown to have acceptable test-retest reliability (ICC=0.753). CONCLUSIONS: TrSQ can be used as a valid and reliable questionnaire in evaluating patient satisfaction with telerehabilitation in neurological diseases. However, in order for it to be widely applicable, adaptation to different languages is needed.


Asunto(s)
Satisfacción del Paciente , Telerrehabilitación , Humanos , Encuestas y Cuestionarios , Masculino , Femenino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Anciano , Enfermedades del Sistema Nervioso/rehabilitación , Adulto , Análisis Factorial , Esclerosis Múltiple/rehabilitación , Enfermedad de Parkinson/rehabilitación , Psicometría
10.
BMC Med Inform Decis Mak ; 24(1): 233, 2024 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-39180041

RESUMEN

BACKGROUND: The increasing demand for remote medical care, driven by digital healthcare advancements and the COVID-19 pandemic, necessitates effective solutions tailored to patients and healthcare practitioners. Co-design, involving collaboration between software developers, patients, and healthcare practitioners, prioritizes end-user needs. Research indicates that integrating patient perspectives enhances user experience and usability. However, its application in healthcare has been limited to small projects. This work focuses on co-designing a technological solution to enhance the monitoring and visual rehabilitation of individuals with Age-Related Macular Degeneration (AMD), a condition that significantly impacts the quality of life in people over 60. Current vision rehabilitation systems lack personalization, motivation, and effective progress monitoring. Involving patients and healthcare practitioners in the design process aims to ensure the final product meets their needs. METHODS: The project employs iterative and collaborative principles, involving a vision rehabilitation expert and two AMD patients as active users in the application's development and validation. The process begins by establishing requirements for user accounts and rehabilitation exercises. It continues with an initial approach extended through user validation. Co-design is facilitated by specific workshops marking each project iteration, totaling four workshops, along with continuous communication sessions between experts and developers to validate design decisions. Initial requirements gathering and constant feedback from end-users, the visual rehabilitator, and patients are crucial for refining the product effectively. RESULTS: The workshops produced a prototype featuring a test to monitor changes and progression and 15 visual rehabilitation exercises. Numerous patient and vision rehabilitation-driven software modifications led to a final design that is responsive and adaptive to end-user needs. CONCLUSIONS: The Rehab-AMD pilot project aims to develop a collaborative and adaptive software solution for AMD rehabilitation by actively involving stakeholders and applying iterative design principles. Co-design in the Rehab-AMD solution proves to be a methodology that identifies usability issues and needs from the initial design stages. This approach ensures that software developers create a final product that is genuinely useful and manageable for people with AMD and the targeted vision rehabilitators.


Asunto(s)
Degeneración Macular , Humanos , Degeneración Macular/rehabilitación , Diseño de Software , Telerrehabilitación , COVID-19
11.
Stud Health Technol Inform ; 316: 147-151, 2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-39176694

RESUMEN

Older individuals often face disabilities or diseases that lower their quality of life (QoL). While inpatient rehabilitation can initially enhance QoL, there is often a lack of continuation at home. Virtual coaches (VCs) as specific embodied conversational agents promise appropriate support for home rehabilitation. They emerge as complementary digital aids to ensure care continuity. This paper presents the results of implementing a full-featured VC for older patients' home rehabilitation in a multi-stage study, summarizing the main results regarding QoL outcomes and user experience tests. The study confirms the intervention as an engaging means for rehabilitation (mostly above user experience thresholds) and improvements of QoL (>10% between experimental and control groups).


Asunto(s)
Servicios de Atención de Salud a Domicilio , Tutoría , Calidad de Vida , Humanos , Anciano , Masculino , Femenino , Interfaz Usuario-Computador , Telerrehabilitación
12.
Cancer Med ; 13(15): e70022, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39095954

RESUMEN

INTRODUCTION: The COVID-19 pandemic impacted healthcare organizations, necessitating a rapid transition from in-person to virtual care. Our study explored the feasibility of a mixed in-person/telerehabilitation intervention for cancer patients and its effects on cancer-related fatigue (CRF), quality of life (QoL), physical function, patient satisfaction, and perceived usefulness. METHODS: TRACE 2020 is an observational prospective study that enrolled adult cancer patients, between January 2021 and March 2023, who were eligible for a rehabilitation program to be provided also in telerehabilitation. Patients were assessed at baseline and after the rehabilitation program. Adherence to sessions, reasons for non-adherence and adverse events were collected. RESULTS: Of the 23 patients enrolled, 87% received a mixed intervention, with an average of 60% in-person sessions and 40% telerehabilitation sessions. Adherence was very high (91%). Evaluation scales showed an improvement in CRF, QoL, and lower limb strength and a relevant increase in patients' level of physical activity (PA). Most patients reported good satisfaction; the few criticisms mainly concerned difficulties in connectivity, lack of physical contact and difficulties in understanding how to perform exercises during telerehabilitation sessions. The physiotherapist underlined the usefulness of the innovative approach and suggested ways to facilitate future implementation. CONCLUSION: A mixed intervention including telerehabilitation is feasible and accepted by cancer patients. It may have a positive effect on their CRF, QoL, and level of PA and render patient care more flexible. The findings suggest what characteristics the target population for telerehabilitation should have, in order to integrate telerehabilitation in standard care for cancer patients.


Asunto(s)
COVID-19 , Estudios de Factibilidad , Neoplasias , Satisfacción del Paciente , Calidad de Vida , Telerrehabilitación , Humanos , COVID-19/epidemiología , COVID-19/rehabilitación , Masculino , Neoplasias/rehabilitación , Femenino , Persona de Mediana Edad , Estudios Prospectivos , Anciano , Italia , SARS-CoV-2 , Fatiga/rehabilitación , Adulto , Pandemias
13.
Telemed J E Health ; 30(9): 2419-2430, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38946606

RESUMEN

Background: People with rare neurological diseases (RNDs) often experience symptoms related to movement disorders, requiring a multidisciplinary approach, including rehabilitation. Telemedicine applied to rehabilitation and symptom monitoring may be suitable to ensure treatment consistency and personalized intervention. The objective of this scoping review aimed to emphasize the potential role of telerehabilitation and teleassessment in managing movement disorders within RNDs. By providing a systematic overview of the available literature, we sought to highlight potential interventions, outcomes, and critical issues. Methods: A literature search was conducted on PubMed, Google Scholar, IEEE, and Scopus up to March 2024. Two inclusion criteria were followed: (1) papers focusing on telerehabilitation and teleassessment and (2) papers dealing with movement disorders in RNDs. Results: Eighteen papers fulfilled the inclusion criteria. The main interventions were home-based software and training programs, exergames, wearable sensors, smartphone applications, virtual reality and digital music players for telerehabilitation; wearable sensors, mobile applications, and patient home video for teleassessment. Key findings revealed positive outcomes in gait, balance, limb disability, and in remote monitoring. Limitations include small sample sizes, short intervention durations, and the lack of standardized protocols. Conclusion: This review highlighted the potential of telerehabilitation and teleassessment in addressing movement disorders within RNDs. Data indicate that these modalities may play a major role in supporting conventional programs. Addressing limitations through multicenter studies, longer-term follow-ups, and standardized protocols is essential. These measures are essential for improving remote rehabilitation and assessment, contributing to an improved quality of life for people with RNDs.


Asunto(s)
Trastornos del Movimiento , Enfermedades del Sistema Nervioso , Enfermedades Raras , Telerrehabilitación , Humanos , Trastornos del Movimiento/rehabilitación , Enfermedades Raras/rehabilitación , Enfermedades del Sistema Nervioso/rehabilitación , Telemedicina/organización & administración
14.
BMC Geriatr ; 24(1): 586, 2024 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-38977995

RESUMEN

OBJECTIVE: Through a randomized controlled trial on older adults with sarcopenia, this study compared the training effects of an AI-based remote training group using deep learning-based 3D human pose estimation technology with those of a face-to-face traditional training group and a general remote training group. METHODS: Seventy five older adults with sarcopenia aged 60-75 from community organizations in Changchun city were randomly divided into a face-to-face traditional training group (TRHG), a general remote training group (GTHG), and an AI-based remote training group (AITHG). All groups underwent a 3-month program consisting of 24-form Taichi exercises, with a frequency of 3 sessions per week and each session lasting 40 min. The participants underwent Appendicular Skeletal Muscle Mass Index (ASMI), grip strength, 6-meter walking pace, Timed Up and Go test (TUGT), and quality of life score (QoL) tests before the experiment, during the mid-term, and after the experiment. This study used SPSS26.0 software to perform one-way ANOVA and repeated measures ANOVA tests to compare the differences among the three groups. A significance level of p < 0.05 was defined as having significant difference, while p < 0.01 was defined as having a highly significant difference. RESULTS: (1) The comparison between the mid-term and pre-term indicators showed that TRHG experienced significant improvements in ASMI, 6-meter walking pace, and QoL (p < 0.01), and a significant improvement in TUGT timing test (p < 0.05); GTHG experienced extremely significant improvements in 6-meter walking pace and QoL (p < 0.01); AITHG experienced extremely significant improvements in ASMI, 6-meter walking pace, and QoL (p < 0.01), and a significant improvement in TUGT timing test (p < 0.05). (2) The comparison between the post-term and pre-term indicators showed that TRHG experienced extremely significant improvements in TUGT timing test (p < 0.01); GTHG experienced significant improvements in ASMI and TUGT timing test (p < 0.05); and AITHG experienced extremely significant improvements in TUGT timing test (p < 0.01). (3) During the mid-term, there was no significant difference among the groups in all tests (p > 0.05). The same was in post-term tests (p > 0.05). CONCLUSION: Compared to the pre-experiment, there was no significant difference at the post- experiment in the recovery effects on the muscle quality, physical activity ability, and life quality of patients with sarcopenia between the AI-based remote training group and the face-to-face traditional training group. 3D pose estimation is equally as effective as traditional rehabilitation methods in enhancing muscle quality, functionality and life quality in older adults with sarcopenia. TRIAL REGISTRATION: The trial was registered in ClinicalTrials.gov (NCT05767710).


Asunto(s)
Sarcopenia , Telerrehabilitación , Humanos , Sarcopenia/fisiopatología , Sarcopenia/rehabilitación , Sarcopenia/terapia , Anciano , Masculino , Femenino , Persona de Mediana Edad , Postura/fisiología , Imagenología Tridimensional/métodos , Calidad de Vida , Aprendizaje Profundo
15.
Schizophr Res ; 270: 451-458, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38996522

RESUMEN

BACKGROUND: Although physical activity (PA) is beneficial to young people with early psychosis (YEP) to improve physical health and psychiatric symptoms, few YEP initiate and maintain PA. The sports group interventions offered in early psychosis services had to be suspended due to the COVID-19 pandemic. Telehealth has shown promising results in different fields of health services including for patients with mental health disorders. METHODS: Descriptive retrospective study aiming to determine the feasibility and acceptability of a telekinesiology intervention among YEP and to describe its multicenter implementation. The PA sessions were delivered to YEP by a kinesiologist and peer support workers. Feasibility was measured by the number of programs approached which referred participants, and the proportion of referred YEP who participated to at least one PA session. Acceptability was measured by the proportion of participants who attended more than one PA session, the number of sessions attended per participant and by surveys on patient satisfaction. RESULTS: Of the 35 clinics approached, 150 YEP (of 214 referred) from 13 clinics participated to at least one of the 204 telekinesiology sessions (offered 2-3 times/week from May 2020 to May 2022) The mean number per participant was 5.5 sessions. 106 YEP engaged in more than one session (mean of 7.3 sessions per persistent participant). The mean number of participants per session was 4 (1-12). 99 % of the survey respondents were very satisfied/or satisfied with the sessions. CONCLUSION: Telekinesiology appears to be an acceptable and feasible option to be implemented simultaneously in multiple early intervention services.


Asunto(s)
COVID-19 , Ejercicio Físico , Estudios de Factibilidad , Aceptación de la Atención de Salud , Trastornos Psicóticos , Telerrehabilitación , Humanos , Trastornos Psicóticos/rehabilitación , Trastornos Psicóticos/terapia , Masculino , Femenino , Adulto Joven , Estudios Retrospectivos , Adulto , Adolescente , Terapia por Ejercicio/métodos , Intervención Médica Temprana/métodos , Satisfacción del Paciente
17.
BMJ Open ; 14(7): e074325, 2024 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-38964791

RESUMEN

OBJECTIVE: To assess the effects of telerehabilitation on clinical symptoms, physical function, psychological function and quality of life (QoL) in patients with post-COVID-19. DESIGN: Systematic review and meta-analysis of randomised controlled trials (RCTs). DATA SOURCES: PubMed, Web of Science, Embase and Cochrane Library were searched for publications from 1 January 2020 to 17 April 2024. ELIGIBILITY CRITERIA: RCTs investigating the effects of telerehabilitation in patients with post-COVID-19 were included. The outcomes of interest encompassed clinical symptoms, physical function, psychological function and QoL. Only studies reported in English were included. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently extracted data and evaluated the risk of bias. Statistical analysis was conducted using Review Manager V.5.3, employing mean difference (MD) with a 95% CI, and the corresponding P value was used to ascertain the treatment effect between groups. Heterogeneity was quantified using the I2 statistic. The quality of evidence was assessed by GRADE. RESULTS: 16 RCTs (n=1129) were included in this systematic review, 15 of which (n=1095, 16 comparisons) were included in the meta-analysis. The primary pooled analysis demonstrated that, compared with no rehabilitation or usual care, telerehabilitation can improve physical function (measured by 30 s sit-to-stand test [6 RCTs, n=310, MD=1.58 stands, 95% CI 0.50 to 2.66; p=0.004]; 6 min walking distance [6 RCTs, n=324, MD=76.90 m, 95% CI 49.47 to 104.33; p<0.00001]; and physical function from the 36-item short-form health survey [5 RCTs, n=380, MD=6.12 units, 95% CI 2.85 to 9.38; p=0.0002]). However, the pooled results did not indicate significant improvements in clinical symptoms, pulmonary function, psychological function or QoL. The quality of the evidence was graded as low for physical function and Hospital Anxiety and Depression Scale-anxiety and very low for other assessed outcomes. The overall treatment completion rate was 78.26%, with no reports of severe adverse events in any included trials. CONCLUSIONS: Despite the lack of significant improvements in certain variables, telerehabilitation could be an effective and safe option for enhancing physical function in patients with post-COVID-19. It is advisable to conduct further well-designed trials to continue in-depth exploration of this topic. STUDY REGISTRATION: PROSPERO, CRD42023404647.


Asunto(s)
COVID-19 , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Telerrehabilitación , Humanos , COVID-19/rehabilitación , SARS-CoV-2 , Resultado del Tratamiento
18.
Front Endocrinol (Lausanne) ; 15: 1433297, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39015181

RESUMEN

Objective: This study aims to determine whether tele-rehabilitation has similar effects to conventional face-to-face physical rehabilitation for diabetic patients with heart failure with preserved ejection fraction (HFpEF). Materials and methods: Demographic, laboratory, diagnostic and rehabilitation information for patients with type 2 diabetes with HFpEF were extracted from disease-specific databases. Outcome measures, including the Short Physical Performance Battery (SPPB), 6-minute walk distance, frailty status, European Quality of Life 5-Dimension 5-Level questionnaire (EQ-5D-5L) and reduction in HbA1c from admission, patients who received tele-rehabilitation therapy were compared to those received face-to-face rehabilitation. Results: In this study, 90 patients with type 2 diabetes and HFpEF using tele-rehabilitation were matched with 90 patients with type 2 diabetes and HFpEF using face-to-face physical rehabilitation. Improvements in the results of the SPPB scores, 6-min walk distance and gait speed and EQ-5D-5L were noted from the follow-up time point 3 months to 6 months in both two groups. There were no significant differences in functional tests and quality of life between the two groups. Conclusion: Our study proved that mobile-based tele-rehabilitation programs are non-inferior to face-to-face physical rehabilitation for diabetes patients after HFpEF. In addition, adherence to the telerehabilitation program showed that the novel technology was accepted well and could be an alternative to the conventional face-to-face rehabilitation program.


Asunto(s)
Diabetes Mellitus Tipo 2 , Insuficiencia Cardíaca , Calidad de Vida , Volumen Sistólico , Telerrehabilitación , Humanos , Diabetes Mellitus Tipo 2/rehabilitación , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/fisiopatología , Insuficiencia Cardíaca/rehabilitación , Insuficiencia Cardíaca/fisiopatología , Masculino , Femenino , Anciano , Persona de Mediana Edad
19.
Int J Chron Obstruct Pulmon Dis ; 19: 1707-1719, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39081777

RESUMEN

Background: Pulmonary rehabilitation (PR) is an effective intervention for people with chronic obstructive pulmonary disease (COPD). However, fewer than 5% of eligible individuals receive pulmonary rehabilitation, largely due to limited by the accessibility of rehabilitation and difficulties associated with travel and transport. Supervised home-based tele-rehabilitation (SHTR) is an alternative model to center-based pulmonary rehabilitation. We will determine whether supervised home-based tele-rehabilitation is non-inferior to center-based pulmonary rehabilitation. Methods: The participants will undergo an 8-week rehabilitation program. Pulmonary rehabilitation comprises four main modules: exercise training, education, nutritional support, and psychological and behavioral interventions. We mainly focus on the module of exercise training and education. The education module includes information on exercise training, nutrition, and psychology, which are presented in an educational booklet provided to each participant. Blinded assessors will evaluate the outcomes at baseline, post-intervention, and 6 months after the intervention. The primary outcome is the change in the 6-minute walking distance. Secondary outcomes will assess changes in the patients' 1-minute sit-to-stand test, maximal inspiratory pressure (MIP), scales (CAT, mMRC, HAD), diaphragm ultrasound (TD, DE, DIF), changes in extrathoracic muscle volume and mass, completion rate of patient exercise prescriptions, occurrence of adverse events, as well as disease exacerbation and rehospitalization rates after rehabilitation and during the 6-month follow-up. Discussion: In order to improve the accessibility of pulmonary rehabilitation and patient-related outcomes, it is necessary to propose an alternative model of pulmonary rehabilitation. This trial will establish whether a supervised home-based tele-rehabilitation is not inferior to traditional center-based pulmonary rehabilitation. Trial Registration: Chinese Clinical Trial Registry ChiCTR2300076969. Registered on October 25, 2023.


Asunto(s)
Terapia por Ejercicio , Tolerancia al Ejercicio , Servicios de Atención de Salud a Domicilio , Estudios Multicéntricos como Asunto , Enfermedad Pulmonar Obstructiva Crónica , Recuperación de la Función , Telerrehabilitación , Humanos , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , China , Resultado del Tratamiento , Terapia por Ejercicio/métodos , Factores de Tiempo , Pulmón/fisiopatología , Persona de Mediana Edad , Centros de Rehabilitación , Masculino , Educación del Paciente como Asunto/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Femenino , Anciano , Estudios de Equivalencia como Asunto , Estado Funcional , Prueba de Paso
20.
Curr Med Res Opin ; 40(8): 1421-1430, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38994747

RESUMEN

OBJECTIVE: Use of tele-technology for monitoring symptoms, functional parameters, and quality-of-life of people with asthma is essential. Delivering this information among patients is mandated for a better outcome and made possible via patient education (PE). This review aims to summarize the types of telerehabilitation modalities, dosage, and outcome measures used to assess the effectiveness of PE among people with asthma. METHODS: We adopted a scoping review methodology. Thematic analysis was used to synthesize the data. The Preferred Reporting System for Meta-Analysis for Scoping Reviews (PRISMA-ScR) was followed during the review process. RESULTS: PubMed, Embase, and Scopus were searched, with 34 studies meeting inclusion criteria. Results are presented in three themes: telerehabilitation platforms used to deliver PE among patients with asthma; content, duration, and frequency of the PE administered; and patient-reported outcome measures used to evaluate the effectiveness of PE. CONCLUSION: This scoping study detailed the types of telerehabilitation modalities, dosage, and outcome measures used to assess the effectiveness of PE in people with asthma. This review will be especially beneficial to those considering where additional research or implementation of telerehabilitation for asthma patients is required. The studies emphasized the involvement of several healthcare experts, emphasizing the significance of a multidisciplinary approach to efficient PE delivery and possible improvements in asthma management through telerehabilitation. Although a range of telerehabilitation platforms were generally accepted, hybrid models that integrate online and in-person sessions could further enhance patient satisfaction and quality-of-life. Comprehensive economic analyses are also required, and solving technology issues is essential to maximizing the efficacy of these initiatives.


Asunto(s)
Asma , Educación del Paciente como Asunto , Calidad de Vida , Telerrehabilitación , Asma/rehabilitación , Humanos , Educación del Paciente como Asunto/métodos , Telemedicina
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