Telemedicine Technologies Efficacy in a Complex Rehabilitation Program: аn Open Controlled Study of 64 Patients after Transpedicular Spine Fixation

Abstract

AIM. To evaluate the efficiency of telemedicine technologies in the complex rehabilitation of patients after transpedicular fixation of the lumbar spine. MATERIAL AND METHODS. 64 patients (38 men and 26 females, age 31 to 67 years) after transpedicular fixation of the lumbar spine where included in the study. All patients underwent 2-weeks inpatient medical rehabilitation. The telemedicine platform «Steps Reabil» was used in the study group (35 patients) for home-based rehabilitation. Patients received e-mail links to the video recording of 10 home-based physical exercises. The control group (29 patients) received a leaflet describing similar 10 physical exercises. Rehabilitation diagnosis by ICF domains (b28013, b7303, b7600, d4500, e1151), backache on 100-mm visual analog scale (VAS) and on Roland-Morris Disability Questionnaire (RDQ), Health Assessment Questionnaire (HAQ), Spielberger-Khanin reactive anxiety test, Beck depression inventory (BDI), 10-meters walking test were evaluated before starting home-based physical exercises and after 1 month. RESULTS AND DISCUSSION. The best patient adherence (74 %) to regular home-based physical exercises using the telemedicine platform was observed after 2 weeks, by the 2nd month the adherence decreased. Telerehabilitation improved the values of the qualifiers of ICF domains, reduced backache on VAS by 43.2 % (p < 0.05), on RDQ by 47.8 % (p < 0.05), HAQ by 57.1 % (p < 0.01), 10-meters walking test by 39.0 % (p < 0.05), reactive anxiety level by 30.6 % (p < 0.05), subclinical depression symptoms on BDI by 44.2 % (p < 0.05), with statistically significant differences from the control group in most parameters (р < 0.05), excluding 10-meters walking test. These results are consistent with the data of numerous studies that have demonstrated the efficiency of technology-based distance telerehabilitation in patients with various diseases. CONCLUSION. Telemedicine technologies allow to conduct the individual home-based rehabilitation program, to control its efficiency, which ensures the continuity of rehabilitation activities at all stages.