Efficacy Of Telerehabilitation Research Articles

The effects of telerehabilitation in adults with complex biventricular congenital heart conditions: protocol for a multi-centre, randomised controlled trial—CH-FIT

BackgroundAccumulated evidence suggests that exercise training exerts beneficial effects on people with congenital heart conditions. These findings are predominantly derived from small, single-centre exercise trials conducted in outpatient rehabilitation facilities. In recent years, the delivery of exercise interventions remotely has increased through digital communications technology (telerehabilitation). However, very little research to date has been conducted into the efficacy of telerehabilitation in people with a congenital heart condition.AimsTo evaluate the effects of a telehealth-delivered exercise intervention in people with a history of a surgical biventricular repair due to a congenital heart condition.MethodsOne hundred eligible adolescent (≥ 16 years) and adult participants living with a complex biventricular congenital heart condition will be recruited from four Australian sites and randomised to either (1) a 16-week telehealth-delivered combined (aerobic and resistance) exercise training programme of moderate-to-vigorous intensity or (2) usual care (control group), in a 1:1 allocation, with an 8-month follow-up.Outcomes of interestThe primary outcome will be the change in aerobic capacity expressed as peak oxygen uptake (VO2peak). Secondary outcomes will include changes in vascular function, muscle oxygenation, metabolic profile, body composition and musculoskeletal fitness, neurohormonal activation, neurocognitive function, physical activity levels, dietary and nutritional status, and quality of life. Outcomes will be assessed at baseline, 16 weeks, and 12 months (to determine longer-term maintenance potential).DiscussionIf found to be efficacious, telerehabilitation may be an alternative option for delivering exercise, improving health outcomes, and increasing accessibility to exercise programmes. Efficacy data is required to quantify the clinical significance of this delivery mode of exercise.Trial registrationACTRN12622000050752Trial registration date: 17 January 2022Trial registration URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382635&showOriginal=true&isReview=trueTrial registry name: Australian and New Zealand Clinical Trials Registry

Efficacy of telerehabilitation in patients with nonspecific neck pain: A meta-analysis.

At a rate of more than 30% annually, neck pain is a very prevalent musculoskeletal ailment that is second only to low back pain as the most common cause of disability. Most occurrences of neck pain are nonspecific. Telerehabilitation is regarded as a potentially effective healthcare approach in this setting. This review aims to evaluate how a telerehabilitation-based intervention affected individuals with nonspecific neck pain (NNP) in terms of pain and disability. PubMed, Web of Science, Scopus, Embase, MEDLINE, Cochrane library, ClinicalTrials.gov, CNKI, and WanFang were consulted from inception to September 2023, with the inclusion of randomized controlled trials only. The experimental data were meta-analyzed using RevMan 5.3. The meta-analysis contained eight studies; there was no significant difference in pain improvement in patients with NNP by telerehabilitation compared to conventional care (SMD = -0.10, 95% CI: -0.48 to 0.28), but there was a significant effect on disability improvement (SMD = -0.41, 95% CI: -0.78 to -0.03). Telerehabilitation demonstrated more significant improvements in pain (SMD = -1.16, 95% CI: -1.99 to -0.32) and disability (MD = -3.78, 95% CI: -5.29 to -2.27) compared to minimal or no intervention. This study emphasizes the potential benefits of employing telerehabilitation in patients with NNP, especially in reducing pain intensity and improving disability. But additional study is required to fully grasp the potential of telerehabilitation in this field.

STASISM: A Versatile Serious Gaming Multi-Sensor Platform for Personalized Telerehabilitation and Telemonitoring.

Telemonitoring and telerehabilitation have shown promise in delivering individualized healthcare remotely. We introduce STASISM, a sensor-based telerehabilitation and telemonitoring system, in this work. This platform has been created to facilitate individualized telerehabilitation and telemonitoring for those who need rehabilitation or ongoing monitoring. To gather and analyze pertinent and validated physiological, kinematic, and environmental data, the system combines a variety of sensors and data analytic methodologies. The platform facilitates customized rehabilitation activities based on individual needs, allows for the remote monitoring of a patient's progress, and offers real-time feedback. To protect the security of patient data and to safeguard patient privacy, STASISM also provides secure data transmission and storage. The platform has the potential to significantly improve the accessibility and efficacy of telerehabilitation and telemonitoring programs, enhancing patients' quality of life and allowing healthcare professionals to provide individualized care outside of traditional clinical settings.

Efficacy of telerehabilitation with digital and robotic tools for the continuity of care of people with chronic neurological disorders: The TELENEURO@REHAB protocol for a randomized controlled trial.

Chronic Neurological Disorders (CNDs) are among the leading causes of disability worldwide, and their contribution to the overall need for rehabilitation is increasing. Therefore, the identification of new digital solutions to ensure early and continuous care is mandatory. This protocol proposes to test the usability, acceptability, safety, and efficacy of Telerehabilitation (TR) protocols with digital and robotic tools in reducing the perceived level of disability in CNDs including Parkinson's Disease (PD), Multiple Sclerosis (MS), and post-stroke patients. This single-blinded, multi-site, randomized, two-treatment arms controlled clinical trial will involve PD (N = 30), MS (N = 30), and post-stroke (N = 30). Each participant will be randomized (1:1) to the experimental group (20 sessions of motor telerehabilitation with digital and robotic tools) or the active control group (20 home-based motor rehabilitation sessions according to the usual care treatment). Primary and secondary outcome measures will be obtained at the baseline (T0), post-intervention (T1, 5 weeks after baseline), and at follow-up (T2, 2 months after treatment). a multifaceted evaluation including quality of life, motor, and clinical/functional measures will be conducted at each time-point of assessment. The primary outcome measures will be the change in the perceived level of disability as measured by the World Health Organization Disability Assessment Schedule 2.0. The implementation of TR protocols will enable a more targeted and effective response to the growing need for rehabilitation linked to CNDs, ensuring accessibility to rehabilitation services from the initial stages of the disease.

The Efficacy and Safety of Telerehabilitation for Fibromyalgia: Systematic Review and Meta-analysis of Randomized Controlled Trials.

Fibromyalgia is a chronic pain syndrome characterized by persistent and widespread musculoskeletal pain. Telerehabilitation is a promising treatment for patients with fibromyalgia through long-term monitoring, intervention, supervision, consultation, and education. This study aimed to perform a comprehensive systematic review and meta-analysis of the efficacy and safety of telerehabilitation in patients with fibromyalgia. Randomized controlled trials (RCTs) related to fibromyalgia and telerehabilitation were systematically searched in the PubMed, PEDro, Cochrane Library, ScienceDirect, Ovid MEDLINE, Embase, and Web of Science databases from inception to November 13, 2022. Two independent researchers screened the literatures and evaluated the methodological quality using the Cochrane Risk of Bias Tool. The outcome measures included the Fibromyalgia Impact Questionnaire scale, pain intensity, depression, pain catastrophizing, quality of life (QoL), and adverse events. Pooled effect sizes were calculated by Stata SE 15.1; a fixed effects model was used when I2<50%, whereas a random effects model was used when I2≥50%. A total of 14 RCTs with 1242 participants were included in this meta-analysis. The pooled results indicated that the telerehabilitation improved the Fibromyalgia Impact Questionnaire score (weighted mean difference -8.32, 95% CI -11.72 to -4.91; P<.001), pain intensity (standardized mean difference [SMD] -0.62, 95% CI -0.76 to -0.47; P<.001), depression levels (SMD -0.42, 95% CI -0.62 to -0.22; P<.001), pain catastrophizing (weighted mean difference -5.81, 95% CI -9.40 to -2.23; P=.001), and QoL (SMD 0.32, 95% CI 0.18 to 0.47; P<.001) in patients with fibromyalgia compared to control interventions. Only 1 RCT reported a mild adverse event of telerehabilitation; the other 13 RCTs did not mention this. Telerehabilitation can improve the symptoms and QoL of fibromyalgia. However, the safety of telerehabilitation remains uncertain due to the lack of sufficient evidence for the management of fibromyalgia. More rigorously designed trials are needed in the future to verify the safety and efficacy of telerehabilitation in fibromyalgia. PROSPERO CRD42022338200; https://tinyurl.com/322keukv.

Feasibility and efficacy of telerehabilitation in the management of patients with head and neck cancer during and after oncological treatment: A systematic review.

The aim in this review was to evaluate recent advances in telerehabilitation for the management of patients with head and neck cancer (HNC) during and after their oncological treatment. A systematic review was carried out in three databases (Medline, Web of Science and Scopus) in July 2022. The methodological quality of randomised clinical trials and quasi-experimental ones was assessed using the Cochrane tool (RoB 2.0) and the Critical Appraisal Checklists of the Joanna Briggs Institute, respectively. 14 out of 819 studies met the inclusion criteria: 6 studies were randomised clinical trials, 1 was a single-arm study with historical controls and 7 were feasibility studies. Most studies reported high participant satisfaction and efficacy of telerehabilitation used, in addition, no adverse effects were reported. None of the randomised clinical trials achieved a low overall risk of bias, whereas the methodological risk of bias of the quasi-experimental studies was low. This systematic review demonstrates that telerehabilitation offers feasible and effective interventions for the patients with HNC follow-up, during and after their oncological treatment. It was observed that telerehabilitation interventions should be personalised according to the patient's characteristics and the stage of the disease. Further research on telerehabilitation to support caregivers as well as to carry out studies with a long-term follow-up of these patients are imperative.

Efficacy of tele-rehabilitation in patients with chronic obstructive pulmonary disease: a systematic review

The COVID-19 pandemic has required the use of new technologies to carry out rehabilitation sessions for COP D remotely. The aim of this systematic review was to analyse the available evidence on the efficacy of telerehabilitation in COPD patients. PubMed, WOS, PEDro and Cochrane databases were consulted. The systematic review included nine clinical trials, 55.5% of which display good methodological quality. The most commonly used rehabilitation methods were applications or software for real-time video-calls, visualisation of exercises and recording progress. TR was as effective as outpatient pulmonary rehabilitation, with greater benefits in functional capacity, self-efficacy, mental health, exacerbations and emergency care visits, offering a cost-effective option with high patient satisfaction. The small number of studies and the variety of rehabilitation methods examined limit the value of the evidence obtained.

Feasibility, Safety, and Effectiveness of Telerehabilitation in Mild-to-Moderate Parkinson's Disease.

IntroductionParkinson's disease (PD) patients frequently engage in rehabilitation to ameliorate symptoms. During the Coronavirus disease 2019 (COVID-19) pandemic, access to rehabilitation programs has been markedly limited, consequently, telerehabilitation gained popularity. In this prospective, open-label, and pilot study, we aimed to investigate feasibility, safety, and efficacy of telerehabilitation in mild-to-moderate PD patients.Materials and MethodsTwenty-three PD patients, with Hoehn and Yahr stage <3, without gait disturbances or dementia and capable of using the televisit platform, were recruited for a 5-week telerehabilitation program, consisting of 1 remote visit with a therapist and a minimum of two sessions of >30-min of self-conducted exercises per week. Patients received video tutorials of exercises and were asked to keep a diary of sessions. At baseline (T0), at the end of the intervention (T1), and 1 month after the end of treatment (T2), patients were remotely assessed with MDS-UPDRS part I-III, PDQ-39, Functional Independence Measure (FIM), and Frontal Assessment Battery scales, respectively. Acceptable compliance to the program was defined as >60% matching of frequency and duration of sessions, whereas optimal compliance was set at >80% matching.ResultsThe dropout rate was 0%. Over 85% of patients reached acceptable adherence cut-off and around 70% reached optimal one. No adverse events were reported during sessions. The repeated measure analysis of variance (rANOVA) showed a significant effect of factor “time” for MDS-UPDRS-III (p < 0.0001) with a mean reduction of 4.217 points between T0 and T1 and return to baseline at T2. No significant effect was found for other outcome measures.ConclusionOur findings demonstrate that telerehabilitation is safe, feasible, and effective on motor symptoms in mild-to-moderate PD patients.

Safety, Acceptability, and Proof of Concept Efficacy of Telerehabilitation on Sleepiness and Quality of Life in Veterans with End-Stage Pulmonary Disease (RP519)

Safety, Acceptability, and Proof of Concept Efficacy of Telerehabilitation on Sleepiness and Quality of Life in Veterans with End-Stage Pulmonary Disease (RP519)

The Efficacy of Telerehabilitation in Older Adults after a Hip Injury: A Narrative Review

Background: As the global population ages, the prevalence of hip fractures in older adults is increasing. At the same time, the use of telemedicine and telerehabilitation is also increasing due to the development of new computer technologies and more advanced telemedicine devices. Therefore, older adults can benefit from telerehabilitation interventions after a fall and injury to their hip. Aim: The aim of this review is to study the available literature and describe research data on the feasibility and efficacy of telerehabilitation in geriatric patients after a hip injury. Method: The PubMed and Google Scholar were searched in English with the following keywords: telerehabilitation AND hip fracture OR bone fracture AND old adults OR elderly. The search was performed on studies published in the last six years. Results: A total of six studies were included in the review for further analysis. All studies involved hip fractures in older adult patients (n = 181). In three studies the telerehabilitation method was by telephone, while in the other three a computer was used. Furthermore, two of the studies did not involve a control group. All studies have concluded that telerehabilitation is not only feasible and applicable in older adults, but its effects in many cases are like those of regular rehabilitation. Discussion-Conclusions: Even though telerehabilitation is quite common these days, few studies seem to examine the effect of telerehabilitation on geriatric patients after a hip injury. For this reason, its exact effects have not yet been fully clarified. However, in situations of health crisis where standard physiotherapy is impossible, telerehabilitation is offered as an option without any negative impact on patients and with equally satisfactory results as regular rehabilitation. The subject requires further investigation.

The Effectiveness and Efficacy of Telerehabilitation in Persons with SCI during COVID-19

To evaluate the feasibility, effectiveness and participant satisfaction of low-cost telerehabilitation for a research study aimed to improve upper extremity (UE) strength and motor control in a person with spinal cord injury (SCI) during the COVID-19 pandemic. Prospective single-subject design. SCI rehabilitation hospital and research center for 14 weeks and home-telerehabilitation for 6 weeks. A 63-year-old male with chronic C4 ASIA Impairment Scale C tetraplegia. Therapy sessions (45 minutes, 3 times/week) of UE strengthening and functional task exercises occurred for 14 weeks in an outpatient setting and then transitioned to home because of the COVID-19 pandemic. For telerehabilitation, a videoconferencing application allowed for real-time audio and visual communication during treatment sessions. A caregiver was available to assist with exercises/equipment set-up as needed. Widely available therapy equipment (e.g., resistance bands, cuff weights) was provided to the participant. Telehealth Usability Questionnaire (TUQ), consisting of 17 questions addressing usefulness, ease of use, effectiveness, reliability, and satisfaction of telerehabilitation. Participants rank these categories between 1: disagree, and 7: agree. The participant responded with a rank of 7 (agree) to all questions except for two which were ranked 6. These highly ranked scores indicated the high level of the subject’s satisfaction about telerehabilitation for a research study. The excellent results generated suggests that a closely monitored telerehabilitation program might lead to similar outcomes and improvements resulting from an in-clinic rehabilitation program, as ranked by the participant. This case was successful in part because of the availability of a caregiver to assist and the participant’s familiarity with exercises, which might be a limitation for others. Additional participants and objective measures are underway to confirm this finding.

Efficacy of Tele-Rehabilitation for the Management of Physical Impairments of the Children with Cerebral Palsy in the Inclusive Educational Settings:A Protocol for a Systematic Review

Introduction: Cerebral palsy (CP) elucidates a group of permanent disorders of movement and posture disorders caused by non-progressive damage to developing brain with a prevalence rate of about 2-2.5 per 1000 live births in the world. Despite the effectiveness of tele-rehabilitation in various physical ailments, there is a paucity of the literature of tele-rehabilitation for CP in inclusive educational settings. Therefore, the aim of the present review is to identify the efficacy of tele-rehabilitation in limiting down and managing these physical impairments of CP children in educational settings. Method and Analysis: This protocol for a systematic review is based on principles of the preferred reporting items for systematic reviews & meta-analysis protocols (PRISMA-P). Published literature in the English language on the efficacy of tele-rehabilitation in improving physical impairment among CP children between ages 3-18 years will be included in the review. The electronic databases such as PubMed, Scopus, Pedro, EMBASE, and MEDLINE (Ovid) will be used for literature search between 2000 to 2018 years. The Rev Man 5.3 software will be used to extract the data. Down and Black critical appraisal checklist will be employed to evaluate the risk of bias. The guidelines for grading of Recommendations, Assessment, Development, and Evaluation (GRADE) will be used to assess the quality of research evidence. Ethics & dissemination: This review does not inculpate the collection of primary data, so no ethical approval is required for the study. Findings of the review will be disseminated through peer-reviewed publication and conference presentation. Criteria for the review were set a priori and the present protocol got registration from PROSPERO (International Prospective Register of Ongoing Systematic Review) with ID: 42019130555.

Telerehabilitation and Virtual Gaming in a School-Based Setting for At-Risk Youth

Abstract Date Presented 3/30/2017 This case study explored the efficacy of telerehabilitation in a private school–based setting for two at-risk youths. Both children improved overall performance within their environments. Timocco software was a successful method of telerehabilitation in the at-risk school environment. Primary Author and Speaker: Varleisha Gibbs Additional Authors and Speakers: Sara Benham Contributing Authors: Jennifer Abraham, Julie Mathew

Efficacy of Telerehabilitation in Patients with Stroke in Turkey: A Pilot Study

Efficacy of Telerehabilitation in Patients with Stroke in Turkey: A Pilot Study

Telerehabilitation for persons with multiple sclerosis.

Telerehabilitation, an emerging method, extends rehabilitative care beyond the hospital, and facilitates multifaceted, often psychotherapeutic approaches to modern management of patients using telecommunication technology at home or in the community. Although a wide range of telerehabilitation interventions are trialed in persons with multiple sclerosis (pwMS), evidence for their effectiveness is unclear. To investigate the effectiveness and safety of telerehabilitation intervention in pwMS for improved patient outcomes. Specifically, this review addresses the following questions: does telerehabilitation achieve better outcomes compared with traditional face-to-face intervention; and what types of telerehabilitation interventions are effective, in which setting and influence which specific outcomes (impairment, activity limitation and participation)? We performed a literature search using the Cochrane Multiple Sclerosis and Rare Diseases of the Central Nervous System Review Group Specialised Register( 9 July, 2014.) We handsearched the relevant journals and screened the reference lists of identified studies, and contacted authors for additional data. Randomised controlled trials (RCTs) and controlled clinical trials (CCTs) that reported telerehabilitation intervention/s in pwMS and compared them with some form of control intervention (such as lower level or different types of intervention, minimal intervention, waiting-list controls or no treatment (or usual care); interventions given in different settings) in adults with MS. Two review authors independently selected studies and extracted data. Three review authors assessed the methodological quality of studies using the GRADEpro software (GRADEpro 2008) for best-evidence synthesis. A meta-analysis was not possible due to marked methodological, clinical and statistical heterogeneity between included trials and between measurement tools used. Hence, we performed a best-evidence synthesis using a qualitative analysis. Nine RCTs, one with two reports, (N = 531 participants, 469 included in analyses) investigated a variety of telerehabilitation interventions in adults with MS. The mean age of participants varied from 41 to 52 years (mean 46.5 years) and mean years since diagnosis from 7.7 to 19.0 years (mean 12.3 years). The majority of the participants were women (proportion ranging from 56% to 87%, mean 74%) and with a relapsing-remitting course of MS. These interventions were complex, with more than one rehabilitation component and included physical activity, educational, behavioural and symptom management programmes.All studies scored 'low' on the methodological quality assessment. Overall, the review found 'low-level' evidence for telerehabilitation interventions in reducing short-term disability and symptoms such as fatigue. There was also 'low-level' evidence supporting telerehabilitation in the longer term for improved functional activities, impairments (such as fatigue, pain, insomnia); and participation measured by quality of life and psychological outcomes. There were limited data on process evaluation (participants'/therapists' satisfaction) and no data available for cost effectiveness. There were no adverse events reported as a result of telerehabilitation interventions. There is currently limited evidence on the efficacy of telerehabilitation in improving functional activities, fatigue and quality of life in adults with MS. A range of telerehabilitation interventions might be an alternative method of delivering services in MS populations. There is insufficient evidence to support on what types of telerehabilitation interventions are effective, and in which setting. More robust trials are needed to build evidence for the clinical and cost effectiveness of these interventions.

Editors' Note: Volume Overview

This issue of the International Journal of Telerehabilitation (IJT) contains original research evaluating the efficacy of telerehabilitation; a randomized study measuring costs and outcomes of tele-intervention when serving families of children who are deaf/hard-of-hearing; and a telephone-based physiotherapy intervention for patients with osteoarthritis of the knee. A feasibility study on the use of e-supervision to support speech-language pathologist graduate students during student teaching practica outlines benefits, limitations, and implications for future practice. In addition to innovative research, this issue includes announcements from the American Telemedicine Association and the Mid-Atlantic Telehealth Resource Center.

Editors' note: volume overview.

The current issue of the International Journal of Telerehabilitation (IJT) contains original research evaluating the efficacy of telerehabilitation; an evaluation of a telerehabilitation system for community based research; and work that examines users’ perceptions of the privacy and security of the three top used consumer-based, free Voice and video over the Internet Protocol (VoIP) software systems (e.g., Skype and others) used by health care providers to deliver therapeutic services via telerehabilitation. Two Brief Communications authored by speech-language pathologists present the possibilities for significant telehealth related cost-savings when telepractice is implemented in clinical practice. Finally, this issue presents a report generated by a working group within the American Telemedicine Association’s Telerehabilitation Special Interest Group, and announcements from the American Telemedicine Association and the International Society for Augmentative and Alternative Communication (ISAAC).