Telerehabilitation For Patients Research Articles

Effects of pelvic floor muscle training applied with telerehabilitation in patients with multiple sclerosis having lower urinary track symptoms: A randomized controlled trial

In this study, the researchers aimed to investigate the effects of pelvic floor muscle training (PFMT) applied with telerehabilitation on urinary symptoms, quality of life, and subjective perception of improvement and satisfaction in multiple sclerosis (MS) patients having lower urinary tract symptoms. Patients were randomly divided into PFMT (n:21) and control (n:21) groups. The PFMT group received PFMT via telerehabilitation for 8 weeks and lifestyle advice, while the control group received only lifestyle advice. Although lifestyle advice alone was not effective, PFMT applied with telerehabilitation was an effective method in the management of lower urinary tract symptoms in MS patients. PFMT applied with telerehabilitation can be considered as an alternative method.

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

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.

Comparison of Functional Outcomes between Supervised Rehabilitation and Telerehabilitation in Female Patients with Patellofemoral Pain Syndrome during the COVID-19 Pandemic.

Patellofemoral pain syndrome (PFPS) is a common cause of anterior knee pain, and therapeutic exercises are recommended. During the COVID-19 pandemic, despite recommendations on the importance of telerehabilitation, insufficient studies have investigated functional outcomes between supervised rehabilitation and telerehabilitation in patients with PFPS. This study aimed to compare the muscle strength, muscle activation time, and patient-reported outcomes between supervised rehabilitation and telerehabilitation in female patients with PFPS. A total of 61 patients (supervised, n = 30; telerehabilitation, n = 31) participated. Muscle strength and activation time of the quadriceps and hamstrings were measured using an isokinetic device. Hip muscle strength was evaluated using a hand-held dynamometer. Patient-reported outcomes were measured using the visual analog scale (VAS) for pain, Kujala Anterior Knee Pain Scale (AKPS) for functional ability, and Tampa scale for kinesiophobia (TSK-11). No significant differences were found in muscle strength, muscle activation time, or patient-reported outcomes of the involved knees between the two groups (p > 0.05). In addition, the rate of change in all parameters did not significantly differ between the two groups (p > 0.05). Telerehabilitation, such as a home-exercise program supervised by physical therapists, may be as effective as supervised rehabilitation in improving functional outcomes in female patients with PFPS.

Telerehabilitation for patients who have been hospitalised with covid-19: a qualitative study

Purpose The aim of this qualitative study was to explore the views of participants of a group-based, supervised, telerehabilitation programme, following discharge from hospital with Covid-19. This study was part of a single-centre, fast-track (wait-list), randomised, mixed-methods, feasibility trial of telerehabilitation (Registration: Clinicaltrials.gov reference:285205). Methods Semi-structured interviews were conducted over a virtual teleconference platform with 10 participants who took part in a telerehabilitation programme following Covid-19 after discharge from an acute hospital. Data were transcribed verbatim and analysed using thematic analysis. Results Five themes were important from the participant perspective: telerehabilitation programme as part of the Covid-19 journey; the telerehabilitation programme design and delivery; peer aspects; the role of the instructor; and the role of technology and online delivery. Conclusions Overall, the telerehabilitation programme was a positive experience for participants. The instructors were central to this positive view as was the group nature of the programme. The group aspect was particularly important in supporting the broader perceived wellbeing gains, such as the sense of enjoyment and reduced social isolation. Several participants would have liked to have continued with the exercises beyond the six-week intervention indicating that the programme could be a way to help people sustain a physically active lifestyle. IMPLICATIONS FOR REHABILITATION Participants who were recovering from Covid-19 following hospital admission perceived the telerehabilitation to be a positive experience overall. The group aspect of the telerehabilitation programme was important in supporting the broader perceived wellbeing gains such as the sense of enjoyment and reduced social isolation. Telerehabilitation programmes for Covid-19 may need to include pathways for participants to continue to engage in exercise beyond the time-limited six-week intervention to support ongoing self-management.

Considerations for ensuring safety during telerehabilitation of people with stroke. A protocol for a scoping review.

Exercise interventions have a positive impact on people with stroke. However, access to exercise interventions is variable, and there may be a delay in the start of rehabilitation. Telerehabilitation has enabled the delivery of exercise interventions replacing the traditional face-to-face approach. Aspects related to the safety of people with stroke should be considered to avoid adverse events during the delivery of exercise interventions remotely. However, such information is scattered in the literature, and the detail with which measures taken during the implementation of exercise interventions for people with stroke are reported is unknown. To summarise measures or aspects targeted at reducing the incidence of adverse events during the delivery of exercise interventions through telerehabilitation in patients after stroke. A scoping review will be conducted. A systematic search in MEDLINE-Ovid, Embase-Ovid CENTRAL, CINAHL Complete (EBSCOhost), and other resources will be carried out. We will include primary studies, published in full text in any language, involving people with stroke who undergo telerehabilitation where exercise is the main component. Two reviewers will independently select studies and extract data, and disagreements will be resolved by consensus or a third reviewer. The results will be reported in a narrative form, using tables and figures to support them. To implement this strategy within rehabilitation services, one of the first aspects to be solved is to ensure the safety of people. The results of this scoping review could contribute an information base for clinicians and decision-makers when designing remotely delivered exercise intervention programs. INPLASY202290104.

Therapeutic Exercise Interventions through Telerehabilitation in Patients with Post COVID-19 Symptoms: A Systematic Review.

The worldwide incidence of COVID-19 has generated a pandemic of sequelae. These sequelae require multidisciplinary rehabilitative work to address the multisystemic symptoms that patients will present with now and in the future. The aim of the present systematic review is to analyze the current situation of telerehabilitation in patients with COVID-19 sequelae and its effectiveness. Searches were conducted on the following databases: PubMed, Scopus, PEDro, and Web of Science (WOS). There was no complete homogeneity among the five selected articles, so we differentiated two clinical subgroups for the clustering of outcome measures: (group one) patients with post-discharge symptoms and (group two) patients with permanent symptoms or "long COVID-19" defined as persistent symptoms > 2 months. For group one, post-discharge sequelae, improvements were obtained in cardiovascular parameters, and physical test studies in group two presented very favorable results in all the cardiorespiratory measures and physical tests evaluated. Telerehabilitation through therapeutic exercise based on mixed protocols of aerobic, respiratory, and low-load strength exercises appear to be an effective and safe strategy for the recovery of short- and long-term post-COVID-19 sequelae.

The energy crisis in Europe 2022: new challenges ahead for rehabilitation

International Journal of Therapy and RehabilitationVol. 29, No. 10 EditorialThe energy crisis in Europe 2022: new challenges ahead for rehabilitationMassimiliano PolastriMassimiliano PolastriCorrespondence to: Massimiliano Polastri; E-mail Address: [email protected]Department of Continuity of Care and Integration, Physical Medicine and Rehabilitation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalySearch for more papers by this authorMassimiliano PolastriPublished Online:31 Oct 2022https://doi.org/10.12968/ijtr.2022.0134AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Chamber. The UK's first hospital to be completely powered by solar energy. 2022. https://tinyurl.com/5n962ws7 (accessed 4 October 2022) Google ScholarEuronews. UK consumers face 80% rise in energy bills from October as regulator raises price cap. 2022. https://tinyurl.com/3srpxu7x (accessed 4 October 2022) Google ScholarEuropean Central Bank. Natural gas dependence and risks to Euro area activity. 2022. https://tinyurl.com/5n7pmr75 (accessed 4 October 2022) Google ScholarEuropean Commission. New solar energy system at Potenza's San Carlo hospital. 2017. https://tinyurl.com/jmwxd9tw (accessed 4 October 2022) Google ScholarEurostat. Natural gas price statistics. 2022a. https://tinyurl.com/2f849ja4 (accessed 4 October 2022) Google ScholarEurostat. Electricity price statistics. 2022b. https://tinyurl.com/2md5ksv5 (accessed 4 October 2022) Google ScholarNHS England. Solar power sparks an electrical future for Milton Keynes University Hospital. 2021. https://tinyurl.com/mr32mead (accessed 4 October 2022) Google ScholarÖnal G, Güney G, Gün F, Huri M. Telehealth in paediatric occupational therapy: a scoping review. Int J Ther Rehabil. 2021;28(7):1–16. https://doi.org/10.12968/ijtr.2020.0070 Link, Google ScholarPanda S, Bali S, Kirubakaran B, Hagenberg A. Telerehabilitation and total knee arthroplasty: a systematic review and meta-analysis of randomised controlled trials. Int J Ther Rehabil. 2015;22(Suppl 8):S6. https://doi.org/10.12968/ijtr.2015.22.Sup8.S6 Link, Google ScholarPolastri M. Telerehabilitation in patients with COVID-19. Int J Ther Rehabil. 2022;29(5):1–3. https://doi.org/10.12968/ijtr.2022.0065 Google ScholarSkalamera M. The Ukraine crisis: the neglected gas factor. Orbis. 2015;59(3):398–410. https://doi.org/10.1016/j.orbis.2015.05.002 Crossref, Google ScholarTrading Economics. EU natural gas. 2022. https://tinyurl.com/584rj6j (accessed 4 October 2022) Google ScholarWorld Health Organization. Joint statement: working together towards COVID-19 and seasonal influenza vaccinations for this winter. https://tinyurl.com/4ezajy6u (accessed 24 October 2022) Google Scholar FiguresReferencesRelatedDetailsCited byThe ongoing energy crisis and the provision of electrophysical therapiesMassimiliano Polastri, Maurizio Borsari, Luca Macrelli25 January 2023 | International Journal of Therapy and Rehabilitation, Vol. 30, No. 1 2 October 2022Volume 29Issue 10ISSN (online): 1759-779X Metrics History Published online 31 October 2022 Published in print 2 October 2022 Information© MA Healthcare LimitedPDF download

Effectiveness and feasibility of telerehabilitation in patients with COVID-19: a systematic review and meta-analysis

ObjectivesTo determine the pooled effectiveness and feasibility of telerehabilitation in patients with COVID-19.DesignSystematic review and meta-analysis of randomised controlled trials (RCTs).Data sourcesPubMed, CINAHL, Science Direct, PEDro, Google Scholar and Cochrane...

Telemedicine as a socio-medical process. Experiences from remote monitoring of long-COVID patients in Poland

Aim. Long-COVID syndrome is still under broad investigation. It is known, however, that the consequences of COVID-19 disease can permanently affect the health and quality of life of patients in many respects. For this reason, monitoring parameters in patients who are still experiencing symptoms is an extremely serious task for medicine. It is possible with the use of telehealth paradigm, which helps to provide long-term care. The use of wearable medical devices that record certain vital parameters (e.g., Aidmed) can ensure that the patient is under constant surveillance after an infection. For this reason, the development and introduction of nationwide telemonitoring and telerehabilitation programs for the long-COVID patients seems to be a key solution.
 Methods. The main goal of this analysis, which involved 373 patients, is to present practical experiences and discuss the strengths and weaknesses of the use of remote diagnostic tools in patients with long-COVID syndrome. The analysis based on a multicentre study in Poland focuses on the technological and social aspects of Aidmed telehealth system. The results were obtained on the basis of the deliberative reflection method, conducted by a multidisciplinary team: 2 medical sociologists, 1 epidemiologist, 2 biomedical students (secretary roles in the projects), 2 computer scientists and 2 medical doctors. 
 Results. The analysis showed that the use of telemedicine tools is quicker and allows to obtain more accurate diagnostic data (strengths). It is also inclusive and educational in relation to the excluded groups of patients (opportunities). However, it may lead to limitation of contacts between the doctor and the patient (threats) and limited access due to high costs and time investments (weaknesses).
 Conclusions. Remote home monitoring and telerehabilitation of patients with long-COVID syndrome has the potential to reduce the burden of disease and prevent overloading of the healthcare system. Therefore, it should be widely used. However, we need to learn how to implement it correctly. Our recommendations are: 1) technology should be inclusive in both e-literacy and health literacy; 2) solutions must be as simple as possible for an end user; 3) the entire process requires efficient logistics facilities.

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.

Deploying Serious Games for Cognitive Rehabilitation

The telerehabilitation of patients with neurological lesions has recently assumed significant importance due to the COVID-19 pandemic, which has reduced the possibility of access to healthcare facilities by patients. Therefore, the possibility of exercise for these patients safely in their own homes has emerged as an essential need. Our efforts aim to provide an easy-to-implement and open-source methodology that provides doctors with a set of simple, low-cost tools to create and manage patient-adapted virtual reality telerehabilitation batteries of exercises. This is particularly important because many studies show that immediate action and appropriate, specific rehabilitation can guarantee satisfactory results. Appropriate therapy is based on crucial factors, such as the frequency, intensity, and specificity of the exercises. Our work’s most evident result is the definition of a methodology that allows the development of rehabilitation exercises with a limited effect in both economic and implementation terms, using software tools accessible to all.

Telerehabilitation for Patients with Cancer: A Scoping Review.

This study was aimed at identifying how telemedicine is used for rehabilitation of patients with cancer. An electronic literature search was conducted using the PubMed database covering January 2015 to October 2020. To be included in the review, studies had to report telerehabilitation interventions for patients with cancer. Randomized controlled trials, quasi-experimental studies, as well as feasibility and usability studies were included, and reviews were excluded. Overall, 33 eligible studies were found but only 22 were considered for inclusion. After a detailed analysis, 16 studies were included. Most of the studies concluded that telehealth systems supporting physical exercise were effective to improve function, quality of life, pain, satisfaction and muscle strength. Limitations in most of the studies included non-randomized design and limited number of subjects. We conluded that more studies are needed for stronger evidence of this type of treatment and to facilitate clinical practice in this field.

Efficacy and Safety of Hybrid Cardiac Telerehabilitation in Patients with Hypertrophic Cardiomyopathy without Left Ventricular Outflow Tract Obstruction and Preserved Ejection Fraction—A Study Design

Hypertrophic cardiomyopathy (HCM) is the most common congenital disease increasing the risk of sudden cardiac death. For many years, HCM patients were excluded from exercise training. However, there are data showing that patients with HCM undergoing supervised exercise training could improve physical performance without serious adverse events. A project was designed as a randomized clinical trial to assess the effectiveness and safety of hybrid cardiac rehabilitation (HCR)—a combination of hospital-based cardiac rehabilitation (1 month) with a new form of home-based telemonitored cardiac rehabilitation (2 months) in HCM patients without left ventricular (LV) outflow tract obstruction and preserved systolic function. Sixty patients who fulfil the inclusion criteria have been randomly assigned (1:1) to either HCR plus usual care (training group) or usual care only (control group). The primary endpoint is a functional capacity evaluated by peak oxygen uptake (pVO2). Secondary endpoints include workload time during the cardiopulmonary exercise testing, a six-minute walk test distance, NT-pro BNP level, echocardiographic parameters of the left ventricular diastolic function (E/A, E/e’, myocardial strain rate), right ventricular systolic pressure, a gradient in the LV outflow tract, and quality of life. The tertiary analysis includes safety, acceptance and adherence to the HCR program. Our research will provide innovative data on the effectiveness and safety of hybrid cardiac rehabilitation in HCM patients without LV outflow tract obstruction and preserved systolic function. Clinical trials registry: ClinicalTrials.gov Identifier NCT03178357.

The effectiveness of telerehabilitation in patients after total knee replacement: A systematic review and meta-analysis of randomized controlled trials

Background Total knee replacement is a commonly adopted surgical intervention to reduce physical limitations and pain in advanced-stage knee osteoarthritis. However, these patients may experience physical dysfunction to limit their access during conventional rehabilitation after total knee replacement. The use of telemedicine may be the promising solution. This study aims to compare the effectiveness of telerehabilitation with conventional in-person rehabilitation in patients who underwent a total knee replacement. Methods For this systematic review on randomized controlled trials, PubMed, Medline, EMBASE, Cochrane Library, ScienceDirect and CINAHL databases were searched for eligible articles published between 1 January 2003 and 28 February 2022. The eligibility criteria were patients who underwent total knee replacement, randomized controlled trials and publications in English. The main outcome measures were focused on pain and physical function. Reference lists of relevant studies were also manually checked to find additional studies. Two independent reviewers conducted study selection separately. PEDro scale was used to assess the methodological quality of the included randomized controlled trials. A meta-analysis was performed on the collected data. Review Manager (RevMan, version 5.3) was used for all analyses. Results A total of 11 studies met the eligibility criteria and included 1825 participants in the systematic review. Overall, the results revealed that the effectiveness of telerehabilitation is comparable to conventional in-person rehabilitation in improving various pain and functional outcomes in patients who underwent a total knee replacement. In the meta-analysis with the fixed-effects model, no significant difference was found in the improvement of pain and physical function in patients with knee osteoarthritis compared with conventional rehabilitation (Standardized Mean Difference (SMD) –0.15, 95% CI −0.47 to 0.16, P = 0.34 and SMD –0.04, 95% CI −0.19 to 0.12, P = 0.62, respectively). In addition, the utilization of hospital resources and costs were significantly lower in telerehabilitation when compared with in-person rehabilitation. Conclusion Telerehabilitation was comparable to conventional in-person rehabilitation in improving clinical outcomes following total knee replacement. However, it might be a more preferable alternative rehabilitation intervention for patients following total knee replacement given the significantly lower cost of telerehabilitation.

Phase III impact of telerehabilitation in patients with coronary heart disease

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiac rehabilitation (CR) in coronary heart disease (CAD) has been shown to improve physical capability and health-related quality of life, reducing morbimortality. However, CR accessibility is still low and patient adherence remains poor. It has been hypothesized that using mobile applications to telemonitor exercise-based CR would increase patient adherence to CR, improving results. Hybrid cardiac telerehabilitation (HCTR) is a new concept that includes center and home interventions. Objectives Investigate the effects of HCTR program on improving physical activity, quality of life and reducing cardiovascular risk factors among patients with CAD 1 year after CR phase II. Materials and methods Longitudinal retrospective study with patients who attended phase 2 CR program (CRP) at a hospital center between august 2018-november 2020. They were divided in 2 groups: group 1 completed conventional CRP (CCRP), 12 weeks of monitored hospital physical exercise and educational sessions; group 2 participated on HCTR program (CCRP associated to a tele-monitorization platform consisting of a mobile application, MOVIDA.eros, with medical prescription of physical exercise and remote interaction). Group 2 maintained use of MOVIDA.eros on phase 3. Evaluations were performed on T0 – phase 2 onset, T1 – end of phase 2, T2 – 1 year after T1, with registration of age, gender, occupation, body mass index (BMI), exercise stress testing, echocardiogram (evaluation of left ventricular ejection fraction [LVEF]), LDL, HDL cholesterol, triglycerides, NTproBNP levels, and application of EuroQol-5D questionnaire (EQ5D), International Physical Activity Questionnaire – Short Form (IPAQ). Statistical analysis was completed through software SPSS v28. p-values <0.05 were considered statistically significant. Results We analyzed 68 patients, 46 on group 1 and 22 on group 2. Variable analysis revealed similar group characteristics, except for age (p=0.011) and LVEF (p=0.005). There was an association between HCTR adherence and occupation (p=0.002; greater proportion of intellectual professionals on group 2). We observed a significant IPAQ (p=0.018) and EQ-5D index (p=0.034) improvement between T0 to T1 in both groups, but only in group 2 persisted till T2. In exercise stress testing, both groups revealed an increase in METs at T1 and decrease at T2, without significant differences between them. Regarding lipid profile, HbA1c, NTproBNP and BMI, both groups improved from T0 to T1 maintaining it till T2 with no differences between them, however in group 2 HDL cholesterol levels were greater and HbA1c levels were lower than group 1. In both groups, LVEF increased from T0 to T1 and from T1 to T2 in both groups, with faster and higher improvement in group 2. Conclusions HCTR outperformed CCRP improving physical activity, patient quality of life, HDL cholesterol and faster improvement of LVEF. These findings encourage the use of a mobile platform in CR.

Telerehabilitation in patients with recent hospitalization due to acute decompensated heart failure: protocol for the Tele-ADHF randomised controlled trial

Abstract Funding Acknowledgements Type of funding sources: None. Background/introduction Cardiac rehabilitation (CR) has favourable effects in chronic heart failure (CHF) patients on exercise capacity, the risk at hospital (re-)admission and quality of life. Although CR is generally recommended, it is still under-utilized in the daily clinical practice partly due to logistics reasons, limited availability, and patient-related barriers. Cardiac telerehabilitation (CTR) could solve some of these barriers, and have the same favourable outcomes. Purpose The aim of this study is to investigate if CTR in recently hospitalized CHF patients improves their physical functional capacity when compared to no rehabilitation. Methods This randomised controlled trial compares CTR with no rehabilitation after hospitalization for acute decompensated heart failure (ADHF). 64 patients will be included during hospitalization, and start with Remote Patient Management (RPM). After a short period of stable CHF, the patients will be randomised for RPM combined with CTR (intervention group), or RPM alone (control group). The intervention group will start with an 18-weeks program with exercise training, supported by a (remote) technology-assisted dietary intervention and mental health guiding. The training program starts with three centre-based and two home-based video training sessions followed by video coaching sessions. The primary endpoint is physical functional capacity, evaluated using the Short Physical Performance Battery (SPPB) score. Secondary endpoints are recovery after submaximal exercise by evaluating VO2 recovery kinetics (τ-rec), subjective health status, health related quality of life, compliance and acceptance, and readmission rate. Future implications This will be the first study to use an CTR program with integrated RPM after hospitalization for ADHF.

Telerehabilitation in patients with COVID-19

International Journal of Therapy and RehabilitationVol. 29, No. 5 EditorialTelerehabilitation in patients with COVID-19Massimiliano PolastriMassimiliano PolastriCorrespondence to: Massimiliano Polastri; E-mail Address: [email protected]Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalySearch for more papers by this authorMassimiliano PolastriPublished Online:2 Jun 2022https://doi.org/10.12968/ijtr.2022.0065AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Buabbas AJ, Albahrouh SE, Alrowayeh HN, Alshawaf H. Telerehabilitation during the COVID-19 pandemic: patients' attitudes and satisfaction and physical therapists' experiences. Med Princ Pract. 2022 [online ahead of print]. https://doi.org/10.1159/000523775 Crossref, Google ScholarEuropean Center for Disease Prevention and Control. COVID-19 situation update worldwide, as of week 18, updated 12 May 2022. 2022. https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases (accessed 18 May 2022) Google ScholarGonçalves A-C, Leckie T, Hunter A, Fitzpatrick D, et al.. Technology supported rehabilitation for patients of critical illness caused by COVID-19: a protocol for a mixed-methods study. Int J Ther Rehabil. 2020;27(10):1–9. https://doi.org/10.12968/ijtr.2020.0102 Link, Google ScholarGore S, Keysor J. COVID-19 post-acute sequela rehabilitation: a look to the future through the lens of COPD and pulmonary rehabilitation. Arch Rehabil Res Clin Transl. 2022 [online ahead of print]. https://doi.org/10.1016/j.arrct.2022.100185 Google ScholarKepenek-Varol B, Zeren M, Dinçer R, Erkaya S. Breathing and relaxation exercises help improving fear of COVID-19, anxiety, and sleep quality: a randomized controlled trial. J Integr Complement Med. 2022 [online ahead of print]. https://doi.org/10.1089/jicm.2021.0381 Crossref, Google ScholarMinghelli B, Soares A, Guerreiro A, et al.. Physiotherapy services in the face of a pandemic. Rev Assoc Med Bras (1992). 2020;66(4):491–497. https://doi.org/10.1590/1806-9282.66.4.491 Crossref, Google ScholarMukaino M, Tatemoto T, Kumazawa N, et al.. Staying active in isolation: telerehabilitation for individuals with the severe acute respiratory syndrome coronavirus 2 infection. Am J Phys Med Rehabil. 2020;99(6):478–479. https://doi.org/10.1097/PHM.0000000000001441 Crossref, Google ScholarPaneroni M, Vitacca M, Bernocchi P, Bertacchini L, Scalvini S. Feasibility of tele-rehabilitation in survivors of COVID-19 pneumonia. Pulmonology. 2022;28(2):152–154. https://doi.org/10.1016/j.pulmoe.2021.03.009 Crossref, Google ScholarPehlivan E, Palali I, Gayretti Atan S et al.. The effectiveness of post-discharge telerehabilitation practices in COVID-19 patients: tele-COVID study randomized controlled trial. Ann Thorac Med. 2022;17(2):110–117. https://doi.org/10.4103/atm.atm_543_21 Crossref, Google ScholarPolastri M, Costi S. Observational studies of rehabilitation during the COVID-19 pandemic. Int J Ther Rehabil. 2021;28(5):1–3. https://doi.org/10.12968/ijtr.2021.0068 Link, Google ScholarPolastri M, Ciasca A, Nava S, Andreoli E. Two years of COVID-19: trends in rehabilitation. Pulmonology. 2022 [online ahead of print]. https://doi.org/10.1016/j.pulmoe.2022.01.012 Crossref, Google ScholarSoyama S, Mano T, Kido A. Oropharyngeal dysphagia telerehabilitation in the intensive care unit for COVID-19: a case report. Codas. 2022;34(6):e20210023. https://doi.org/10.1590/2317-1782/20212021023 Crossref, Google ScholarVieira AGDS, Pinto ACPN, Garcia BMSP et al.. Telerehabilitation improves physical function and reduces dyspnoea in people with COVID-19 and post-COVID-19 conditions: a systematic review. J Physiother. 2022;68(2):90–98. https://doi.org/10.1016/j.jphys.2022.03.011 Crossref, Google ScholarWinters JM. Telerehabilitation research: emerging opportunities. Annu Rev Biomed Eng. 2002;4:287–320. https://doi.org/10.1146/annurev.bioeng.4.112801.121923 Crossref, Google Scholar FiguresReferencesRelatedDetailsCited byThe energy crisis in Europe 2022: new challenges ahead for rehabilitationMassimiliano Polastri31 October 2022 | International Journal of Therapy and Rehabilitation, Vol. 29, No. 10 2 May 2022Volume 29Issue 5ISSN (online): 1759-779X Metrics History Published online 2 June 2022 Published in print 2 May 2022 Information© MA Healthcare LimitedPDF download

Pulmonary Tele-Rehabilitation in Patients (Post Covid-19) With Respiratory Complications: A Randomized Controlled Trial

Background: The coronavirus disease of 2019 (COVID-19) epidemic has resulted in a growing population of individuals recovering from SARS-CoV. Although the evidence is limited, observational data suggest that patients who suffer from COVID may experience symptoms long after recovery from acute illness, referred as “long COVID,” post-COVID syndrome or “post-COVID conditions”.The recovery from COVID-19 disease is very different but many features appear to be similar to recovery from other viral illnesses. Our study aims to investigate and validate the effectiveness of respiratory rehabilitative therapeutic program in patients with chronic COVID.Objective: To analyse the effects of a Pulmonary Tele-rehabilitation Program in Covid-19 Outpatients who received Pulmonary Rehab (Breathing and Therapeutic Exercises) compared to those who only received conventional care. Method: A Randomized Controlled Trial study has been undertaken.30 Post COVID Patients meeting inclusion criteria were randomly allocated into two groups. Experimental Group received therapeutic protocol and Controlled Group received conventional care. Duration for the study was 6 weeks. The Significant and relevant tests for this study are Modified Borg Dyspnoea Rating Scale and Fatigue Severity Scale. Result: The statistical analysis was carried out using‘t- test’ to determine the effectiveness of breathing and therapeutic exercises. Results showed that the patients in experimental group recovered more rapidly and demonstrated independence in their ADL without any further complications.Females were more fatigued than males, therefore benefitted more from the therapeutic program. Conclusion: This study demonstrated improvement in patients who received the therapeutic program. No telerehab patients required additional oxygen supplementation or any medical care. Telerehabilitation allowed a valuable service to patients with COVID-19 and helped them to rehabilitate themselves without having to leave their home.

Impact of tele rehabilitation on clinical outcomes in patients recovering from COVID-19: a preliminary investigation

Pulmonary rehabilitation has proven to be an effective therapeutic intervention for people with chronic respiratory disease. Considering the highly contagious nature of coronavirus disease (COVID-19), it becomes imperative to develop a method which can effectively improve clinical disease outcomes of these patients without any physical contact. The purpose of the study was to investigate the impact of tele rehabilitation on dyspnoea, endurance and quality-of-life in patients recovering from COVID 19. Thirty-two participants (age: 42.5±13.94, height: 165.8±10.06, weight: 68.5±9.63, body mass index: 25.0±3.61) who are recovering from COVID-19 were recruited as per the eligibility criteria. They were randomly allocated into two groups, Tele rehabilitation (n=16) and Control (n=16) by lottery method. All the selected participants were assessed at baseline for perceived dyspnoea, endurance and quality-of-life. Patients in the Tele rehabilitation group received 14 sessions of rehabilitation on alternate days online via google meet over a period of 28 days. Control group received usual care during the study period. Standard statistical tests were employed to test the study hypothesis. Results suggested a significant improvement in both dyspnoea (P=0.001) and endurance (P<0.001) in response to tele rehabilitation. Domains of quality-of-life such as physical role (P=0.02), vitality (P=0.04), emotional role (P=0.03), mental health (P=0.02) and physical components score (P=0.007) also showed significant improvement with tele rehabilitation in patients recovering from COVID-19. Findings of this preliminary study concludes that tele rehabilitation may be considered a treatment of choice in patients recovering from COVID-19 for improving outcomes of dyspnoea, endurance and quality-of-life.

Continuing Care through Telerehabilitation for Patients in a COVID-19 Referral Center in the Philippines: A Case Series

In April 2020, the Department of Rehabilitation Medicine (DRM) of the University of the Philippines - Philippine General Hospital (UP-PGH) transitioned to a telerehabilitation program called ITAWAG, an acronym for Introducing Telerehab As a Way to Access General rehabilitation medicine services. This was in response to the designation of UP-PGH as a COVID-19 referral center and the abrupt closure of all its in-patient and out-patient rehabilitation services. Eleven previous in-patients and out-patients with musculoskeletal and neurologic impairments continued their rehabilitation programs remotely, either through a phone call or video call. Their clinical outcomes and the implementation of the ITAWAG program were monitored to determine the effectiveness of an offsite continuing care program. Using the Clinical Global Impressions-Severity (CGI-S) scale, eight patients had a reduction in the severity of their illness, while the remaining three clients had no change. Feedback surveys showed that most clients and caregivers (68%) and health providers (77%) were satisfied with the program's implementation and its outcome. A frequent complaint was the poor phone reception and internet connection. As threats of a COVID-19 outbreak continue, telerehabilitation gives patients a safe, affordable, and convenient alternative for follow-up and continuity of care in medical rehabilitation. Integrating the ITAWAG program into the initial facility-based rehabilitation management can enhance its value in optimizing functional gains and resolving its shortcomings.