A home‐based tele‐rehabilitation protocol for patients with hip fracture called @ctivehip

Abstract

Home‐based tele‐rehabilitation programs are under development and may be a future option for some patients. The objectives of this non‐randomized clinical trial are to design a home‐based multidisciplinary tele‐rehabilitation protocol for patients with hip fracture, and to compare this protocol versus the home‐based usual outpatient rehabilitation protocol. Seventy patients treated for an acute hip fracture, aged 65 years or older, with a high pre‐fracture functional level (Functional Independence Measure score >90), without severe cognitive impairment, absence of terminal disease, discharged to their own home or a relativés home postoperatively, allowed weight‐bearing, and with signed informed consent, will be allocated into a tele‐rehabilitation group (n = 35) or a control group (n = 35). The inclusion criterion for the intervention group will be to have a caregiver with the ability to access the Internet who is willing to perform exercises and activities with the patient at home. The intervention includes a program of physical exercise and occupational therapy (five weekly sessions during 12 weeks), and recommendations for patients and their caregivers, all delivered through a website. The patient's functional level (Functional Independence Measure), quality of life (Euro‐Qol), physical performance (Timed Up and Go), caregiver burden (Zarit Interview), and other descriptive data will be assessed at hospital discharge, 4 weeks, and 12 weeks. This project will add to the knowledge concerning the feasibility of tele‐rehabilitation as an option to promote recovery of the pre‐fracture functional level for some patients with a hip fracture. http://ClinicalTrials.gov Identifier: NCT02968589NCT.

COVID-19 y fractura por fragilidad de la cadera. Recomendaciones conjuntas de la Sociedad Española de Fracturas Osteoporóticas y la Sociedad Española de Geriatría y Gerontología

“…Aunque los resultados de programas de telerrehabilitación han demostrado su eficacia en algún tipo específico de procedimiento 52 , lo cierto es que hoy en día la implementación de estos sistemas es todavía muy baja. No obstante, existen actualmente en España iniciativas evaluadas de programas de telerrehabilitación tras FxFrgCad que han demostrado ser una buena opción para promover la recuperación funcional hasta el nivel pre-fractura para algunos pacientes con este tipo de patología 53 . Por ello consideramos que, si se dispone de esta posibilidad, este tipo de programas pudieran resultar una opción muy interesante para la recuperación funcional de los pacientes con FxFrgCad en el momento actual.…”

Addressing COVID-19 Challenges in a Randomized Controlled Trial on Exercise Interventions in a High-Risk Population

“…27 Guidance and practical tips are published, as well as technical and feasibility issues, ethical and data safety issues, practical issues, clinical trials, and trial protocols. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][30][31][32][33][34][35] Collectively, telemedicine encompasses various conditions, populations, and applications and seems to be similar to in-person care. 14,[17][18][19]21,22,30 Participants and caregivers feel comfortable and are satis ed in the short term, even if they have no experience in virtual participation.…”

“…Many have, therefore, implemented telemedicine exercise or rehabilitation programs, developed guidance, or are currently testing telemedicine in clinical trials. 5,6,11,16,17,19,21,22,[33][34][35] A strength of our list is the implementation of wide sources from the literature to the perspectives of interprofessional and international experts experienced in clinical research in the application of different forms of exercise programs, telemedicine, care of chronically ill elderly individuals with physical and partly mental restrictions, and mind-body medicine. This provides a practical list on how to proceed with telemedicine exercise interventions and points out critical issues and challenges.…”

Current Telerehabilitation Approaches in Orthopaedic Physiotherapy

“…Web tabanlı egzersiz reçeteleme, hasta eğitim, iletişim, egzersiz takip platformları son yıllarda sıklıkla karşımıza çıkmaktadır. [21][22][23][24] Bu platformlar, kullanım açısından birbirinden farklılık gösterse de genel amaçlar açısından benzerlik göstermektedir. Yakın zamanda hem web hem de mobil platformlar için geliştirilen uygulamada, hastaların egzersiz protokollerinin oluşturulması ve yönetimi için hem manuel hem de otomatize bir protokol ayarlama modülü geliştirilmiştir.…”

“…Bu çalışmada, web tabanlı platform ile multidisipliner bir telerehabilitasyon protokolü tasarlamak ve bu protokol ile evde yapılan konvansiyonel ayaktan rehabilitasyon protokolünü karşılaştırmak amaçlanmış olup, geliştirme çalışmalarının devam etmekte olduğunu bildirmişlerdir. 23 27 Benzer dizaynla tasarlanmış web tabanlı eğitim platformlarının etkinliğinin araştırıldığı çalışmada, kronik diz ağrısı tedavisinde benzer sonuçlara ulaşılmıştır. 28 Telerehabilitasyon uygulamalarının, konvansiyonel uygulamalara kıyasla üstünlüğünü açıklayabilecek nitelikte sonuç elde edilen bir çalışmada, osteoartrit hastaları için uzun süre egzersize devam etmenin, motivasyonel ve diğer davranışsal faktörler de dâhil olmak üzere, kullanıcıların ihtiyaçlarına göre uyarlanmış bir teknolojinin kullanılmasıyla mümkün olduğu sonucuna varılmıştır.…”