Accelerating Telemedicine for Cerebral Palsy During the COVID-19 Pandemic and Beyond

Abstract

The effects of COVID-19 extend beyond the pandemic and are expected to transform healthcare in various ways, many of which remain unknown. With social distancing, telemedicine may become the preferred communication channel between caregivers and patients. Implications for cerebral palsy (CP) children are that this will pose a challenge within this transformation. CP, as a discreet entity, is not considered a risk factor. However, specific comorbidities in individuals with CP, such as chronic lung disease, are known as COVID-19 risk factors. The overall risk for the CP population is probably a factor of age and comorbidities. Staying at home for CP children is both a challenge and an opportunity. Escalation of behavioral conflicts or improved participation and equality within the household may emerge. Interestingly, restricted mobility for the general population narrows existing gaps of ambulation. Telemedicine is the primary way of providing services for chronic conditions during the pandemic and is expected to expand beyond pre-Coronavirus era use. The advantages of telemedicine vary, more so during pandemic times, according to severity, restrictions, and availably of telemedicine. A multidisciplinary therapeutic presence is more accessible with telemedicine, bringing together various specialties and approaches to the child's natural environment. Accessible, continuous care is expected to lower comorbidities, as demonstrated for other chronic conditions. Enhanced monitoring is crucial for younger children as devastating complications, such as hip dysplasia, could be minimized. Last but not least, we will discuss digital health care as an accelerator for participatory medicine, including networked patients and families, as responsible drivers of their health as full partners.

Feasibility and Acceptability of Clinical Pediatric Telerehabilitation Services

“…While the best option for many patients will be to return to in-person visits once the pandemic is over, specific populations may benefit from continued access to telerehabilitation visits ( Ben-Pazi et al, 2020 ). One of these populations is those working on generalization of skills learned in clinic to home (e.g., patients with ASD, those recovering from an injury; Tenforde et al, 2017 ) Often the last phase of motor learning is practice in other environments ( Schmidt & Lee, 2005 ).…”

“…The primary limiting factors for implementation have been the limited payor reimbursement, perceived and actual technological barriers, liability concerns, and privacy concerns ( Brophy, 2017 ; Dorsey & Topol, 2016 ; Lee et al, 2018 ; Olson et al, 2018 ; Sauers-Ford et al, 2019 ; Tomines, 2019 ). The COVID-19 pandemic resulted in a lessening of the aforementioned barriers to clinical implementation, as well as presented an urgent need to provide safe and effective rehabilitation services to patients during a vulnerable time ( Badawy & Radovic, 2020 ; Ben-Pazi et al, 2020 ; Ohannessian et al, 2020 ; Olayiwola et al, 2020 ). While the pandemic has had many negative effects on health and well-being of people around the world, it has resulted in an unprecedented rise in the use of telerehabilitation out of necessity for providing safe access to care during a public health crisis.…”

Leisure‐time physical activity interventions for children and adults with cerebral palsy: a scoping review

“…Telehealth interventions incorporate information communication technology to remotely connect clients/patients with health care providers at home, and this method of service has gained substantial global acceptance due to the COVID-19 pandemic. 31 In addition to reducing caregiver or participant burden, telehealth interventions can also reduce burden on a therapist or researcher who promotes LTPA by negating the need for in-person supervision. Indeed, telehealth technology was incorporated into the largest LTPA intervention reviewed in the present study.…”

“…Telehealth interventions might be an ideal solution for tackling some of the substantial time and transportation barriers to enrollment in LTPA interventions. Telehealth interventions incorporate information communication technology to remotely connect clients/patients with health care providers at home, and this method of service has gained substantial global acceptance due to the COVID‐19 pandemic 31 . In addition to reducing caregiver or participant burden, telehealth interventions can also reduce burden on a therapist or researcher who promotes LTPA by negating the need for in‐person supervision.…”

Global Survey on Telemedicine Utilization for Movement Disorders During the COVID‐19 Pandemic

“…(https://www.who.int/news-room/detail/27-04-2020-who-timeline-covid-19) This declaration triggered almost immediate global restrictions to routine healthcare access, principally to limit viral transmission, but also to prioritize healthcare resources to address the novel virus. These restraints threatened continuity of care for patients with chronic medical conditions, including Parkinson's disease and other movement disorders 1,2 . Escalation of telemedicine presented an obvious alternative to bridge the gap without considerably compromising the quality of medical care 3 …”