Introducing remote physical rehabilitation for patients with chronic disorders by means of telemedicine

Abstract

This study involved an evaluation of a telemedicine service implemented as a partial replacement of a physical outpatient rehabilitation program. The telemedicine service was an exercise-based tele-rehabilitation service facilitating remote physical rehabilitation for patients suffering from chronic lower back pain or pulmonary disease. Effectiveness was evaluated with multiple outcomes on quality (complaints, disability and physical condition) and access (usability, satisfaction and motivational character of the service). Patients referred by their rehabilitation physician to a physical outpatient rehabilitation program between October 2009 and May 2010 were asked to participate in the control group. Patients referred to the program between June 2010 and December 2011 were asked to participate in the intervention group. The control group received the conventional rehabilitation program. The intervention group received the rehabilitation program in which telemedicine was used as partial replacement of face to face care. Instead of 3 visits per week to the clinic as was being carried out in conventional care, patients visited the outpatient rehabilitation clinic for 2 days and they were instructed to exercise at least 1 day in their own environment using the exercise-based tele-rehabilitation service. One hundred and eighteen patients were included in this study: 38 patients in the control group and 80 patients in the intervention group. Both groups equally benefit from the outpatient rehabilitation program. There were no significant differences between the groups. The usability (system usability scale sore of 71.2 (SD 15.0; n=47), satisfaction (average rate 6.0 (SD 2.0; n=55), and level of motivation of the exercisebased tele-rehabilitation service were sufficient, but slightly disappointing. The telemedicine supported the outpatient rehabilitation program as partial replacement of face to face care was as effective as the conventional outpatient rehabilitation program.

Co-creation of an ICT-supported cancer rehabilitation application for resected lung cancer survivors: design and evaluation

“…To familiarize participants with telehealthcare and its wide range of possibilities [ 18 , 25 ], mock-ups were shown with potential functionalities: (1) tailored information about disease and treatment, (2) tailored lifestyle information, (3) ambulant monitoring of health status, (4) web based tailored exercise program, (5) contact with professional by means of ICT (e.g., e-consultation), and (6) contact with fellow lung cancer patients. The content of the mock-ups were based on existing applications that are already available for other chronic diseased populations such as COPD [ 26 , 27 ]. During the interview needs and requirements regarding content (UTAUT component ‘performance expectancy’), usability/ease of use (‘effort expectancy’), influence of important others on use (‘social influence’), facilitators and barriers for use (‘facilitating conditions’), and intention to use the service were assessed.…”

The effectiveness of exercise-based telemedicine on pain, physical activity and quality of life in the treatment of chronic pain: A systematic review

“…Three studies met less than six criteria, implying a low methodological quality. 38,46,48 One article was a CCT with a historical control group, 48 resulting in a high risk of bias. Three studies had non-comparable groups at baseline.…”

“…The average duration of the intervention in the respective studies was six months (range 1-24 months). Fifty-six per cent of the interventions were delivered by means of internet or smartphone, 38,39,40,46,48,49,[51][52][53] the other 44% were delivered by phone. [41][42][43][44][45]47,50 In all studies, home-based exercises were employed as part of the intervention of interest.…”

“…Three interventions included general encouragement of physical activity, 39,43,53 whereas most featured individually tailored exercise programmes. 38,[40][41][42][44][45][46][47][48][49][50][51][52] Time-contingent, graded activity principles were used frequently. [38][39][40][41][42]45,47,52,53 Some studies employed general lowmoderate intensity (aerobic) activities, like walking and cycling.…”

“…45,47 In two studies the telemedicine intervention was compared to face-to-face physiotherapy care. 44,48 Fourteen studies reported short-term outcome measures (immediately post treatment). Long-term follow-up was reported in eight studies, with an average duration of 12 months (range 3-30 months).…”