Telerehabilitation and recovery of motor function: a systematic review and meta-analysis

Agostini, Michela; Moja, Lorenzo; Banzi, Rita; Pistotti, Vanna; Tonin, Paolo; Venneri, Annalena; Turolla, Andrea

doi:10.1177/1357633x15572201

Cited by 236 publications

(201 citation statements)

References 94 publications

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“…Two recent studies provide statements such as, “there is a strong positive effect for patients following orthopedic surgery” [1] and “there is unequivocal evidence that the management of musculoskeletal conditions via real-time telerehabilitation is effective in improving physical function, disability, and pain” [33]. We agree with these statements, but only and exclusively for some pathologies.…”

Section: Discussionmentioning

confidence: 56%

“…The increasing availability of low-cost Internet and communication technologies has boosted the opportunity to apply technology-based solutions to provide health services during hospitalization and after discharge from hospital [1]. With the general ageing of the population—at least in industrialized countries—and the limited resources devoted to public health, the development of new rehabilitation models and practices seems mandatory in order to cope with the change in population needs [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…With the growing number of telerehabilitation programs and with emerging databases providing potentially useful and reliable data on clinical outcomes [26], it is reasonable to expect that the number of scientific publications will rapidly increase [27], along with the number of systematic reviews on the topic [4]. Systematic reviews that included telerehabilitation interventions in musculoskeletal conditions yielded a few eligible trials, so efficacy remains inconclusive [1,28]. Telerehabilitation shows promise in many fields, but compelling evidence of the benefit for, and impact on, routine rehabilitation programs is still limited.…”

Section: Introductionmentioning

confidence: 99%

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Evidence of Benefit of Telerehabitation After Orthopedic Surgery: A Systematic Review

et al. 2017

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BackgroundIn addition to traditional physiotherapy, studies based on telerehabilitation programs have published the results of effectiveness, validity, noninferiority, and important advantages in some neurological, cognitive, and musculoskeletal disorders, providing an opportunity to define new social policies and interventions.ObjectivesThe aim of this systematic review is to investigate the effects of telerehabilitation after surgical procedures on orthopedic conditions as well as to describe how interventions are designed and to determine whether telerehabilitation is comparable with conventional methods of delivery. This systematic review summarizes the levels of evidence and grades of recommendation regarding telerehabilitation intervention (synchronous or asynchronous provided via the telerehabilitation medium, either in conjunction with, or in isolation of, other treatment interventions) after surgical procedures on orthopedic conditions.MethodsStudy quality was assessed using the Physiotherapy Evidence Database (PEDro) scores and grade of recommendation following the recommendation of the Oxford Centre for Evidence-Based Medicine.ResultsWe found 3 studies with PEDro scores between 6 and 8, which is considered as level 1 evidence (good; 20% [3/15]), 4 studies with a score of 5, which is considered as level 2 evidence (acceptable; 27% [4/15]), and the remaining 8 studies had scores of 4 or less, which is considered (poor; 53% [8/15]). A total of 1316 participants received telerehabilitation intervention in the selected studies, where knee and hip replacement were 75% of all the studies. Strong and moderate grades of evidence (grade of recommendation A–B) were found in knee and hip replacement interventions. Studies on the upper limb were 25% of the studies, but only 1 study presented a moderate grade of evidence (grade of recommendation B) and the rest were of poor methodological quality with weak evidence (grade of recommendation C).ConclusionsConclusive evidence on the efficacy of telerehabilitation for treatment after an orthopedic surgery, regardless of pathology, was not obtained. We found strong evidence in favor of telerehabilitation in patients following total knee and hip arthroplasty and limited evidence in the upper limb interventions (moderate and weak evidence). Future research needs to be more extensive and conclusive. To the best of the authors’ knowledge, this is the first attempt at evaluating the quality of telerehabilitation intervention research after surgical procedures on orthopedic conditions in a systematic review. Clinical messages and future research recommendations are included in the review.

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Section: Discussionmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evidence of Benefit of Telerehabitation After Orthopedic Surgery: A Systematic Review

et al. 2017

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“…Evidence supports the use of telehealth in the delivery of acute stroke care, but the utility of telehealth in the post-acute treatment of patients with stroke is less clear 5,6 . Telerehabilitation has been defined as “the delivery of rehabilitation services via information and communication technologies” 7 , and therefore can include a broad range of services.…”

Section: Introductionmentioning

confidence: 99%

A Home-Based Telerehabilitation Program for Patients With Stroke

Dodakian

McKenzie

et al. 2017

Neurorehabil Neural Repair

140

126

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Background Though rehabilitation therapy is commonly provided after stroke, many patients do not derive maximal benefit due to access, cost, and compliance. A telerehabilitation-based program may overcome these barriers. We designed then evaluated a home-based telerehabilitation system in patients with chronic hemiparetic stroke. Methods Patients were 3–24 months post-stroke with stable arm motor deficits. Each received 28 days of telerehabilitation using a system delivered to their home. Each day consisted of one structured hour focused on individualized exercises and games, stroke education, and an hour of free-play. Results Enrollees (n=12) had baseline Fugl-Meyer (FM) score of 39±12 (mean±SD). Compliance was excellent: participants engaged in therapy on 329/336 (97.9%) assigned days. Arm repetitions across the 28 days averaged 24,607±9,934 per subject. Arm motor status showed significant gains (FM change 4.8±3.8 points, p=0.0015), with half of subjects exceeding the minimal clinically important difference. Although scores on tests of computer literacy declined with age (r=−0.92, p<0.0001), neither the motor gains nor the amount of system use varied with computer literacy. Daily stroke education via the telerehabilitation system was associated with a 39% increase in stroke prevention knowledge (p=0.0007). Depression scores obtained in person correlated with scores obtained via the telerehabilitation system 16 days later (r=0.88, p=0.0001). In-person blood pressure values closely matched those obtained via this system (r=0.99, p<0.0001). Conclusions This home-based system was effective in providing telerehabilitation, education, and secondary stroke prevention to participants. Use of a computer-based interface offers many opportunities to monitor and improve the health of patients after stroke.

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“…Se ha demostrado el fuerte efecto positivo de la tele-rehabilitación en pacientes que han pasado por una cirugía ortopédica, lo cual sugiere que esta intervención puede ser una opción válida y prometedora para este tipo de pacientes (Agostini et al, 2015). En concreto, la tecnología que más se ha utilizado son los tratamientos online, tecnología que también hemos utilizado en la presente tesis doctoral.…”

Section: Tratamiento Del Dolor Crónico Mediante Ticsunclassified

Eficacia de un Tratamiento Cognitivo Comportamental (TCC) con apoyo de Tecnologías de la Información y la Comunicación (TICs) para el dolor lumbar crónico. Ensayo clínico aleatorizado

González¹

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Al fin veo materializado el trabajo de cuatro años de mi vida. A lo largo de este proceso he crecido como persona, he aprendido, me he equivocado a veces y me he sobrepuesto a las dificultades. Pero sin duda, todo esto no hubiera sido posible sin la inestimable ayuda y apoyo de mis familiares, pareja, amigos y compañeros. Todos ellos han sabido sacar lo mejor de mí en cada momento.En primer lugar, quiero agradecer a mi directora de tesis, Azucena García Palacios, su confianza en mí, su paciencia, comprensión y apoyo durante todo el desarrollo de la tesis, y ya antes en mi época de becaria de colaboración.Gracias por todo lo que me has dado y enseñado a lo largo de estos años, por aceptarme con tanta entrega y estar siempre ahí. También agradecer a Cristina Botella Arbona que me acogiera en su laboratorio y me dejara formar parte de él.Es importante aquí destacar la ayuda de los doctores Julio Doménech y Lourdes Peñalver, agraceder al hospital Arnau de Vilanova que facilitara el desarrollo de este estudio en su centro, y a los pacientes que aceptaron participar en esta investigación y, sin los cuales, todo esto no hubiera sido posible.Me gustaría mencionar a los compañeros de mi equipo de trabajo, Labpsitec, siempre dispuestos a ayudar y a aconsejar. Agradecer a Marian y Adriana su paciencia y comprensión como compañeras de despacho, a Ángel que me transmitiera su entusiasmo, pasión y alegría en cada cosa que hacía, a Diana por compartir conmigo su experiencia y por ofrecerme su ayuda siempre con una sonrisa, y al resto por resolver mis dudas y por los almuerzos de desahogo. He de dar las gracias especialmente a mi compañera y amiga Carla, por haber hecho de mí una persona más tranquila y sosegada. Gracias por darme un respiro cuando me sentía agobiada, ánimos cuando me hacían falta, y por momentos de risas, dentro y fuera del laboratorio. Sin duda has sido un gran descubrimiento y espero tenerte a mi lado mucho tiempo.A mi familia porque soy lo que soy gracias a ellos. A su apoyo incansable a pesar de no comprender muy bien lo que hago, a animarme a seguir adelante cuando yo mostraba mis dudas, a creer en mí cuando yo dejaba de confiar en mis posibilidades y a darme un abrazo, sin lidiar más palabra, justo cuando más lo necesitaba. Especialmente, gracias a mi hermana Alba por hacerme sentir que puedo dar más y que podré conseguir todo aquello que me plantee. Y qué decir de mis amigos, pacientes escuchas del tema reincidente, "la tesis". Siempre me han animado en cada parte del proceso. En especial quiero mencionar a Laura Orellana, gran amiga desde que éramos niñas, es la persona a la que sé que siempre puedo recurrir, y que me va a entender mejor que nadie sin juzgarme. También ella ha estado peleando con su tesis, y finalmente habrá dos doctoras más en el mundo.También me llevo un grato recuerdo de mi paso por Seattle y estoy agradecida por todo lo aprendido y vivido allí. Me traigo muy buenos recuerdos y un par de amigas, Rocío y Elena, que me hicieron muy fácil mi paso por EE.UU.Por último, gracias a mi pare...

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Telerehabilitation and recovery of motor function: a systematic review and meta-analysis

Cited by 236 publications

References 94 publications

Evidence of Benefit of Telerehabitation After Orthopedic Surgery: A Systematic Review

Evidence of Benefit of Telerehabitation After Orthopedic Surgery: A Systematic Review

A Home-Based Telerehabilitation Program for Patients With Stroke

Eficacia de un Tratamiento Cognitivo Comportamental (TCC) con apoyo de Tecnologías de la Información y la Comunicación (TICs) para el dolor lumbar crónico. Ensayo clínico aleatorizado

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