Telerehabilitation for Managing Daily Participation among Breast Cancer Survivors during COVID-19: A Feasibility Study

Loubani, Khawla; Schreuer, Naomi; Kizony, Rachel

doi:10.3390/jcm11041022

Cited by 16 publications

(7 citation statements)

References 52 publications

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“…Additionally, other studies have supported its use in improving QoL, functional abilities, and symptom management (including those of pain, depression, anxiety, fatigue, cognitive decline, and sexual dysfunction) [ 26 ]. Lai et al [ 27 ] found that providing telerehabilitation via the Zoom platform was similar to in-person rehabilitation in terms of the mean time required to recover baseline function.…”

Section: Discussionmentioning

confidence: 99%

Effect of Telerehabilitation and Outpatient Rehabilitation in Women with Breast Cancer

Scaturro

Vitagliani

Mangano

et al. 2023

JFMK

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Telemedicine was shown to be indispensable during the SARS-CoV-2 pandemic to ensure continuity of care for fragile patients. We compared a telerehabilitation program versus an outpatient rehabilitation program in women with breast cancer undergoing quadrantectomy surgery. There were 56 women with breast cancer divided into two groups: the treatment group (TG), made up of 24 patients undergoing a remote rehabilitation project program; and the control group (CG), composed of 32 patients subjected to the same rehabilitation project program in an outpatient setting. At the time of enrollment (T0) and the end of the 8 weeks of treatment (T1), the following questionnaire scores were considered: numerical rating scale (NRS), Disabilities of the Arm, Shoulder and Hand questionnaire (Quick-DASH), Piper fatigue scale (PFS)m and Breast Cancer Therapy Functional Rating Scale (FACT-B). We observed that the CG showed greater improvements than the TG in upper limb function (7.8 ± 4.2 vs. 10.9 ± 4.9; p < 0.05) and quality of life (27.9 ± 7.2 vs. 40.0 ± 3.3; p < 0.05). No difference in efficacy between the two groups was observed for pain (2.2 ± 0.6 vs. 2.3 ± 0.9; p = 0.64) and fatigue (3.2 ± 1.1 vs. 3.2 ± 0.6; p = 0.66). Telerehabilitation is a valid tool in the management of women with breast cancer in the postoperative phase. However, face-to-face rehabilitation treatment may be preferred because it is more effective as it allows the construction of a specific, personalized, and targeted rehabilitation program.

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Section: Discussionmentioning

confidence: 99%

Effect of Telerehabilitation and Outpatient Rehabilitation in Women with Breast Cancer

Scaturro

Vitagliani

Mangano

et al. 2023

JFMK

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“…Video telehealth is one of the ways to increase access to specialty services, such as OT; however, older adults may face barriers to video telehealth. Video telehealth expansion during the COVID-19 pandemic allowed clinicians, such as OT practitioners, to deliver rehabilitation services into patients' homes [21][22][23], thus increasing access by those for whom distance was a barrier [24]. However, although in-home video telehealth is ideal for OT, which focuses care delivery on the intersection between the person and the environment [25], there may be unique considerations for in-home OT video telehealth with older adults.…”

Section: Introductionmentioning

confidence: 99%

Caregivers’ Role in In-Home Video Telehealth: National Survey of Occupational Therapy Practitioners

Gately,

Waller,

Metcalf

et al. 2024

JMIR Rehabil Assist Technol

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Background Older adults face barriers to specialty care, such as occupational therapy (OT), and these challenges are worse for rural older adults. While in-home video telehealth may increase access to OT, older adults’ health- and technology-related challenges may necessitate caregiver assistance. Objective This study examines caregiver assistance with in-home OT video telehealth visits from the perspectives of OT practitioners at Veterans Health Administration (VHA). Methods A web-based national survey of VHA OT practitioners about caregivers’ role in video telehealth was conducted between January and February 2022. Survey items were developed with input from subject matter experts in geriatrics and OT and identified patient factors that necessitate caregiver participation; the extent to which caregivers assist with different types of tasks (technological and clinical tasks); and the perceived facilitators of, benefits of, and barriers to caregiver involvement. Results Of approximately 1787 eligible VHA OT practitioners, 286 (16% response rate) participated. Not all survey items required completion, resulting in different denominators. Most respondents were female (183/226, 81%), White (163/225, 72.4%), and occupational therapists (275/286, 96.2%). Respondents were from 87 VHA medical centers, the catchment areas of which served a patient population that was 34% rural, on average (SD 0.22). Most participants (162/232, 69.8%) had >10 years of OT experience serving a patient cohort mostly aged ≥65 years (189/232, 81.5%) in primarily outpatient rehabilitation (132/232, 56.9%). The top patient factors necessitating caregiver involvement were lack of technical skills, cognitive impairment, and advanced patient age, with health-related impairments (eg, hearing or vision loss) less frequent. Technological tasks that caregivers most frequently assisted with were holding, angling, moving, repositioning, or operating the camera (136/250, 54.4%) and enabling and operating the microphone and setting the volume (126/248, 50.8%). Clinical tasks that caregivers most frequently assisted with were providing patient history (143/239, 59.8%) and assisting with patient communication (124/240, 51.7%). The top facilitator of caregiver participation was clinician-delivered caregiver education about what to expect from video telehealth (152/275, 55.3%), whereas the top barrier was poor connectivity (80/235, 34%). Increased access to video telehealth (212/235, 90.2%) was the top-rated benefit of caregiver participation. Most respondents (164/232, 70.7%) indicated that caregivers were at least sometimes unavailable or unable to assist with video telehealth, in which case the appointment often shifted to phone. Conclusions Caregivers routinely assist VHA patients with in-home OT video visits, which is invaluable to patients who are older and have complex medical needs. Barriers to caregiver involvement include caregivers’ challenges with video telehealth or inability to assist, or lack of available caregivers. By elucidating the caregiver support role in video visits, this study provides clinicians with strategies to effectively partner with caregivers to enhance older patients’ access to video visits.

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“…Telerehabilitation could decrease barriers to access by delivering services to patients when and where they need them. Research trials performed prior to the COVID pandemic suggest telerehabilitation is safe and feasible [12][13][14][15][16][17][18][19][20], acceptable to survivors and clinicians [12][13][14]16,18], and associated with improved functional and/or psychosocial outcomes [12][13][14][15][18][19][20][21]. When coupled with the high rates of smartphone ownership in the United States (89% of adults) [22], these findings suggest telerehabilitation now, more than ever, could be leveraged as a flexible and practical way to expand access to cancer-specialized rehabilitation services [21,23,24].…”

Section: Introductionmentioning

confidence: 99%

In-Clinic versus Hybrid Cancer Rehabilitation Service Delivery during the COVID-19 Pandemic: An Outcome Comparison Study

Wood,

Giri,

Kendig

et al. 2023

Current Oncology

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Diminished health-related quality of life (HRQOL) is common among cancer survivors but often amendable to rehabilitation. However, few access real-world rehabilitation services. Hybrid delivery modes (using a combination of in-clinic and synchronous telehealth visits) became popular during the COVID-19 pandemic and offer a promising solution to improve access beyond the pandemic. However, it is unclear if hybrid delivery has the same impact on patient-reported outcomes and experiences as standard, in-clinic-only delivery. To fill this gap, we performed a retrospective, observational, comparative outcomes study of real-world electronic medical record (EMR) data collected by a national outpatient rehabilitation provider in 2020–2021. Of the cases meeting the inclusion criteria (N = 2611), 60 were seen to via hybrid delivery. The outcomes evaluated pre and post-rehabilitation included PROMIS® global physical health (GPH), global mental health (GMH), physical function (PF), and the ability to participate in social roles and activities (SRA). The patient experience outcomes included the Net Promoter Survey (NPS®) and the Select Medical Patient-Reported Experience Measure (SM-PREM). A linear and logistic regression was used to examine the between-group differences in the PROMIS and SM-PREM scores while controlling for covariates. The hybrid and in-clinic-only cases improved similarly in all PROMIS outcomes (all p < 0.05). The association between the delivery mode and the likelihood of achieving the minimal important change in the PROMIS outcomes was non-significant (all p > 0.05). No between-group differences were observed in the NPS or SM-PREM scores (all p > 0.05). Although more research is needed, this real-world evidence suggests that hybrid rehabilitation care may be equally beneficial for and acceptable to cancer survivors and supports calls to expand access to and reimbursement for telerehabilitation.

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Telerehabilitation for Managing Daily Participation among Breast Cancer Survivors during COVID-19: A Feasibility Study

Cited by 16 publications

References 52 publications

Effect of Telerehabilitation and Outpatient Rehabilitation in Women with Breast Cancer

Effect of Telerehabilitation and Outpatient Rehabilitation in Women with Breast Cancer

Caregivers’ Role in In-Home Video Telehealth: National Survey of Occupational Therapy Practitioners

In-Clinic versus Hybrid Cancer Rehabilitation Service Delivery during the COVID-19 Pandemic: An Outcome Comparison Study

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