Telerehabilitation in individuals with severe acquired brain injury

Abstract

Background:Severe acquired brain injury (SABI) rehabilitation should be as intensive and long as to allow the patients get the best independence and quality of life (QoL), but facing with the rehabilitation socioeconomic burden. Telerehabilitation (TR) could supply frail subjects requiring long-term rehabilitation.Methods:A multicenter, prospective, parallel design, single-blind trial will be conducted at the IRCCS Neurolesi Bonino Pulejo (Messina, Italy) and IRCCS Hospital San Camillo (Venice, Italy) involving patients suffering from SABI and requiring home motor and cognitive rehabilitation. We will investigate the use of TR, based on advanced Information and Communication Technology (ICT) solutions, taking into account that the supervision of rehabilitation at home will be enriched with the counseling and vital parameters monitoring. The enrolled patients will be balanced for pathology, and randomized in 2 groups, performing TR (G1) or standard rehabilitation training (G2), respectively, according to a pc-generated random assignment. TR will be delivered by means of an advanced video-conferencing system, whereas the patient will be provided with low-cost monitoring devices, able to collect data about his/her health status and QoL. In both the groups each treatment (either cognitive or motor, or both as per patient functional status) will last about 1 hour a day, 5 days/week, for 12 weeks. Two structured telephone interviews will be administered to the patients (when possible) and/or their caregivers, and to all the healthcare professionals involved in the patient management, 1 week after the beginning and at the end of the TR. All the patients will undergo a complete neurological and cognitive examination performed by skilled physicians and psychologists, blindly. Clinical evaluations will be administered blindly, before and after the treatments.Results:the data of this study should demonstrate that TR is at least non-inferior in comparison with the same amount of usual territorial rehabilitative physical treatments, taking into account patients’ functional recovery, psychological well-being, caregiver burden, and healthcare costs.Conclusion:data coming from this study could demonstrate the usefulness of TR in facing the rehabilitation socioeconomic burden of managing patients with SABI, so to allow the patients get the best independence and quality of life (QoL).

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“…The potential of telerehabilitation could be confirmed by Calabrò et al (95), who are conducting a multicenter study on the role of cognitive telerehabilitation in individuals with ABI, evaluating the functional recovery of patients, psychological well-being, the burden of caregivers with a cost-effectiveness analysis.…”

Continuity of Care During COVID-19 Lockdown: A Survey on Stakeholders' Experience With Telerehabilitation

“…Professionals reported a high level of agreement with the statement regarding the potential effect of telerehabilitation in enhancing the sense of competence of patients and caregivers in relation to the disability. This perception, based on a screen-mediated observation during remote treatment, has been assessed in previous studies in which professionals' feedback during sessions has shown to make patients and caregivers proactive, thus empowering their ability to care for their loved ones (23,(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59). Based on the logit regression, remote media skilled professionals and those below the age of 40 have a higher probability to report that telerehabilitation could favor the patient's/family's sense of competence.…”

Innovation technology in neurorehabilitation: introducing a hub and spoke model to avoid patient “migration” in Sicily

“…The Hub Center, in turn, sends those patients with less severe pathologies to the peripheral spoke center closest to their home. Moreover, telerehabilitation can be provided directly by the Hub Center using the Virtual Reality Rehabilitation System, so that spoke center inpatients may benefit from skilled therapists and clinicians (Calabrò et al , 2018).…”