310 research outputs found
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“This Is Going To Be Different, But It’s Not Impossible”: Adapting To Telehealth Occupational Therapy For Autistic Children
Full text linkThis qualitative study examined participants’ experiences of transitioning to telehealth-delivered pediatric occupational therapy for autistic children during the COVID-19 pandemic. We interviewed three clinic administrators, four occupational therapists, and six parents of autistic children (n=13) from three Los Angeles area clinics over a 7-month period. Our narrative and thematic analyses yielded three overarching themes: Transformative Experiences, Reimagining Therapy, and Going Forward. Overall, we found that the transition to telehealth shifted participants’ preconceptions about themselves, their relationships, and the nature of occupational therapy. Many deepened their relationships; adapted interventions; uncovered surprising capabilities; and challenged the occupational therapy status quo to advocate for ongoing virtual delivery. Our findings bear relevance to the body of current literature debating the post-pandemic viability of telehealth-delivered occupational therapy
A Comparative Analysis of Telerehabilitation and Telemedicine Utilization During the COVID-19 Pandemic in Poland: Trends, Patterns, and Implications
Full text linkThe study aimed to examine the influence of COVID-19 on the adoption of teleservices in Poland, with a focus on contrasting patterns between rehabilitation and ambulatory care settings. We conducted a retrospective analysis of a national dataset to assess trends in telehealth use from 2020 to 2022. The use of teleservices peaked in April 2020 in both sectors. The share of the teleservices in the period of October 2020-December 2022 was much higher in the ambulatory (average 7,8%) than the rehabilitation sector (average 0,16%). Although, the analysis showed a moderate relationship between COVID-19 incidence and telehealth utilization (Spearman's rho from 0.39 and 0.52). Our findings demonstrate no statistically significant difference in Spearman’s rho values between ambulatory care and rehabilitation, indicating a similar strength of response to the pandemic waves. Our findings underscore the importance of telehealth services in ensuring healthcare accessibility during times of crisis, emphasizing their role in facilitating continuity of care amidst pandemic-related disruptions. This study contributes to the understanding of telehealth utilization trends during the COVID-19 pandemic, offering insights into the adaptive responses of healthcare systems to unprecedented challenges. Further research is warranted to explore the long-term implications of telehealth use and to inform strategies for optimizing healthcare delivery in post-pandemic contexts.
Innovative Hybrid Cloud Solutions For Physical Medicine and Telerehabilitation Research
Full text linkPurpose: The primary objective of this study was to develop and implement a Hybrid Cloud Environment for Telerehabilitation (HCET) to enhance patient care and research in the Physical Medicine and Rehabilitation (PM&R) domain. This environment aims to integrate advanced information and communication technologies to support both traditional in-person therapy and digital health solutions. Background: Telerehabilitation is emerging as a core component of modern healthcare, especially within the PM&R field. By applying digital health technologies, telerehabilitation provides continuous, comprehensive support for patient rehabilitation, bridging the gap between traditional therapy, and remote healthcare delivery. This study focuses on the design, and implementation of a hybrid HCET system tailored for the PM&R domain. Methods: The study involved the development of a comprehensive architectural and structural organization for the HCET, including a three-layer model (infrastructure, platform, service layers). Core components of the HCET were designed and implemented, such as the Hospital Information System (HIS) for PM&R, the MedRehabBot system, and the MedLocalGPT project. These components were integrated using advanced technologies like large language models (LLMs), word embeddings, and ontology-related approaches, along with APIs for enhanced functionality and interaction. Findings: The HCET system was successfully implemented and is operational, providing a robust platform for telerehabilitation. Key features include the MVP of the HIS for PM&R, supporting patient profile management, and rehabilitation goal tracking; the MedRehabBot and WhiteBookBot systems; and the MedLocalGPT project, which offers sophisticated querying capabilities, and access to extensive domain-specific knowledge. The system supports both Ukrainian and English languages, ensuring broad accessibility and usability. Interpretation: The practical implementation, and operation of the HCET system demonstrate its potential to transform telerehabilitation within the PM&R domain. By integrating advanced technologies, and providing comprehensive digital health solutions, the HCET enhances patient care, supports ongoing rehabilitation, and facilitates advanced research. Future work will focus on optimizing services and expanding language support to further improve the system's functionality and impact
Editorial for the Special Issue of the International Journal of Telerehabilitation
Full text linkThis editorial introduces the special issue of the International Journal of Telerehabilitation, which highlights advancements in telerehabilitation technologies and their applications in healthcare, particularly in cancer care. The issue addresses the importance of remote healthcare, especially in regions like Ukraine, where the wartime situation has posed significant challenges to traditional rehabilitation services. It also presents the Ukrainian Language Edition of the Guidelines on Telerehabilitation of Breast Cancer Patients and a theoretical study on the transdisciplinary aspects of telerehabilitation. The editorial further emphasizes the significance of the upcoming 4th National Congress of Physical and Rehabilitation Medicine in Ukraine, which will focus on multidisciplinary rehabilitation approaches amidst ongoing conflict
Telerehabilitation Guidelines for Patients with Breast Cancer
Full text linkThis article provides a comprehensive analysis of the current developments in telerehabilitation, focusing on the regulatory and legal frameworks for delivering telerehabilitation services, the clinical manifestations of postmastectomy pain syndrome, and the role and significance of the International Classification of Functioning, Disability, and Health (ICF) in the telerehabilitation of patients with breast cancer (BC). The document also explores telerehabilitation interventions for BC.
A detailed description of the software and hardware tools is provided, including the structural and functional overview of the Telerehabilitation Platform (TRP), software modules such as "Telerehabilitation," "Medical Reports," the Administrative Subsystem, the Information-Analytical Subsystem, which encompass the PM&R physician’s digital workspace, the PM&R Expert Subsystem, and the Patient’s digital workspace. It also covers existing and prospective scales for evaluating the effectiveness of telerehabilitation, as well as the specifics of working with identified patients in accordance with the eHealth (Electronic Healthcare System of Ukraine) requirements.
The guidelines conclude with organizational and methodological aspects for implementing telerehabilitation programs, including initial and stage-specific rehabilitation assessments, basic ICF sets, and various patient-specific telerehabilitation programs. These include a patient-centered program for the preoperative stage of telerehabilitation and individualized programs for the post-acute and long-term phases. The eight appendices include questionnaires, physical therapy programs, protocols, diaries, and requirements for the equipment and staff of the telerehabilitation/telemedicine office, among other resources
Hybrid Cardiac Telerehabilitation After Acute Coronary Syndrome: Self-selection Predictors and Outcomes
Full text linkAims: To evaluate the effectiveness of a hybrid cardiac telerehabilitation (HCTR) program after acute coronary syndrome (ACS) on patient quality of life (QoL) and physical activity indices throughout phases 2-3 and establish predictors for hybrid program self-selection.
Methodology: This single-centre longitudinal retrospective study included patients who attended a cardiac rehabilitation program (CRP) between 2018-2021. Patients self-selected between two groups: Group 1 – conventional CRP (CCRP); Group 2 – HCTR. Baseline characteristics were registered. EuroQol-5D (EQ-5D) and International Physical Activity Questionnaire (IPAQ) were applied at three times: T0 – phase 2 onset; T1 – phase 3 onset; T2 – 3 months after T1.
Results: 59 patients participated (Group 1 – 27; Group 2 – 32). We found significant between-group differences regarding occupation (p=0.003). Diabetic patients were less likely to self-select into HCTR (OR=0.21; p<0.05). EQ-5D visual analogue scale and IPAQ result significantly improved between T0-T2 only for HCTR (p=0.001; p=0.021).
Conclusions: HCTR was superior to CCRP on physical activity indices and QoL of ACS patients
Letter to the Editor – Update from Ukraine: Development of the Cloud-based Platform for Patient-centered Telerehabilitation of Oncology Patients with Mathematical-related Modeling
Full text linkThis Letter to the Editor provides an update on the research from the Glushkov Institute of Cybernetics of the National Academy of Sciences of Ukraine. The Institute’s research team in collaboration with Ternopil National Medical University began a new project called “Development of the cloud-based platform for patient-centered telerehabilitation of oncology patients with mathematical-related modeling.” The project is dedicated to the development of a hybrid cloud-based platform, and the creation on its basis of information technology for the telemedicine rehabilitation of cancer patients, and adapted for patients with combat stress disorder. The distinctive features of the proposed technology are a combination of artificial intelligence methods with accurate mathematical methods for optimization: developing mathematical models of problems of discrete, and non-smooth optimization, subgradient space transformation algorithms (to minimize non-smooth functions with tens of thousands of variables), and a method of global equilibrium search, etc
Effectiveness of Telerehabilitation for Correcting Posture in Elderly with Thoracic Kyphosis in Urban Thailand
Full text linkIntroduction: Thoracic kyphosis (TK) is an abnormal thoracic spine. Telerehabilitation and conventional physical therapy were compared for correct posture in the thoracic angle, forward head posture, back muscle strength, and cost-effectiveness. Method: Twenty-two Thai women 60 years of age and over, with thoracic angles over 45 degrees, participated in this study. Participants were randomly allocated into a telerehabilitation group (TG) or a control group (CG). TG and CG underwent a thoracic corrective exercise program for 1 hour each session, three times per week for 8 weeks. Result: Thoracic angle, forward head posture, and back muscle strength improved (P < .05) in both groups. Furthermore, cost-effectiveness showed the cost of intervention in TG lower than CG, approximately 133.78 US$. Conclusion: Our study showed no difference in telepractice program efficacy and effectiveness compared to in-person treatment in the clinic. Thus, telerehabilitation may be an alternative treatment for the elderly who cannot travel to the hospital
Development of a Physical Therapy Telehealth Examination Battery for People with Parkinson Disease
Full text linkScope: The rapid transition to telehealth following the COVID-19 pandemic raised challenges for remote delivery of physical therapy. One challenge was identifying outcome measures for people with Parkinson Disease (PwP) that could safely be conducted via telehealth. This paper evaluates the feasibility of a telehealth physical therapy examination battery for PwP in early to middle stage of disease progression. Methodology: We reviewed recommended outcome measures from the American Physical Therapy Association’s Academy of Neurologic Physical Therapy (ANPT) Parkinson Evidence Database to Guide Effectiveness (EDGE) document and evaluated their appropriateness for remote administration. A clinical decision tree was created to streamline the examination process, incorporating elements of the ANPT movement analysis of tasks as a movement screen. The examination battery was then conducted on three PwP and evaluated for safety and feasibility. Conclusion: This physical therapy telehealth examination battery provides physical therapists with a method to conduct safe and efficient remote assessments for PwP
An Examination of Occupational Therapy Telehealth Service Delivery Among Novice Users During the COVID -19 Pandemic
Full text linkThe COVID -19 pandemic allowed for widespread implementation of telehealth as a delivery method for occupational therapy (OT) services. The purpose of this study was to investigate the perceptions of novice telehealth OT practitioners regarding telehealth as a delivery method for OT services. Quantitative data was collected through a modified version of the Telehealth Usability Questionnaire and analyzed via descriptive statistics. Qualitative data was collected by open-ended questions and analyzed via thematic analysis. OT practitioners’ responses revealed four major themes: logistics of telehealth practice, role of client champions, capacity of the OT practitioner, and styles and approaches. The study revealed that OT sessions delivered via telehealth increased access to clients and continuity of services. Client champion engagement, effective coaching strategies, and practitioner flexibility supported the success of OT telehealth sessions