310 research outputs found
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Clinicians' Perspectives of a Novel Home-based Multidisciplinary Telehealth Service for Patients with Chronic Spinal Pain
Full text linkChronic spinal pain conditions can often be successfully managed by a non-surgical, multidisciplinary approach, however many individuals are unable to access such specialised services within their local community. A possible solution may be the delivery of care via telerehabilitation. This study aimed to evaluate clinicians’ perspectives on providing clinical care via telerehabilitation during the early implementation of a novel spinal telerehabilitation service. Eight clinicians’ were recruited, completing surveys at four separate time points. Confidence in providing treatment via telerehabilitation significantly improved with time (?2(3)=16.22, p=0.001). Clinicians became significantly more accepting of telerehabilitation being a time- (?2(3)=11.237, p=0.011), and cost-effective (?2(3)=9.466, p=0.024) platform in which they could deliver care. Overall satisfaction was high, with technology becoming easier to use (p=0.026) and ability to establish rapport significantly improved with experience (p=0.043). Understanding clinicians’ perspectives throughout the early implementation phase of a new telerehabilitation service is a critical component in determining long-term sustainability.
State Occupational and Physical Therapy Telehealth Laws and Regulations: A 50-State Survey
Full text linkThe Center for Connected Health Policy conducted a scan of current state policy affecting occupational therapy (OT) and physical therapy (PT) practice, supervision, and additional requirements for using telehealth. While most states have established telehealth policies for other health care professions, this 50-state scan shows that many states made some reference to telehealth practice for OT (37 states) and PT (40 states). The states that adopted these policies also tended to adopt them in either law or regulation, but not both, and showed no discernable patterns favoring either. Additionally, eight states included OT and PT within telehealth laws that concurrently apply to multiple health professions. More commonly, states enacted policy within laws or regulations specific to OT and PT. Most policies including limitations on telehealth practice for OT and PT did not appear to create requirements that are more restrictive than what is generally seen in telehealth across all states
Telerehabilitation in Multiple Sclerosis: Results of a Randomized Feasibility and Efficacy Pilot Study
Full text linkA prospective, randomized, three-arm, evaluator blinded study to demonstrate the feasibility of a telerehabilitation (TR) program in individuals with ambulatory deficits secondary to Multiple Sclerosis (MS) and evaluate its efficacy when compared to conventional on-site physical therapy (PT) was completed. Thirty participants were evaluated at baseline and randomized to one of three groups with intervention lasting 8 weeks: Group 1 (control)- customized unsupervised home-based exercise program (HEP) 5 days a week; Group 2 (TR)- remote PT supervised via audio/visual real-time telecommunication twice weekly; Group 3 (PT)- in-person PT at the medical facility twice weekly. Outcomes included patient reported outcomes (PROs) obtained through questionnaires, and measurements of gait and balance performed with bedside tests and a computerized system. Functional gait assessment improved from baseline in all three groups. There were no significant differences between the TR and the conventional PT groups for a variety of outcome measures. TR is a feasible method to perform PT in persons with MS and has comparable efficacy to conventional in-person PT as measured by patient reported outcomes and objective outcomes of gait and balance
What is Important in E-health Interventions for Stroke Rehabilitation? A Survey Study among Patients, Informal Caregivers, and Health Professionals.
Full text linkIncorporating user requirements in the design of e-rehabilitation interventions facilitates their implementation. However, insight into requirements for e-rehabilitation after stroke is lacking. This study investigated which user requirements for stroke e-rehabilitation are important to stroke patients, informal caregivers, and health professionals. The methodology consisted of a survey study amongst stroke patients, informal caregivers, and health professionals (physicians, physical therapists and occupational therapists). The survey consisted of statements about requirements regarding accessibility, usability and content of a comprehensive stroke e-health intervention (4-point Likert scale, 1=unimportant/4=important). The mean with standard deviation was the metric used to determine the importance of requirements. Patients (N=125), informal caregivers (N=43), and health professionals (N=105) completed the survey. The mean score of user requirements regarding accessibility, usability and content for stroke e-rehabilitation was 3.1 for patients, 3.4 for informal caregivers and 3.4 for health professionals. Data showed that a large number of user requirements are important and should be incorporated into the design of stroke e-rehabilitation to facilitate their implementation.
Script Training Using Telepractice with Two Adults With Chronic Non-fluent Aphasia
Full text linkTwo male participants with chronic (> 2 years), non-fluent aphasia and their family members participated in script training using videoconferencing. Functional scripts were developed by people with aphasia (PWA) and their family members. Accuracy of scripts was measured by total target words produced per turn. Participant 1 with Broca’s aphasia produced scripts with 0% accuracy pre-treatment and 87.5% accuracy post-treatment. Participant 2 with Transcortical Motor aphasia produced scripts with 20.2% accuracy pre-treatment and 63.5% accuracy post-treatment. Pre- and post-questionnaires for communication effectiveness and the use of telepractice for speech therapy indicated improvements in answering yes/no questions, participating in conversations with strangers, and increasing confidence and satisfaction with technology delivered treatment. The use of videoconferencing to deliver script training appears beneficial for individuals with chronic aphasia
Case Studies in Physical Therapy: Transitioning a "Hands-On" Approach into a Virtual Platform
Full text linkTechnology is expanding at an unprecedented rate. Because patients value the speed and convenience of the internet, there is an increasing demand for telemedicine. Practitioners must therefore adapt their clinical skills to evolving online technologies. This paper presents a series of three case studies in which a physical therapist first assessed and treated musculoskeletal disorders via a live, secure video. The basis of the mechanical assessment was observation of movement rather than palpation. In each case, the virtual mechanical assessment identified a specific sub-classification with a directional preference. All patients reported improvements in symptoms and function in less than four visits and all maintained a reduction in symptoms after three months. Given the “hands-off” role of the evaluator, this approach can become an effective tool in the evolving healthcare platform of telerehabilitation.
The Provider’s Experience of Delivering an Education-based Wellness Program via Telehealth
Full text linkProvider acceptance is a first step to implementing a successful telehealth program. This pilot study examined the experience of six providers delivering an education-based wellness program in a telehealth format. Providers indicated an overall positive experience with high Telehealth Usability Questionnaire (TUQ) total scores (5.6 ± 1.1) and in their comments. High TUQ subscale scores for Usefulness (6.7 ± 0.4) and Ease of Use (5.3 ± 0.3) indicated providers found the telehealth system usable. Strong relationship bonds that developed offset the reported drawback of technical issues related to connectivity and audio. Providers with a wide range of computer experience all reported synchronous remote training via phone and videoconference meetings was adequate to prepare them to deliver classes via telehealth. This research indicates motivated providers with varying technology experience can have a positive telehealth experience with customized remote support.
The Effect of Telerehabilitation on Missed Appointment Rates
Full text linkThe purpose of this study was to examine the effect of telerehabilitation on missed appointment rates in a rehabilitation clinic. Clients fail to attend scheduled appointments for a variety of reasons. Unmet appointments represent a loss of financial support as well as diminished efficiency and capacity to provide services. Speech therapy utilizing multiple appointments is most difficult to maintain during a treatment regimen. This may cause individuals to miss appointments and therefore not achieve desired results. For this study, researchers utilized an intense speech therapy technique, the Lee Silverman Voice Treatment (LSVT®) to measure compliance with scheduled appointments. Participants were randomized to either in-person treatment or telerehabilitation treatment at a site distant from the speech-language pathologist. Participants in the telerehabilitation (TR) condition completed significantly more appointments than participants in the in-person (IP) condition. When comparing results of treatment for each condition, there were no significant differences in outcome whether treated in the IP or TR condition of the study for monologue and picture description tasks, which are closely associated with conversational speech. There was a difference in the reading task with participants demonstrating significantly better post treatment results in the IP condition. The reason for this disparity is unclear and warrants further study