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Bridging the Access Gap: The Telepractice Experience of Speech Therapists and Audiologists at a Public Health Care Facility in South Africa
Full text linkSouth Africa is a low to middle income country (LMIC) with a population of 60 million people. The public health sector serves more than 80% of the population. Chris Hani Baragwanath Academic Hospital is a central level public health care facility situated in Gauteng. The Speech Therapy and Audiology Department provides insight into their telepractice services through a qualitative approach. The onset of the COVID-19 pandemic resulted in therapists exploring telepractice as a sustainable model of service delivery. Therapists and patients encountered many challenges to the implementation of telepractice, however, the commitment of therapists ensured that creative solutions were developed. A comprehensive needs analysis at public health institutions is required to ensure the sustainability of telepractice. A hybrid model (telepractice and in-person consults) holds the potential to reduce the financial burden on patients and increase access to quality patient- centered care
Comparison of Goal Achievement When Transitioning from In-Person Therapy to Teletherapy in the Westchester County Early Intervention Program Due to the COVID-19 Pandemic
Full text linkThe sudden transition to virtual therapeutic services during the COVID-19 pandemic provided a unique opportunity to explore telehealth as a platform for delivering early intervention (EI) services. Through retrospective chart review of 93 children, we collected the following data: demographics, diagnosed conditions, therapy type, service format, and provider-reported participant goal achievement (1=no progress, 2=little progress, 3=moderate progress, 4=great deal of progress, 5=outcome achieved) over a six-month period before and after transitioning to telehealth. Pre- and post-transition progress scores were compared using the Wilcoxon signed-rank test. Results demonstrated maintained progress among children who transitioned from in-person to virtual services for similar therapy types. Children receiving speech therapy in-person and virtually demonstrated increased achievement (3.00 vs 3.33; p=0.032). Participants receiving a particular therapy post-transition but not in-person attained similar achievement as those who received the same therapy only in-person. Our research suggests that teletherapy may be a viable option for delivering EI services.
 
Supervising Students During a Global Pandemic: Clinical Educators’ Perceptions of a Student-Led Telerehabilitation Service During COVID-19
No full textScope: In March 2020, COVID-19 restrictions prompted services delivered by student-led clinics in the university sector to transition to telehealth. This provided a unique opportunity to explore the challenges and opportunities faced by clinical educators when supervising students to deliver telehealth. Methodology: Semi-structured interviews were conducted with allied health clinical educators who supervised students on clinical placement who were required to provide services via telehealth. Clinical educators across the disciplines of audiology, occupational therapy, physiotherapy, and speech pathology were asked to reflect on their experiences and perceptions of the rapid transition to a telehealth model for student clinical placements. A content analysis approach was used to analyse qualitative data. Conclusions: From the perspective of clinical educators, student-led telehealth services can effectively meet client needs while achieving student learning outcomes. This study highlights many opportunities for student learning via telehealth in the clinical education environment and the role of the clinical educator in the learning experience
Benefits and Challenges of Telerehabilitation Use By Pediatric Physiotherapists During the COVID-19 Pandemic In Western and Southern India: A Cross Sectional Survey
Full text linkAs the worldwide COVID-19 pandemic spread, many physiotherapists chose telerehabilitation (TR) to continue delivering therapy. This study was conducted to document the perceived benefits and challenges of TR faced by pediatric physiotherapists in western and southern India. Using the snowball method, electronic survey forms were distributed to 275 pediatric physiotherapists in Western and Southern India; 110 responses were available for analysis. A majority of respondents had experience with TR (n=83, 75.5%), while others had never used TR (n=27, 24.5%). TR was reported to be less effective than in-person therapy for treating children and adolescents during the COVID-19 pandemic. Therapists reported significant difficulties during TR sessions; these included assessing and modifying exercises for children. As the popularity of TR grows, pediatric physiotherapists will need to be aware of the benefits and challenges they will face during TR sessions. Most pediatric physiotherapists believed the interaction between parents and therapists is a requisite for optimal service delivery
A Special Issue For Challenging Circumstances
Full text linkThis Editor's Note explains the circumstances of this Special Issue -- a research article received from the V.M. Glushkov institute of Cybernetics of the National Academy of Sciences of Ukraine, Kyiv, Ukraine. Information about the author team is also included
The Effectiveness of Telerehabilitation on Balance and Functional Mobility in Patients with Stroke: A Systematic Review and Meta-Analysis
Full text linkObjective: The aim of this systematic review and meta-analysis was to investigate the effectiveness of telerehabilitation on improving balance and functional mobility in stroke survivors. Methods: Comprehensive searching was conducted from inception to May 2022. The inclusion criteria were studies evaluating the effectiveness of telerehabilitation in stroke survivors. Data regarding participants, intervention, outcome measures, and main results were extracted. PEDro scale and the Grading of Recommendations Assessment Development and Evaluation (GRADE) were used to assess the methodological quality and quality of evidence, respectively. Data Analysis: A total of fourteen articles )594 patients) were included. A meta-analysis using a random-effect model was performed on thirteen studies )530 patients). Standardized mean difference (SMD) with 95% confidence interval (CI) was calculated for balance and functional mobility. Results: PEDro scale revealed ten good-quality studies, three fair-quality studies, and one poor-quality study. According to the available evidence, telerehabilitation has a small effect size in improving both balance (SMD 0.33 [95% CI 0.03 to 0.63]; P =0.03; low quality of evidence) and functional mobility (SMD 0.27 [95% CI 0.02 to 0.52]; P =0.03; low quality of evidence). Conclusion: Telerehabilitation may improve balance and functional mobility in stroke survivors. However, it is evident that more high-quality research is required due to the existence of low to very low-quality evidence with limited confidence in the effect estimate. Registration: PROSPERO registration number (CRD42022306410)
Telehealth For Individuals with Parkinson’s Disease During Covid-19 In Brazil: A Prospective Case Series
Full text linkObjective: To implement a telerehabilitation prevention, treatment, and follow-up physical therapy protocol for monitoring individuals with Parkinson´s disease (PD) and to verify its effectiveness in minimizing the deleterious effects of the COVID-19 pandemic. Design: Prospective case series, involving 40 participants with mild to moderate PD recruited from a specialized neurorehabilitation group. The study was divided into four parts: (1) Phone calls to assess the feasibility of participating in remote physical therapy. (2) Social media training. (3) Baseline and post-intervention assessment for functional lower extremity strength, fear of falling, quality of life, depression, anxiety, activities of daily living, verbal fluency. (4) Intervention protocol consisting of 20 remote weekly physical therapy sessions, graphic material for physical and cognitive training, social activities, and education. Conclusion: The telerehabilitation protocol was viable and effective for patients with PD as an alternative to in-person treatment during the COVID-19 pandemic
Capacity Building Using Digital Technology for Occupational Therapists and Caregivers in Pakistan: A Participatory Action Research Approach
Full text linkThis paper describes the development and implementation of a telehealth system in Pakistan to build capacity of healthcare service providers and caregivers of children with developmental disabilities. An asynchronous telehealth system, in the form of a web app, improved therapy-related communication between the therapists and caregivers, thus enabling capacity building through sustained communication among the stakeholders. Participatory Action Research (PAR) identified barriers associated with communication, knowledge transfer, and caregiver learning. Data were collected via observations, interviews, focus groups, and field notes. The experiences of therapists and caregivers were analyzed to design and develop a system that works as a learning mechanism for caregivers in their native languages. The system also addresses socio-economic, geographic, and communication barriers as well as pandemic-imposed obstacles
Editors' Note
Full text linkThe International Journal of Telerehabilitation (IJT) is a biannual journal dedicated to advancing telerehabilitation by disseminating peer-reviewed information about current research and practices. IJT is indexed by PubMed and Scopus.
IJT is published via the open journal system (OJS) and sponsored by the University of Pittsburgh’s Office of Scholarly Communication and Publishing at the University Library System. This institutional support enables IJT to be subscription free and require no author fees.
The current issue of the multi-disciplinary IJT features impactful research across rehabilitation disciplines. As context, COVID-19, a global pandemic, even with the availability of vaccines, is still dramatically affecting healthcare worldwide to greater or lesser degrees, as well as the global economy. Submissions to IJT continue to increase, ostensibly to document how telerehabilitation is meeting these challenges. We regret that we are unable to publish the high volume of articles that are being submitted. Instead, we strive to promptly suggest other placements for work that is not central to the mission of the journal (i.e., telerehabilitation) or relevant to the larger IJT audience
Letter to the Editor – Update from Ukraine: Rehabilitation and Research
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 clinical research team is currently rehabilitating the military personnel of the Defense Forces of Ukraine with combat stress reaction and post-traumatic stress disorder using hybrid e-rehabilitation methods and techniques. Current research in the field of digital health and IoMT in Ukraine is creating innovative information technology for computerized electrocardiography. The conduct of rehabilitation and research in an active war zone with safety concerns, limited resources for research, and intermittent loss of power and water is very challenging.