310 research outputs found
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Quality of Life in Patients With Heart Failure Assisted By Telerehabilitation: A Systematic Review and Meta-Analysis
Full text linkIntroduction: Heart failure (HF) is a syndrome that implies several physical and emotional changes that compromise quality of life. Telerehabilitation is a strategy developed with the aim of involving and motivating cardiac patients to participate in cardiac rehabilitation in their daily routine at home. Objective: To review the impact of telerehabilitation on the quality of life of patients with HF. Methods: This is a systematic review using the PICO strategy, with a search conducted in the electronic data sources PubMed, LILACS (Latin American and Caribbean Literature in Health Sciences) and SciELO (Scientific Electronic Library Online), with the following descriptors: heart failure, congestive heart failure, chronic heart failure, distance rehabilitation, virtual rehabilitation, telerehabilitation, telemedicine, quality of life and HRQoL, combined by the Boolean operators “AND” and “OR”, including articles between 2011 and 2021. Results: Nine articles were found after reading the abstract and titles; five of these met the inclusion criteria. They showed that telerehabilitation contributes to a better quality of life due to the daily increase in mental, social, and sexual activities, exercise tolerance, improvement of symptoms such as edema, fatigue, and dyspnea and reduction of mortality and readmission rates. Telerehabilitation was effective in improving quality of life in patients with HF (mean difference (MD) = -0,22; CI 95% -0.40 to 0.04. Conclusion: Telerehabilitation was at least as effective as usual care and conventional cardiac rehabilitation in improving the quality of life in patients with HF
Feasibility and Perception of a Diet and Exercise Intervention Delivered via Telehealth to Firefighters
Full text linkIntroduction: Firefighters have a high risk of cardiovascular incidence due to their poor health, fitness, and dietary habits. The purpose of this study was to examine the feasibility of a diet and exercise intervention within firefighters delivered exclusively via telehealth to help reduce the risks of cardiovascular disease. Additionally, the firefighters’ perception of their health was assessed. Methods: Fifteen firefighters participated in a six-week Mediterranean diet and a functional circuit exercise intervention with pre- and post-fitness testing and survey completion. The firefighters had weekly video calls with their telehealth coach. Results: Self-assessed health improved with the intervention from an average of 5.9 to 7.9 out of 10. Both weight and BMI significantly decreased with the intervention. Overall, firefighters had high adherence to both portions of the intervention. Discussion: Telehealth interventions may be efficacious in improving firefighter fitness levels and overall health as firefighters saw positive health and fitness improvements.
 
Feasibility of Virtual Assessment of Physical Frailty in Solid Organ Transplant Recipients – A Single Centre, Observational Study
Full text linkObjectives: To describe the feasibility of virtual assessments of physical frailty in solid organ transplant (SOT) recipients using a modified Fried Frailty Index (mFFI) and Short Physical Performance Battery (SPPB), and to describe the prevalence of frailty 12-months post-transplant using virtual assessment. Methods: Virtual assessments were performed using an e-questionnaire and a video-call for functional tests. Feasibility variables included: internet quality, video-call duration, presence of a companion, and adverse events. Results: 34 SOT recipients, median age 62 (46-67), 76% lung recipients, 47% female, were included. The video-call had a median duration of 12 minutes (10-15 min), without adverse events. A companion was present in 23 (68%) video-call assessments. Fifteen SOT recipients (44%) were classified as pre-frail by the mFFI, and none were frail. Three participants (8.8%) were classified as frail using the SPPB. Conclusion: Virtual frailty assessments can be used as an alternative to in-person assessments in SOT recipients
COVID-19 Lessons From The Field: Toward A Pediatric Physical Therapy Telehealth Framework
Full text linkIntroduction: Telehealth is an established health service delivery method, yet little is known regarding pediatric physical therapy telehealth. We aimed to evaluate users’ experiences and create a framework for effective delivery. Methods: A pediatric physical therapists’ telehealth user survey was conducted. Results: Seventy-three respondents varied in years of experience and caseload. Most found telehealth easy to learn and use, and they believed the treatment they delivered was useful. Three main themes for successful treatments emerged and were organized into a framework for effective delivery: (1) caregivers’ involvement; (2) therapist telehealth ‘toolbox’ (sub-divided into: treatment management tools, and therapist-caregivers’ collaboration tools); and (3) telehealth client (child) characteristics. Conclusion: This study suggests a new framework for effective pediatric physical therapy telehealth delivery to support best practice, for use by administrators and therapists and recommends directions for further research
Telehealth Service Delivery in Medicaid Home- and Community-Based Services for People with Intellectual and Developmental Disabilities
Full text linkMedicaid Home- and Community-Based Services (HCBS) 1915(c) waivers are the largest funding mechanism for Long-Term Supports and Services (LTSS) for people with intellectual and developmental disabilities (IDD) in the United States. This study’s aim was to examine telehealth service provision in Medicaid HCBS waivers for people with IDD. We analyzed fiscal year 2021 Medicaid HCBS waivers for people with IDD and emergency Appendix K authorizations (2020-2022) to examine permanent and temporary use of telehealth respectively. The overwhelming majority of waivers (98.1%) temporarily permitted the use of telehealth service delivery for people with IDD. However, only a fraction (27.6%) permanently included the use of telehealth for people with IDD. The most prevalent types of services that permitted telehealth service delivery were: employment, day, and prevocational services; clinical and therapeutic services; and in-home and residential supports. When developing and implementing telehealth, it is important to consider the needs of people with IDD
Does the Integration of Telehealth into Occupational Therapy Practice Impact Clinical Outcomes for Hand and Upper Limb Rehabilitation? A Matched Case Control Study
Full text linkHealth services are capitalizing on the rise of telehealth and seeking to develop sustainable models incorporating telehealth into standard care. Further research is required to explore the service and clinical outcomes of telehealth in occupational therapy hand and upper limb practice. This research utilized a case-control study to explore the feasibility and clinical outcomes of case matched patients who received a telehealth hybrid model versus traditional in-person care. One hundred and two patients were recruited (n=51 in the controls and cases) with a mean age of 45 years. Telehealth was not inferior to standard care with no significant increase in therapy time (p=0.441) or length of referral (p=0.047). There was no difference in clinical adverse events (p=0.741). Patients who received telehealth had significantly less withdrawals from the service (p = 0.031). Patient and therapist satisfaction were high, supporting the ongoing use and continued implementation of telehealth in occupational therapy
Improving Functional Communication Outcomes in Post-Stroke Aphasia via Telepractice: An Alternative Service Delivery Model for Underserved Populations
Full text linkMany persons with aphasia (PWA) have limited access to speech-language treatment (SLT) due to limited funding, speech-language pathologist shortages, geographical barriers, physical disabilities, transportation barriers, and COVID-19 pandemic. The purpose of this study was to determine if telepractice is an effective and feasible service delivery model for PWA. Ten PWA completed 8 hours of remote treatment over 4 weeks. Synchronous telepractice sessions employed Oral Reading for Language in Aphasia (ORLA) and Conversational Script Training (CST). Pre- and post-assessment outcome measures included the Communication Activities of Daily Living-3 (CADL-3) and the Communication Confidence Rating Scale for Aphasia (CCRSA). Participants completed a telepractice satisfaction survey following post-assessment. All participants demonstrated improvements in CCRSA scores, total words produced correctly on trained CST stimuli, and total words produced correctly on trained ORLA stimuli. No differences were noted in CADL-3 scores. All participants were highly satisfied with telepractice as a service delivery model.
The Implementation of Teleconsultations in a Physiotherapy Service During COVID-19 Pandemic in Brazil: A Case Report
Full text linkIntroduction: The Brazilian Council of Physiotherapy and Occupational Therapy regulated the use of teleconsultation during the COVID-19 pandemic, creating uncertainty about its use in Brazil. Objective: To describe the experience of teleconsultations during the COVID-19 pandemic. Methods: Four patients participated in the study with the following diagnoses: Parkinson’s disease, stroke, peripheral facial paralysis, and tibial plateau fracture. Patients underwent up to 10 physiotherapy sessions via digital tools. The 5-A self-management tool (Assess, Advise, Agree, Assist, Arrange) guided the sessions. Results: The teleconsultation type varied between synchronous (n = 1; 25%); asynchronous (n = 2; 50%) and synchronous/asynchronous (n = 1; 25%). There was 75% (n = 3) adherence and one withdrawal (25%). As the benefits of teleconsultations, the patients pointed out the convenience, maintenance of the exercises, and contact with the professional. The reported limitations were the lack of the use of physiotherapeutic devices. Conclusion: Teleconsultations contribute to the continuity of physiotherapy treatment during social isolation. Adherence to treatment was facilitated by access to the technology and by offering patients the choice of teleconsultation type.
 
Keeping PACE With 21st Century Healthcare: A Framework for Telehealth Research, Practice, and Program Evaluation in Occupational Therapy
Full text linkThe use of telehealth to deliver occupational therapy services rapidly expanded during the COVID-19 pandemic. There are frameworks to evaluate services delivered through telehealth; however, none are specific to occupational therapy. Therefore, occupational therapy would benefit from a framework to systematically evaluate components of telehealth service delivery and build evidence to demonstrate the distinct value of occupational therapy. The PACE Framework outlines four priority domains to address areas of need: (1) Population and Health Outcomes; (2) Access for All Clients; (3) Costs and Cost Effectiveness; and (4) Experiences of Clients and Occupational Therapy Practitioners. This article describes the development and expert reviewer evaluation of the PACE Framework. In addition, the PACE Framework’s domains, subdomains, and outcome measure examples are described along with future directions for implementation in occupational therapy research, practice, and program evaluation. 
Telerehabilitation for Post-Hospitalized COVID-19 Patients: A Proof-of-Concept Study During a Pandemic
Full text linkPurpose: Telerehabilitation could prevent sequelae from COVID-19. We aimed to assess the feasibility of telerehabilitation; describe pulmonary and functional profiles of COVID-19 patients; and explore the effect of telerehabilitation on improving pulmonary symptoms and quality of life. Methods: We conducted a pre-experimental, pre-post pilot study. We recruited COVID-19 patients who had returned home following hospitalization. The intervention included eight weeks of supervised physiotherapy sessions. We documented technological issues, success of recruitment strategies, and participants’ attendance to supervised sessions. We measured the impact of pulmonary symptoms on quality of life and functional health. Results: We scheduled 64 supervised sessions with seven participants with few technological issues. Initial scores showed that pulmonary symptoms moderately to highly impacted quality of life. At eight weeks, all patients had improved from 10 to 45 points on the EuroQol-Visual Analog Scale (EQ-VAS) instrument, indicating clinical significance. Conclusion: We developed and administered a telerehabilitation intervention during a global pandemic that targets key symptoms of the relevant disease