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Special Issue "Evaluating Telerehabilitation for Patients across the Lifespan"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Digital Health".

Deadline for manuscript submissions: closed (30 November 2021).

Special Issue Editors

Dr. Dahlia Kairy
E-Mail Website
Guest Editor
School of Rehabilitation, Université de Montréal, Montreal, QC H3N 1X7, Canada;Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC H3N 1X7, Canada
Interests: technology implementation and evaluation; innovative approaches in rehabilitation; telerehabilitation and virtual reality; knowledge translation; qualitative approaches and mixed methods
Prof. Michel Tousignant
E-Mail Website
Guest Editor
School of Rehabilitation, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
Interests: telerehabilitation; teletreatment; in-home teletreatment; cost of rehabilitation
Dr. Rachel Kizony
E-Mail Website
Guest Editor
Department of Occupational Therapy, University of Haifa, Haifa 3498838, Israel
Interests: neurological rehabilitation; technology for rehabilitation; virtual reality and telerehabilitation; cognitive and functional-cognitive rehabilitation; dual-task paradigms; aging; participation in daily activities
Prof. Patrice L. (Tamar) Weiss
E-Mail Website
Guest Editor
Department of Occupational Therapy, University of Haifa, Haifa 3498838, Israel
Interests: virtual environment and co-located and online technologies to explore the effect of individual and collaborative interfaces for rehabilitation assessment and intervention

Special Issue Information

Dear Colleagues,

Digital and electronic information and communication technologies (ICTs) are becoming increasingly reliable, affordable, and more widely used, including in healthcare. Telerehabilitation can be defined as the use of ICTs to provide rehabilitation services from a distance. Telerehabilitation offers the opportunity to provide care in a new way and may improve access to quality rehabilitation services. Given recent advances in these technologies and new clinical applications, there is a need to summarize and continue to advance the existing literature in the field.

This Special Issue aims to showcase and bring together the latest research and innovations in the field of telerehabilitation. This Special Issue is open to all subjects related to telerehabilitation, including providing all aspects of rehabilitation and habilitation care from a distance (e.g., evaluation, intervention, community integration, monitoring, prevention, education) using ICTs (audio and video technologies, electronic health records, virtual reality applications, etc.). We welcome original studies and reviews including studies regarding telerehabilitation efficacy and effectiveness, economic analyses, qualitative studies, and implementation and sustainability studies across the lifespan and across rehabilitation disciplines. Studies using innovative research methods and technologies are welcomed.

Dr. Dahlia Kairy
Prof. Michel Tousignant
Dr. Racheli Kizony
Prof. Patrice L. (Tamar) Weiss
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • telerehabilitation
  • eHealth
  • mHealth
  • telemedicine
  • telehealth
  • physiotherapy
  • physical therapy
  • occupational therapy
  • speech therapy
  • telecare

Published Papers (6 papers)

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Research

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Article
Instrumental Validity of the Motion Detection Accuracy of a Smartphone-Based Training Game
Int. J. Environ. Res. Public Health 2021, 18(16), 8410; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168410 - 09 Aug 2021
Viewed by 799
Abstract
Demographic changes associated with an expanding and aging population will lead to an increasing number of orthopedic surgeries, such as joint replacements. To support patients’ home exercise programs after total hip replacement and completing subsequent inpatient rehabilitation, a low-cost, smartphone-based augmented reality training [...] Read more.
Demographic changes associated with an expanding and aging population will lead to an increasing number of orthopedic surgeries, such as joint replacements. To support patients’ home exercise programs after total hip replacement and completing subsequent inpatient rehabilitation, a low-cost, smartphone-based augmented reality training game (TG) was developed. To evaluate its motion detection accuracy, data from 30 healthy participants were recorded while using the TG. A 3D motion analysis system served as reference. The TG showed differences of 18.03 mm to 24.98 mm along the anatomical axes. Surveying the main movement direction of the implemented exercises (squats, step-ups, side-steps), differences between 10.13 mm to 24.59 mm were measured. In summary, the accuracy of the TG’s motion detection is sufficient for use in exergames and to quantify progress in patients’ performance. Considering the findings of this study, the presented exer-game approach has potential as a low-cost, easily accessible support for patients in their home exercise program. Full article
(This article belongs to the Special Issue Evaluating Telerehabilitation for Patients across the Lifespan)
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Article
Lessons Learned during a Naturalistic Study of Online Treatment for Pediatric Rehabilitation
Int. J. Environ. Res. Public Health 2021, 18(12), 6659; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126659 - 21 Jun 2021
Viewed by 889
Abstract
The COVID-19 pandemic forced many health care providers to modify their service model by adopting telehealth and tele-rehabilitation with minimal time to plan for its execution. ALYN—Pediatric Rehabilitation Hospital in Jerusalem, Israel, responded with alacrity by providing a broad range of rehabilitation services [...] Read more.
The COVID-19 pandemic forced many health care providers to modify their service model by adopting telehealth and tele-rehabilitation with minimal time to plan for its execution. ALYN—Pediatric Rehabilitation Hospital in Jerusalem, Israel, responded with alacrity by providing a broad range of rehabilitation services to young people via online therapy during the first 5 months of the pandemic. The objectives of this naturalistic study were: (1) to monitor usage and user experience of online rehabilitation provided to young people receiving out-patient sessions of physical therapy, occupational therapy, speech and language therapy and psychology and (2) to consider the advantages and disadvantages of retaining this model of online treatment in full or in part post-COVID-19. The online rehabilitation treatment program was provided to 147 young people, aged 3 months to 20 years (mean 8.5 y; SD 5.3), and monitored and evaluated via data from the medical records as well as interviews, questionnaires and focus groups. The results use descriptive and inferential statistics to analyze data on the types and frequencies of therapy provided to 147 young people. Over a five month-period, 2392 therapy sessions were provided, 61 therapists from four disciplines were involved and 56.4% of the young people received two or more types of therapies via online rehabilitation. A repeated measures ANOVA showed significant differences over time per therapy. Feedback and recommendations about the process from therapists, parents and young people were collected during two focus groups of the professional staff (n = 12), parents and young people (parents n = 5, young people n = 3). Tele-rehabilitation services were perceived to be beneficial and effective by the great majority of young people, their parents and the healthcare professionals. The results are discussed within the context of conventional therapy as well as in comparison to reports of other online services for similar populations. We conclude that a hybrid approach in which in-person therapy sessions are coordinated with synchronous, online sessions, will provide a best-case fit for young people with chronic disabilities. Full article
(This article belongs to the Special Issue Evaluating Telerehabilitation for Patients across the Lifespan)
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Article
Hybrid Tele and In-Clinic Occupation Based Intervention to Improve Women’s Daily Participation after Breast Cancer: A Pilot Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2021, 18(11), 5966; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115966 - 02 Jun 2021
Viewed by 867
Abstract
Background: Women after breast cancer (BC) cope with decreased daily participation and quality of life (QOL) due to physical, cognitive, and emotional symptoms. This study examined a hybrid occupation-based intervention, Managing Participation with Breast Cancer (MaP-BC), to improve daily participation in their meaningful [...] Read more.
Background: Women after breast cancer (BC) cope with decreased daily participation and quality of life (QOL) due to physical, cognitive, and emotional symptoms. This study examined a hybrid occupation-based intervention, Managing Participation with Breast Cancer (MaP-BC), to improve daily participation in their meaningful activities. Methods: Thirty-five women after BC phase were randomly allocated to the MaP-BC intervention (n = 18) or control (n = 17) group (standard care only). Assessments were administered at baseline (T1), 6-week (T2), and 12-week (T3) post-T1. Main outcome: perceived performance and performance-satisfaction with meaningful activities according to the Canadian Occupational Performance Measure. Secondary outcomes: retained activity levels (Activity Card Sort), QOL (Functional Assessment of Cancer Therapy-Breast), cognitive abilities (Montreal Cognitive Assessment and Behavior Rating Inventory of Executive Function), and upper-extremity functioning (Disability of Arm, Shoulder, Hand). Results showed significant interaction (group x time) effects for the primary outcome in performance, F(2,66) = 29.54, p = 0.001, ɳP2 = 0.472, and satisfaction, F(2,66) = 37.15, p = 0.000, ɳP2 = 0.530. The intervention group improved more in performance, t = 5.51, p = 0.0001, d = 1.298, and satisfaction, t = −5.32, p = 0.0001, d = 1.254, than the control group between T1 and T2. Secondary outcomes demonstrated within-group improvements. Conclusion: MaP-BC, a comprehensive occupation-based hybrid intervention tailored to women’s functional daily needs after BC, improved participation in meaningful activities within a short period. Full article
(This article belongs to the Special Issue Evaluating Telerehabilitation for Patients across the Lifespan)
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Article
Patient and Parent Experiences with Group Telerehabilitation for Child Survivors of Acute Lymphoblastic Leukemia
Int. J. Environ. Res. Public Health 2021, 18(7), 3610; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073610 - 31 Mar 2021
Cited by 1 | Viewed by 1240
Abstract
Background: Acute Lymphoblastic Leukemia (ALL) is the most common pediatric cancer. ALL and its treatment cause altered bone-mineral homeostasis, which can contribute to musculoskeletal late adverse effects (LAEs). With the increasing number of childhood cancer survivors, LAEs are reported often, and are aggravated [...] Read more.
Background: Acute Lymphoblastic Leukemia (ALL) is the most common pediatric cancer. ALL and its treatment cause altered bone-mineral homeostasis, which can contribute to musculoskeletal late adverse effects (LAEs). With the increasing number of childhood cancer survivors, LAEs are reported often, and are aggravated by inactive lifestyles. A telerehabilitation program is proposed to strengthen the muscle–bone complex and prevent future impairment. Objective: This study aimed to explore and better understand patient and parent experience of a telerehabilitation program after completion of ALL treatment. Methods: ALL survivors (n = 12), 75% girls, 7.9 to 14.7 years old, within six months to five years of treatment, were recruited to participate in the proposed study, along with a parent. The 16-week group program included 40 potential home-based physical activities, with monthly progression, supervised by a kinesiologist, through an online telerehabilitation platform. Patients could be included in the study if they joined during the first month of intervention of their group (minimum 12 weeks of intervention). A semi-structured post-intervention interview was conducted with the patients and their parent during the final assessment, along with a review of the kinesiologist’s clinical notes, to obtain a portrait of the participants’ experience with the telerehabilitation program. Overarching themes were identified by one author and confirmed by two senior authors before extracting the various aspects of each theme. Results: Of the 12 patients recruited, three were excluded from the analysis because they did not complete the minimum 12 weeks of intervention (one = relapse, one = failure to meet technical requirements, and one = abandoned due to parent’s disinterest). The nine patients who completed the program (six girls; 10.93 ± 2.83 years) had a mean adherence of 89%. The overarching themes identified were the program modalities (group approach with patient–parent paired training, supervised by a kinesiologist), the telerehabilitation system, the participants’ perception of the benefits, and recommendations and suggestions from the families. Both patients and parents expressed very high satisfaction with the program and perceived benefits. Conclusion: Participants appreciated the program and reported they would all recommend it to other families in similar situations. The telerehabilitation method of service delivery was perceived by some as decisive in choosing to participate, while the supervision and intra- and inter-family interactions were the motivating factors that were key to program adherence. Full article
(This article belongs to the Special Issue Evaluating Telerehabilitation for Patients across the Lifespan)
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Article
Transition to Multidisciplinary Pediatric Telerehabilitation during the COVID-19 Pandemic: Strategy Development and Implementation
Int. J. Environ. Res. Public Health 2021, 18(4), 1484; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18041484 - 04 Feb 2021
Cited by 4 | Viewed by 1805
Abstract
Telerehabilitation offers a unique solution for continuity of care in pediatric rehabilitation under physical distancing. The major aims of this study were to: (1) describe the development of telerehabilitation usage guidelines in a large hospital in Israel, and to (2) evaluate the implementation [...] Read more.
Telerehabilitation offers a unique solution for continuity of care in pediatric rehabilitation under physical distancing. The major aims of this study were to: (1) describe the development of telerehabilitation usage guidelines in a large hospital in Israel, and to (2) evaluate the implementation of telerehabilitation from the perspectives of healthcare practitioners and families. An expert focus group developed guidelines which were disseminated to multidisciplinary clinicians. Following sessions, clinicians filled The Clinician Evaluation of Telerehabilitation Service (CETS), a custom-built feedback questionnaire on telerehabilitation, and parents completed the client version of the Therapist Presence Inventory (TPI-C) and were asked to rate the effectiveness of sessions on an ordinal scale. Four goals of telerehabilitation sessions were defined: (1) maintenance of therapeutic alliance, (2) provision of parental coping strategies, (3) assistance in maintaining routine, and (4) preventing functional deterioration. Principal Components Analysis was used for the CETS questionnaire and the relationships of CETS and TPI-C with child’s age and the type of session were evaluated using Spearman’s correlations and the Kruskal–Wallis H test. In total, sixty-seven telerehabilitation sessions, with clients aged 11.31 ± 4.8 years, were documented by clinicians. Three components (child, session, parent) explained 71.3% of the variance in CETS. According to therapists, their ability to maintain the therapeutic alliance was generally higher than their ability to achieve other predefined goals (p < 0.01). With younger children, the ability to provide feedback to the child, grade treatment difficulty and provide coping strategies to the parents were diminished. Families perceived the therapist as being highly present in therapy regardless of treatment type. These results demonstrate a potential framework for the dissemination of telerehabilitation services in pediatric rehabilitation. Full article
(This article belongs to the Special Issue Evaluating Telerehabilitation for Patients across the Lifespan)
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Case Report
Baduanjin Qigong Intervention by Telerehabilitation (TeleParkinson): A Proof-of-Concept Study in Parkinson’s Disease
Int. J. Environ. Res. Public Health 2021, 18(13), 6990; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136990 - 30 Jun 2021
Viewed by 933
Abstract
Many people living with Parkinson’s Disease (PD) face issues with healthcare services, including delays in diagnosis and treatment, as well as limited access to specialized care, including rehabilitation programs. Non-motor and motor signs and symptoms typically observed in people with PD, such as [...] Read more.
Many people living with Parkinson’s Disease (PD) face issues with healthcare services, including delays in diagnosis and treatment, as well as limited access to specialized care, including rehabilitation programs. Non-motor and motor signs and symptoms typically observed in people with PD, such as tremor, rigidity, postural instability, bradykinesia, and freezing are particularly disabling and have been associated with falls, fractures, hospitalizations, and a worse quality of life. Baduanjin Qigong (BDJ) programs have been proven potentially effective in improving physical outcomes and reducing the incidence of falls in PD. The aim of this case report, proof-of-concept, study was to explore the adherence, feasibility, acceptability, and potential efficacy of a BDJ program offered via telerehabilitation in people with PD living in the community. Two participants performed semi-supervised exercise sessions at home, twice a week (over eight weeks) using the TeraPlus platform. Adherence, adverse events, and feasibility (technical implementability), acceptability (patient satisfaction), patient-reported, self-reported, and performance outcomes were measured. Results were based on single-subject descriptive data, minimal detectable change, and anchor-based minimally important difference. Our findings suggest that the intervention seems feasible with no major technical issues or adverse events, and high adherence; acceptable (patient satisfaction); and potentially effective to improve markers of walking performance (gait speed, balance), and quality of life (activities of daily living, mobility). Full article
(This article belongs to the Special Issue Evaluating Telerehabilitation for Patients across the Lifespan)
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