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Telerehabilitation in Colombia: A Country Report and Qualitative Analysis During the Covid-19 Pandemic - Perceptions of Healthcare Providers and Patients. 哥伦比亚的远程康复:在 Covid-19 大流行期间的国家报告和定性分析--医疗服务提供者和患者的看法。
IF 2.5 Q1 REHABILITATION Pub Date : 2024-06-28 eCollection Date: 2024-01-01 DOI: 10.5195/ijt.2024.6605
Sara Gabriela Pacichana-Quinayaz, Lina María Rodríguez Vélez, Daniel Sánchez Cano, Yisel Mabirlly León Sánchez, Olga Marina Hernández Orobio, Maria Ana Tovar Sánchez, Gloria Isabel Toro Córdoba, Francisco Javier Bonilla-Escobar

Given Colombia's status as a middle-income country with healthcare challenges, leveraging telemedicine could significantly benefit hard-to-reach regions, under-resourced and underserved communities. This study provides a comprehensive overview of the country's telerehabilitation landscape, exploring the clinicians' and patients' perspectives during the COVID-19 pandemic through systematic review and qualitative analysis. Sixteen therapists and three patients were identified via snowball sampling. The literature review was scarce and scattered across various topics in the country; some studies delved into specific aspects like legislative frameworks and patient outcomes from different medical specialties. The qualitative analysis demonstrates that despite the learning curve, telerehabilitation strengthens therapeutic support, enhances patient autonomy, fosters a positive patient-provider relationship, achieves treatment goals, promotes family involvement, reduces time and costs, and ensures continuity of therapy services. This study identified research gaps, challenges, and opportunities in telerehabilitation in a Latin American country. Adopting telemedicine technologies in low- and middle-income countries could significantly enhance their healthcare systems.

哥伦比亚是一个中等收入国家,面临着医疗保健方面的挑战,因此利用远程医疗可以极大地惠及难以到达的地区、资源不足和服务欠缺的社区。本研究全面概述了哥伦比亚的远程康复情况,通过系统回顾和定性分析探讨了在 COVID-19 大流行期间临床医生和患者的观点。通过 "滚雪球 "式抽样调查,确定了 16 名治疗师和 3 名患者。文献综述很少,且分散在国内的不同主题中;一些研究深入探讨了特定方面,如立法框架和来自不同医学专业的患者结果。定性分析表明,尽管存在学习曲线,但远程康复加强了治疗支持,提高了患者的自主性,促进了积极的患者-提供者关系,实现了治疗目标,促进了家庭参与,减少了时间和成本,并确保了治疗服务的连续性。这项研究确定了拉丁美洲国家在远程康复方面的研究差距、挑战和机遇。在中低收入国家采用远程医疗技术可以极大地改善这些国家的医疗保健系统。
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引用次数: 0
Digital Technology Enablers of Tele-Neurorehabilitation in Pre- and Post-COVID-19 Pandemic Era - A Scoping Review. COVID-19 大流行前后远程神经康复的数字技术推动因素--范围研究。
IF 2.5 Q1 REHABILITATION Pub Date : 2024-06-28 eCollection Date: 2024-01-01 DOI: 10.5195/ijt.2024.6611
Mohy Uddin, Krishnan Ganapathy, Shabbir Syed-Abdul

Neurorehabilitation (NR), a major component of neurosciences, is the process of restoring a patient's damaged/disorganized neurological function, through training, therapy, and education, while focusing on patient's independence and well-being. Since the advent of the COVID-19 pandemic, various applications of telecare and telehealth services surged drastically and became an integral part of current clinical practices. Tele-Neurorehabilitation (TNR) is one of such applications. When rehabilitation services were disrupted globally due to lockdown and travel restrictions, the importance of TNR was recognized, especially in developed, low, and middle-income countries. With exponential deployment of telehealth interventions in neurosciences, TNR has become a distinct stand-alone sub-specialty of neurosciences and telehealth. Digital technologies, such as wearables, robotics, and Virtual Reality (VR) have enabled TNR to improve the quality of patients' lives. Providing NR remotely using digital technologies and customized digital devices is now a reality, and likely to be the new norm soon. This article provides an overview of the needs, utilization, and deployment of TNR, and focuses on digital technology enablers of TNR in pre- and post-COVID-19 pandemic era.

神经康复(NR)是神经科学的重要组成部分,是通过训练、治疗和教育恢复患者受损/受损神经功能的过程,同时关注患者的独立性和福祉。自 COVID-19 大流行以来,远程护理和远程保健服务的各种应用急剧增加,成为当前临床实践中不可或缺的一部分。远程神经康复(TNR)就是其中之一。当全球范围内的康复服务因封锁和旅行限制而中断时,人们认识到了 TNR 的重要性,尤其是在发达国家、低收入国家和中等收入国家。随着远程保健干预在神经科学领域的迅速发展,TNR 已成为神经科学和远程保健的一个独特的独立子专业。可穿戴设备、机器人和虚拟现实(VR)等数字技术使 TNR 能够改善患者的生活质量。利用数字技术和定制的数字设备远程提供 NR 现在已成为现实,而且很可能很快就会成为新常态。本文概述了 TNR 的需求、使用和部署情况,并重点介绍了 COVID-19 大流行前后 TNR 的数字技术推动因素。
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引用次数: 0
Optimizing Telepractice Selection and Implementation for Persons with Aphasia. 为失语症患者优化远程诊疗的选择和实施。
IF 2.5 Q1 REHABILITATION Pub Date : 2024-06-28 eCollection Date: 2024-01-01 DOI: 10.5195/ijt.2024.6604
Elizabeth O Tibus, Maryanne Weatherill, Amy D Rodriguez

Telepractice is used to conduct many aspects of healthcare, including rehabilitation and research. However, information regarding how to identify optimal candidates and overcome barriers to participating in telepractice are limited. In the context of aphasia rehabilitation research, we developed two tools for optimizing telepractice: (1) the Participant Technology Questionnaire (PTQ), an aphasia-friendly tool for gathering information about potential telepractice participants; and (2) the Virtual-Appropriate Decision Approach (VADA), a framework for assessing and modifying methods that support virtual activities. The PTQ provides valuable information about the effects of human, technology and setting influences that may impact the success of transitioning activities to a virtual format, while the VADA takes findings from the PTQ one step further into application. The PTQ and the VADA can help researchers and clinicians with planning and directing virtual engagement, and both tools have potential to be applied broadly in all areas of telepractice.

远程实践被用于开展医疗保健的许多方面,包括康复和研究。然而,有关如何确定最佳人选和克服参与远程实践的障碍的信息却很有限。在失语症康复研究方面,我们开发了两种优化远程实践的工具:(1) 参与者技术问卷 (PTQ),这是一种适合失语症患者的工具,用于收集潜在远程实践参与者的信息;(2) 虚拟适当决策方法 (VADA),这是一种评估和修改支持虚拟活动方法的框架。PTQ 提供了有关人类、技术和环境影响因素的宝贵信息,这些因素可能会影响将活动成功过渡到虚拟形式,而 VADA 则将 PTQ 的结论进一步应用于实践。PTQ 和 VADA 可以帮助研究人员和临床医生规划和指导虚拟参与,这两种工具都有可能广泛应用于远程实践的各个领域。
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引用次数: 0
The Delphi Method: Developing a Telerehabilitation Practice Guideline for Patients in Indonesia with Long COVID. 德尔菲法:为印度尼西亚的长COVID患者制定远程康复实践指南。
IF 2.5 Q1 REHABILITATION Pub Date : 2024-06-28 eCollection Date: 2024-01-01 DOI: 10.5195/ijt.2024.6610
Nurul Paramita, Dewi Irawati Soeria Santoso, Nury Nusdwinuringtyas, Menaldi Rasmin, Neng Tine Kartinah, Sri Widia A Jusman, Murdani Abdullah, Damayanti Tinduh, Siti Chandra Widjanantie, Melinda Harini, Imelda Rosalyn Sianipar, Boya Nugraha, Christoph Gutenbrunner, Sandra Widaty

Telerehabilitation has the potential to help expand the reach of rehabilitation intervention. An online questionnaire-based Delphi method set out to develop a telerehabilitation guideline for patients in Indonesia with Long COVID. A Delphi panel comprised of 24 experts was selected from all relevant disciplines. Over two rounds of Delphi testing, panelists gave opinions and indicated their level of agreement with each recommendation. Key elements of consensus for a telerehabilitation guideline for patients with Long COVID includes: the benefit of telerehabilitation, types of rehabilitation intervention needed, methods of intervention, criteria for home-based self-exercise training, set-up of rehabilitation prescription, exercise monitoring, evaluation of rehabilitation intervention and duration of rehabilitation intervention. Further research is needed to determine the feasibility and effectiveness of this guideline.

远程康复有望帮助扩大康复干预的覆盖范围。通过基于在线问卷的德尔菲法,为印度尼西亚的长COVID患者制定了远程康复指南。德尔菲小组由 24 名来自各相关学科的专家组成。在两轮德尔菲测试中,小组成员发表了意见,并表明了他们对每项建议的同意程度。针对长COVID患者的远程康复指南达成共识的主要内容包括:远程康复的益处、所需康复干预的类型、干预方法、家庭自我锻炼训练的标准、康复处方的设定、锻炼监测、康复干预的评估和康复干预的持续时间。要确定该指南的可行性和有效性,还需要进一步的研究。
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引用次数: 0
"This Is Going To Be Different, But It's Not Impossible": Adapting To Telehealth Occupational Therapy For Autistic Children. "这会有所不同,但并非不可能":自闭症儿童适应远程医疗职业疗法。
IF 2.5 Q1 REHABILITATION Pub Date : 2024-06-28 eCollection Date: 2024-01-01 DOI: 10.5195/ijt.2024.6608
Amber M Angell, Elinor E Taylor, Joana Nana Serwaa Akrofi, Elaine D Carreon, Marshae D Franklin, Julie Miller, Catherine Crowley, Shona Orfirer Maher

This 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.

这项定性研究考察了参与者在 COVID-19 大流行期间为自闭症儿童过渡到远程医疗儿科职业治疗的经历。在 7 个月的时间里,我们采访了来自洛杉矶地区三家诊所的三名诊所管理人员、四名职业治疗师和六名自闭症儿童家长(人数=13)。通过叙事和主题分析,我们得出了三大主题:转变性体验、重新认识治疗和继续前进。总体而言,我们发现向远程医疗的过渡改变了参与者对自身、人际关系和职业治疗性质的固有观念。许多人加深了他们之间的关系;调整了干预措施;发现了令人惊讶的能力;并挑战了职业治疗现状,倡导持续提供虚拟服务。我们的研究结果与当前关于远程医疗提供的职业疗法在流行病后的可行性的大量文献具有相关性。
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引用次数: 0
The Development and Pilot Testing of a Fidelity Checklist for a Family-Centered Telehealth Intervention for Parents of Children with Motor Delay. 为运动发育迟缓儿童的家长开发和试点测试以家庭为中心的远程医疗干预的忠实性检查表。
IF 2.5 Q1 REHABILITATION Pub Date : 2024-06-28 eCollection Date: 2024-01-01 DOI: 10.5195/ijt.2024.6603
Karen Hurtubise, Michelle Phoenix, Chantal Camden, Raphaëlle Gauthier, Paul Stratford, Rosalie Dostie, Audrée Jeanne Beaudoin, Désirée Maltais, Jade Berbari, Isabelle Gaboury

This multi-methods study describes the development of a pediatric rehabilitation telehealth intervention fidelity checklist, estimates its inter-rater reliability, and documents raters' implementation experience. A literature scan and expert consultation identified eighteen key behaviors and categorized them into three subdomains, measured using a 5-point measurement system. To estimate the checklist's inter-rater reliability, three raters scored 33 video recordings. A Shrout and Fleiss Class 1,1 intraclass correlation (ICC)) and 95% confidence intervals (CI) calculated ICCs = 0.5 (CI: 0, 0.9) for both the Therapist and the Parent-Therapists subdomains, and the Parent subdomain an ICC = 0.3 (CI: 0, 0.8). In the implementation surveys, raters reported high levels of satisfaction (100%), ease of use (84% to 88%), and confidence in their video ratings (87% to 100%). Changes in procedures and scoring were recommended. Capturing raters' implementation experiences is crucial in the early evaluation of the fidelity checklists for telehealth.

这项多方法研究描述了儿科康复远程保健干预忠实性检查表的开发过程,估计了其评分者之间的可靠性,并记录了评分者的实施经验。通过文献扫描和专家咨询,确定了 18 种关键行为,并将其分为三个子域,使用 5 点测量系统进行测量。为了评估核对表的评分者之间的可靠性,三名评分者对 33 份视频记录进行了评分。根据 Shrout 和 Fleiss Class 1,1 类内相关性(ICC)和 95% 置信区间(CI)计算,治疗师和家长-治疗师子域的 ICC = 0.5(CI:0,0.9),家长子域的 ICC = 0.3(CI:0,0.8)。在实施情况调查中,评分者的满意度(100%)、易用性(84% 到 88%)和对视频评分的信心(87% 到 100%)都很高。建议对程序和评分进行修改。掌握评分者的实施经验对于远程医疗保真度检查表的早期评估至关重要。
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引用次数: 0
Corrections to: Hirunwiwatkul, P., Pongpanich, P., Tulvatana, W., Jariyakosol, S., Phuenpathom, W., Krittanupong, S., Chonramak, R., Pichedvanichok, T., Bhidayasiri, R., Nimnuan, C. (2023). Evaluation of psychometric properties of Thai version Telehealth Usability Questionnaire (T-TUQ), International Journal of Telerehabilitation, 15(2), 1-14. https://doi.org/10.5195/ijt.2023.6577. Corrections to:Hirunwiwatkul, P., Pongpanich, P., Tulvatana, W., Jariyakosol, S., Phuenpathom, W., Krittanupong, S., Chonramak, R., Pichedvanichok, T., Bhidayasiri, R., Nimnuan, C. (2023)。泰语版远程保健可用性问卷(T-TUQ)的心理测量特性评估》,《远程康复国际期刊》,15(2),1-14。https://doi.org/10.5195/ijt.2023.6577。
IF 2.5 Q1 REHABILITATION Pub Date : 2024-06-28 eCollection Date: 2024-01-01 DOI: 10.5195/ijt.2024.6633
Parima Hirunwiwatkul

[This corrects the article DOI: 10.5195/ijt.2023.6577.].

[此处更正了文章 DOI:10.5195/ijt.2023.6577]。
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引用次数: 0
Innovative Hybrid Cloud Solutions for Physical Medicine and Telerehabilitation Research. 物理医学和远程康复研究的创新混合云解决方案。
IF 2.5 Q1 REHABILITATION Pub Date : 2024-06-28 eCollection Date: 2024-01-01 DOI: 10.5195/ijt.2024.6635
Kyrylo S Malakhov

Purpose: 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.

目的:本研究的主要目的是开发和实施远程康复混合云环境(HCET),以加强物理医学与康复(PM&R)领域的患者护理和研究。该环境旨在整合先进的信息和通信技术,为传统的面对面治疗和数字健康解决方案提供支持:背景:远程康复正在成为现代医疗保健的核心组成部分,尤其是在物理医学与康复领域。通过应用数字医疗技术,远程康复为患者康复提供持续、全面的支持,缩小了传统治疗与远程医疗之间的差距。本研究重点关注为 PM&R 领域量身定制的混合 HCET 系统的设计和实施:研究涉及 HCET 的全面架构和结构组织的开发,包括三层模型(基础设施层、平台层、服务层)。设计并实施了 HCET 的核心组件,如 PM&R 医院信息系统(HIS)、MedRehabBot 系统和 MedLocalGPT 项目。这些组件利用先进的技术进行了整合,如大型语言模型(LLM)、词嵌入和本体相关方法,以及用于增强功能和交互的应用程序接口:HCET 系统已成功实施并投入运行,为远程康复提供了一个强大的平台。该系统的主要功能包括 PM&R HIS 的 MVP,支持患者档案管理和康复目标跟踪;MedRehabBot 和 WhiteBookBot 系统;以及 MedLocalGPT 项目,该项目提供复杂的查询功能,并可访问广泛的特定领域知识。该系统支持乌克兰语和英语,确保了广泛的可访问性和可用性:HCET 系统的实际实施和运行表明,该系统具有改变 PM&R 领域远程康复的潜力。通过整合先进技术并提供全面的数字健康解决方案,HCET 可加强对患者的护理、支持持续康复并促进高级研究。未来的工作重点是优化服务和扩大语言支持,以进一步提高系统的功能和影响力。
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引用次数: 0
Editors' Note. 编辑注
IF 2.5 Q1 REHABILITATION Pub Date : 2024-06-28 eCollection Date: 2024-01-01 DOI: 10.5195/ijt.2024.6634
Ellen R Cohn, Jana Cason
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引用次数: 0
A Comparative Analysis of Telerehabilitation and Telemedicine Utilization During the COVID-19 Pandemic in Poland: Trends, Patterns, and Implications. 波兰 COVID-19 大流行期间远程康复和远程医疗使用情况的比较分析:趋势、模式和影响》。
IF 2.5 Q1 REHABILITATION Pub Date : 2024-06-28 eCollection Date: 2024-01-01 DOI: 10.5195/ijt.2024.6627
Anna Krawczyk, Mikołaj Marszałek

The 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.

本研究旨在探讨 COVID-19 对波兰采用远程服务的影响,重点关注康复和非住院医疗环境之间的对比模式。我们对全国数据集进行了回顾性分析,以评估 2020 年至 2022 年远程医疗的使用趋势。远程服务的使用在 2020 年 4 月达到顶峰。在 2020 年 10 月至 2022 年 12 月期间,远程服务在门诊(平均 7.8%)中所占的比例远高于在康复领域(平均 0.16%)中所占的比例。尽管分析表明,COVID-19 发生率与远程保健利用率之间存在一定的关系(Spearman's rho 从 0.39 到 0.52)。我们的研究结果表明,非住院治疗和康复之间的 Spearman's rho 值在统计学上没有显著差异,这表明对大流行病浪潮的反应强度相似。我们的研究结果凸显了远程医疗服务在危机时期确保医疗服务可及性的重要性,强调了远程医疗服务在大流行相关干扰中促进医疗服务连续性的作用。这项研究有助于了解 COVID-19 大流行期间远程医疗的使用趋势,为医疗保健系统适应前所未有的挑战提供了见解。有必要开展进一步研究,以探讨远程保健使用的长期影响,并为在大流行后优化医疗保健服务的战略提供信息。
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引用次数: 0
期刊
International Journal of Telerehabilitation
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