International Journal of Telerehabilitation最新文献

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.

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.

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.

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.

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.

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

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.

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.

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.