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[PMID]:28455277
[Au] Autor:Pastora-Bernal JM; Martín-Valero R; Barón-López FJ; Estebanez-Pérez MJ
[Ad] Endereço:Faculty of Health Sciences, Physiotherapy, University of Málaga, Malaga, Spain.
[Ti] Título:Evidence of Benefit of Telerehabitation After Orthopedic Surgery: A Systematic Review.
[So] Source:J Med Internet Res;19(4):e142, 2017 Apr 28.
[Is] ISSN:1438-8871
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In addition to traditional physiotherapy, studies based on telerehabilitation programs have published the results of effectiveness, validity, noninferiority, and important advantages in some neurological, cognitive, and musculoskeletal disorders, providing an opportunity to define new social policies and interventions. OBJECTIVES: The aim of this systematic review is to investigate the effects of telerehabilitation after surgical procedures on orthopedic conditions as well as to describe how interventions are designed and to determine whether telerehabilitation is comparable with conventional methods of delivery. This systematic review summarizes the levels of evidence and grades of recommendation regarding telerehabilitation intervention (synchronous or asynchronous provided via the telerehabilitation medium, either in conjunction with, or in isolation of, other treatment interventions) after surgical procedures on orthopedic conditions. METHODS: Study quality was assessed using the Physiotherapy Evidence Database (PEDro) scores and grade of recommendation following the recommendation of the Oxford Centre for Evidence-Based Medicine. RESULTS: We found 3 studies with PEDro scores between 6 and 8, which is considered as level 1 evidence (good; 20% [3/15]), 4 studies with a score of 5, which is considered as level 2 evidence (acceptable; 27% [4/15]), and the remaining 8 studies had scores of 4 or less, which is considered (poor; 53% [8/15]). A total of 1316 participants received telerehabilitation intervention in the selected studies, where knee and hip replacement were 75% of all the studies. Strong and moderate grades of evidence (grade of recommendation A-B) were found in knee and hip replacement interventions. Studies on the upper limb were 25% of the studies, but only 1 study presented a moderate grade of evidence (grade of recommendation B) and the rest were of poor methodological quality with weak evidence (grade of recommendation C). CONCLUSIONS: Conclusive evidence on the efficacy of telerehabilitation for treatment after an orthopedic surgery, regardless of pathology, was not obtained. We found strong evidence in favor of telerehabilitation in patients following total knee and hip arthroplasty and limited evidence in the upper limb interventions (moderate and weak evidence). Future research needs to be more extensive and conclusive. To the best of the authors' knowledge, this is the first attempt at evaluating the quality of telerehabilitation intervention research after surgical procedures on orthopedic conditions in a systematic review. Clinical messages and future research recommendations are included in the review.
[Mh] Termos MeSH primário: Medicina Baseada em Evidências/métodos
Ortopedia/métodos
Telemedicina/métodos
Telerreabilitação/métodos
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.2196/jmir.6836


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[PMID]:28493924
[Au] Autor:Charvet LE; Yang J; Shaw MT; Sherman K; Haider L; Xu J; Krupp LB
[Ad] Endereço:Department of Neurology, NYU School of Medicine, New York, New York, United States of America.
[Ti] Título:Cognitive function in multiple sclerosis improves with telerehabilitation: Results from a randomized controlled trial.
[So] Source:PLoS One;12(5):e0177177, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cognitive impairment affects more than half of all individuals living with multiple sclerosis (MS). We hypothesized that training at home with an adaptive online cognitive training program would have greater cognitive benefit than ordinary computer games in cognitively-impaired adults with MS. This was a double-blind, randomized, active-placebo-controlled trial. Participants with MS were recruited through Stony Brook Medicine and randomly assigned to either the adaptive cognitive remediation (ACR) program or active control of ordinary computer games for 60 hours over 12 weeks. Training was remotely-supervised and delivered through a study-provided laptop computer. A computer generated, blocked stratification table prepared by statistician provided the randomization schedule and condition was assigned by a study technician. The primary outcome, administered by study psychometrician, was measured by change in a neuropsychological composite measure from baseline to study end. An intent-to-treat analysis was employed and missing primary outcome values were imputed via Markov Chain Monte Carlo method. Participants in the ACR (n = 74) vs. active control (n = 61) training program had significantly greater improvement in the primary outcome of cognitive functioning (mean change in composite z score±SD: 0·25±0·45 vs. 0·09±0·37, p = 0·03, estimated difference = 0·16 with 95% CI: 0·02-0·30), despite greater training time in the active control condition (mean±SD:56·9 ± 34·6 vs. 37·7 ±23 ·8 hours played, p = 0·006). This study provides Class I evidence that adaptive, computer-based cognitive remediation accessed from home can improve cognitive functioning in MS. This telerehabilitation approach allowed for rapid recruitment and high compliance, and can be readily applied to other neurological conditions associated with cognitive dysfunction. TRIAL REGISTRATION: Clinicaltrials.gov NCT02141386.
[Mh] Termos MeSH primário: Cognição/fisiologia
Esclerose Múltipla/reabilitação
Telerreabilitação/normas
[Mh] Termos MeSH secundário: Adulto
Método Duplo-Cego
Feminino
Seres Humanos
Masculino
Cadeias de Markov
Meia-Idade
Método de Monte Carlo
Testes Neuropsicológicos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170512
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0177177


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[PMID]:28427763
[Au] Autor:Hwang R; Mandrusiak A; Morris NR; Peters R; Korczyk D; Bruning J; Russell T
[Ad] Endereço:Department of Physiotherapy, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia; Physiotherapy, School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia. Electronic address: r.hwang@uq.net.au.
[Ti] Título:Exploring patient experiences and perspectives of a heart failure telerehabilitation program: A mixed methods approach.
[So] Source:Heart Lung;46(4):320-327, 2017 Jul - Aug.
[Is] ISSN:1527-3288
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To describe patient experiences and perspectives of a group-based heart failure (HF) telerehabilitation program delivered to the homes via online video-conferencing. BACKGROUND: Limited information currently exists on patient experiences of telerehabilitation for HF. Patient feedback and end-user perspectives provide important information regarding the acceptability of this new delivery model which may have a substantial impact on future uptake. METHODS: We used mixed-methods design with purposive sampling of patients with HF. We used self-report surveys and semi-structured interviews to measure patient experiences and perspectives following a 12-week telerehabilitation program. The telerehabilitation program encompassed group-based exercise and education, and were delivered in real-time via videoconferencing. Interviews were transcribed and coded, with thematic analysis undertaken. RESULTS: Seventeen participants with HF (mean age [SD] of 69 [12] years and 88% males) were recruited. Participants reported high visual clarity and ease of use for the monitoring equipment. Major themes included motivating and inhibiting influences related to telerehabilitation and improvement suggestions. Participants liked the health benefits, access to care and social support. Participants highlighted a need for improved audio clarity and connectivity as well computer training for those with limited computer experience. The majority of participants preferred a combined face-to-face and online delivery model. CONCLUSION: Participants in this study reported high visual clarity and ease-of-use, but provided suggestions for further improvements in group-based video telerehabilitation for HF.
[Mh] Termos MeSH primário: Insuficiência Cardíaca/reabilitação
Avaliação de Programas e Projetos de Saúde
Inquéritos e Questionários
Telemedicina/métodos
Telerreabilitação/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Criança
Feminino
Seres Humanos
Masculino
Meia-Idade
Apoio Social
Videoconferência
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE


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[PMID]:28328946
[Au] Autor:Sgandurra G; Lorentzen J; Inguaggiato E; Bartalena L; Beani E; Cecchi F; Dario P; Giampietri M; Greisen G; Herskind A; Nielsen JB; Rossi G; Cioni G; CareToy Consortium
[Ad] Endereço:Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Calambrone, Pisa, Italy.
[Ti] Título:A randomized clinical trial in preterm infants on the effects of a home-based early intervention with the 'CareToy System'.
[So] Source:PLoS One;12(3):e0173521, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CareToy system is an innovative tele-rehabilitative tool, useful in providing intensive, individualized, home-based, family-centred Early Intervention (EI) in infants. Our aim was to evaluate, through a Randomized Clinical Trial (RCT) study, the effects of CareToy intervention on early motor and visual development in preterm infants. 41 preterm infants (range age: 3.0-5.9 months of corrected age) were enrolled and randomized into two groups, CareToy and Standard Care. 19 infants randomized in CareToy group performed a 4-week CareToy program, while 22 allocated to control group completed 4 weeks of Standard Care. Infant Motor Profile (IMP) was primary outcome measure, Alberta Infant Motor Scale (AIMS) and Teller Acuity Cards were secondary ones. Assessments were carried out at baseline (T0) and at the end of CareToy training or Standard Care period (T1). T1 was the primary endpoint. After RCT phase, 17 infants from control group carried out a 4-week CareToy program, while 18 infants from the CareToy group continued with Standard Care. At the end of this phase, infants were re-assessed at T2. In RCT phase, delta IMP total score and variation and performance sub-domains were significantly higher (P<0.050) in CareToy group if compared to Standard Care group. Similar results were found for Teller Acuity Cards, while no differences between groups were found for AIMS. No differences were found in any outcome measure results (T2-T0), between infants who started CareToy training before or after one month of standard care. This RCT study confirms the results of a previous pilot study, indicating that CareToy system can provide effective home-based EI. TRIAL REGISTRATION: This trial has been registered at www.clinicaltrials.gov (Identifier NCT01990183).
[Mh] Termos MeSH primário: Deficiências do Desenvolvimento/reabilitação
Intervenção Precoce (Educação)/métodos
Serviços de Assistência Domiciliar
Recém-Nascido Prematuro
Jogos e Brinquedos
Telerreabilitação/métodos
[Mh] Termos MeSH secundário: Desenvolvimento Infantil
Deficiências do Desenvolvimento/fisiopatologia
Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
Destreza Motora
Avaliação de Resultados (Cuidados de Saúde)
Desempenho Psicomotor
Telerreabilitação/instrumentação
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0173521


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[PMID]:28247406
[Au] Autor:Comans T; Mihala G; Sakzewski L; Boyd RN; Scuffham P
[Ad] Endereço:Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Nathan, Qld, Australia.
[Ti] Título:The cost-effectiveness of a web-based multimodal therapy for unilateral cerebral palsy: the Mitii randomized controlled trial.
[So] Source:Dev Med Child Neurol;59(7):756-761, 2017 Jul.
[Is] ISSN:1469-8749
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: To estimate the cost-effectiveness of the Mitii training system for improvements in upper limb function for children with unilateral cerebral palsy (CP). Mitii is a web-based programme delivered at home with set-up and monitoring by therapists. METHOD: A randomized controlled trial was conducted comparing the Mitii training programme to usual care. The Assessment of Motor and Process Skills (AMPS) and Canadian Occupational Performance Measure (COPM) were collected for each child at baseline and 20 weeks. Responders to training were characterized as those who met a minimally important difference on either the AMPS (0.3 logits) or COPM (2 points). Costs of the intervention were calculated by quantifying the equipment and staff cost. A cost per responder was calculated for each of the outcome measures. RESULTS: A total of 102 participants (52 males, 50 females) were included in the analysis. There were significantly more responders in the training group on both the AMPS motor and process scales and the COPM performance and satisfaction scales. The cost per responder for the Mitii programme ranged from AU$3078 to AU$4191 depending on the scale used. INTERPRETATION: The cost of delivering the Mitii training system is modest relative to the improvements in function.
[Mh] Termos MeSH primário: Paralisia Cerebral/economia
Paralisia Cerebral/reabilitação
Terapia Cognitiva/economia
Internet
Telerreabilitação/economia
Extremidade Superior
[Mh] Termos MeSH secundário: Adolescente
Austrália
Paralisia Cerebral/fisiopatologia
Criança
Terapia Combinada/economia
Análise Custo-Benefício
Feminino
Lateralidade Funcional
Seres Humanos
Masculino
Atividade Motora
Satisfação do Paciente
Índice de Gravidade de Doença
Terapia Assistida por Computador/economia
Resultado do Tratamento
Extremidade Superior/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170302
[St] Status:MEDLINE
[do] DOI:10.1111/dmcn.13414


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[PMID]:28245004
[Au] Autor:Piotrowicz E; Orzechowski P; Jasionowska A; Banaszak-Bednarczyk M; Roslaniec M; Piotrowski W; Piotrowicz R
[Ad] Endereço:Instytut Kardiologii im. Prymasa Tysiaclecia Stefana Kardynala Wyszynskiego / The Cardinal Stefan Wyszynski Institute of Cardiology, Warszawa, Poland (Centrum Telekardiologii / Telecardiology Center). epiotrowicz@ikard.pl.
[Ti] Título:[Effects of hybrid comprehensive cardiac telerehabilitation conducted under the pension prevention program of the Social Insurance Institution].
[Ti] Título:Efekty hybrydowej kompleksowej telerehabilitacji kardiologicznej realizowanej w ramach prewencji rentowej Zakladu Ubezpieczen Spolecznych..
[So] Source:Med Pr;68(1):61-74, 2017 Feb 28.
[Is] ISSN:0465-5893
[Cp] País de publicação:Poland
[La] Idioma:pol
[Ab] Resumo:BACKGROUND: The Polish Social Insurance Institution (SII), under its pension prevention initiative, has taken measures to support the patients return to work and thus developed a new model of hybrid, comprehensive, cardiac telerehabilitation (HCCT). The aim of the study was to analyze the effects of HCCT in terms of its acceptance, adherence to and influence on patients' physical capacity and ability to return to work. MATERIAL AND METHODS: The study included 99 patients, aged 54.6±6.3 years, who suffered from cardiovascular diseases. They participated in a 24-day HCCT consisting of preliminary and final examinations, 10 days of out-patients rehabilitation based on cycloergometer training (5 sessions) and Nordic walking training (10 sessions), and 12 days of home telerehabilitation based on Nordic walking training. The effectiveness of HCCT was assessed by comparing changes in functional capacity expressed by metabolic equivalent of task (MET) and a 6-min walking test (6-MWT) distance from the beginning and the end of HCCT. Acceptance of HCCT was evaluated using a questionnaire. Adherence to HCCT was assessed by the patients' participation in the training sessions. Effectiveness of HCCT in terms of return to work was assessed according to SII definition. RESULTS: Hybrid, comprehensive, cardiac telerehabilitation resulted in significant improvement of functional capacity 7.6±2.0 vs. 8.1±2.4 MET (p < 0.0001) and distance in 6-MWT 448.5±79.2 m vs. 480.5±84.1 m (p < 0.0001). There were 82.8% of adherent, 16.2% of partially adherent and 1% of non-adherent patients. After HCCT 48 patients were able to return to work. CONCLUSIONS: Hybrid, comprehensive, cardiac telerehabilitation was well accepted and led to the improvement of the patients' physical capacity. Adherence to HCCT was high and allowed 48.48% of patients return to work. Med Pr 2017;68(1):61-74.
[Mh] Termos MeSH primário: Reabilitação Cardíaca/métodos
Doenças Cardiovasculares/prevenção & controle
Doenças Profissionais/reabilitação
Prevenção Secundária/métodos
Telerreabilitação/métodos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Serviços de Saúde do Trabalhador
Pensões
Polônia
Retorno ao Trabalho
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170616
[Lr] Data última revisão:
170616
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170301
[St] Status:MEDLINE


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[PMID]:28244545
[Au] Autor:Albiol-Pérez S; Gil-Gómez JA; Muñoz-Tomás MT; Gil-Gómez H; Vial-Escolano R; Lozano-Quilis JA
[Ad] Endereço:Sergio Albiol-Pérez, Aragón Health Research Institute (IIS Aragón), Universidad de Zaragoza, C/ Atarazana 4, 44003 Teruel, Spain, E-mail: salbiol@unizar.es.
[Ti] Título:The Effect of Balance Training on Postural Control in Patients with Parkinson's Disease Using a Virtual Rehabilitation System.
[So] Source:Methods Inf Med;56(2):138-144, 2017 Mar 23.
[Is] ISSN:2511-705X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor clinical alterations among others. Postural problems have serious consequences for patients, not only limiting their daily life but also increasing some risks, like the risk of fall. Inadequate postural control and postural instability is a major problem in PD patients. A Virtual Motor Rehabilitation System (VMR) has been tested in patients with PD in the intervention period. Our purpose was to analyze the evolution of the spatial postural control during the intervention period, to see if there are any changes caused precisely by this intervention. METHODS: Ten people with PD carried out 15 virtual rehabilitation sessions. We tested a groundbreaking system based on Virtual Motor Rehabilitation in two periods of time (baseline evaluation and final evaluation). In the training sessions, the participants performed a customizable treatment using a low-cost system, the Active Balance Rehabilitation system (ABAR). We stored the pressure performed by the participants every five hundredths of a second, and we analyzed the patients' pressure when they maintained their body on the left, on the right, and in the center in sitting position. Our system was able to measure postural control in every patient in each of the virtual rehabilitation sessions. RESULTS: There are no significant differences in the performance of postural control in any of the positions evaluated throughout the sessions. Moreover, the results show a trend to an improvement in all positions. This improvement is especially remarkable in the left/right positions, which are the most important positions in order to avoid problems such as the risk of fall. With regard to the suitability of the ABAR system, we have found outstanding results in enjoyment, success, clarity, and helpfulness. CONCLUSIONS: Although PD is a progressive neurodegenerative disorder, the results demonstrate that patients with PD maintain or even improve their postural control in all positions. We think that the main factor influencing these results is that patients use more of their available cognitive processing to improve their postural control. The ABAR system allows us to make this assumption because the system requires the continuous attention of patients, promoting cognitive processing.
[Mh] Termos MeSH primário: Doença de Parkinson/fisiopatologia
Doença de Parkinson/reabilitação
Equilíbrio Postural/fisiologia
Telerreabilitação/métodos
Interface Usuário-Computador
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170626
[Lr] Data última revisão:
170626
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170301
[St] Status:MEDLINE
[do] DOI:10.3414/ME16-02-0004


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[PMID]:28143388
[Au] Autor:Brouwers RW; Kraal JJ; Traa SC; Spee RF; Oostveen LM; Kemps HM
[Ad] Endereço:Department of Cardiology, Máxima Medical Centre, Eindhoven/Veldhoven, The Netherlands. r.brouwers@mmc.nl.
[Ti] Título:Effects of cardiac telerehabilitation in patients with coronary artery disease using a personalised patient-centred web application: protocol for the SmartCare-CAD randomised controlled trial.
[So] Source:BMC Cardiovasc Disord;17(1):46, 2017 Jan 31.
[Is] ISSN:1471-2261
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cardiac rehabilitation has beneficial effects on morbidity and mortality in patients with coronary artery disease, but is vastly underutilised and short-term improvements are often not sustained. Telerehabilitation has the potential to overcome these barriers, but its superiority has not been convincingly demonstrated yet. This may be due to insufficient focus on behavioural change and development of patients' self-management skills. Moreover, potentially beneficial communication methods, such as internet and video consultation, are rarely used. We hypothesise that, when compared to centre-based cardiac rehabilitation, cardiac telerehabilitation using evidence-based behavioural change strategies, modern communication methods and on-demand coaching will result in improved self-management skills and sustainable behavioural change, which translates to higher physical activity levels in a cost-effective way. METHODS: This randomised controlled trial compares cardiac telerehabilitation with centre-based cardiac rehabilitation in patients with coronary artery disease. We randomise 300 patients entering cardiac rehabilitation to centre-based cardiac rehabilitation (control group) or cardiac telerehabilitation (intervention group). The core component of the intervention is a patient-centred web application, which enables patients to adjust rehabilitation goals, inspect training and physical activity data, share data with other caregivers and to use video consultation. After six supervised training sessions, the intervention group continues exercise training at home, wearing an accelerometer and heart rate monitor. In addition, physical activity levels are assessed by the accelerometer for four days per week. Patients upload training and physical activity data weekly and receive feedback through video consultation once a week. After completion of the rehabilitation programme, on-demand coaching is performed when training adherence or physical activity levels decline with 50% or more. The primary outcome measure is physical activity level, assessed at baseline, three months and twelve months, and is calculated from accelerometer and heart rate data. Secondary outcome measures include physical fitness, quality of life, anxiety and depression, patient empowerment, patient satisfaction and cost-effectiveness. DISCUSSION: This study is one of the first studies evaluating effects and costs of a cardiac telerehabilitation intervention comprising a combination of modern technology and evidence-based behavioural change strategies including relapse prevention. We hypothesise that this intervention has superior effects on exercise behaviour without exceeding the costs of a traditional centre-based intervention. TRIAL REGISTRATION: Netherlands Trial Register NTR5156 . Registered 22 April 2015.
[Mh] Termos MeSH primário: Reabilitação Cardíaca/métodos
Doença da Artéria Coronariana/reabilitação
Terapia por Exercício/métodos
Comportamentos Relacionados com a Saúde
Internet
Autocuidado
Telerreabilitação/métodos
[Mh] Termos MeSH secundário: Actigrafia/instrumentação
Atitude Frente aos Computadores
Reabilitação Cardíaca/economia
Protocolos Clínicos
Doença da Artéria Coronariana/diagnóstico
Doença da Artéria Coronariana/fisiopatologia
Doença da Artéria Coronariana/psicologia
Análise Custo-Benefício
Eletrocardiografia/instrumentação
Exercício
Terapia por Exercício/economia
Custos de Cuidados de Saúde
Conhecimentos, Atitudes e Prática em Saúde
Frequência Cardíaca
Seres Humanos
Entrevista Motivacional
Países Baixos
Cooperação do Paciente
Educação de Pacientes como Assunto
Valor Preditivo dos Testes
Recuperação de Função Fisiológica
Tecnologia de Sensoriamento Remoto
Projetos de Pesquisa
Autocuidado/economia
Telemetria/instrumentação
Telerreabilitação/economia
Fatores de Tempo
Resultado do Tratamento
Videoconferência
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170202
[St] Status:MEDLINE
[do] DOI:10.1186/s12872-017-0477-6


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[PMID]:28108429
[Au] Autor:Cranen K; Groothuis-Oudshoorn CG; Vollenbroek-Hutten MM; IJzerman MJ
[Ad] Endereço:Roessingh Research and Development, Telemedicine group, Enschede, Netherlands.
[Ti] Título:Toward Patient-Centered Telerehabilitation Design: Understanding Chronic Pain Patients' Preferences for Web-Based Exercise Telerehabilitation Using a Discrete Choice Experiment.
[So] Source:J Med Internet Res;19(1):e26, 2017 Jan 20.
[Is] ISSN:1438-8871
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patient-centered design that addresses patients' preferences and needs is considered an important aim for improving health care systems. At present, within the field of pain rehabilitation, patients' preferences regarding telerehabilitation remain scarcely explored and little is known about the optimal combination between human and electronic contact from the patients' perspective. In addition, limited evidence is available about the best way to explore patients' preferences. Therefore, the assessment of patients' preferences regarding telemedicine is an important step toward the design of effective patient-centered care. OBJECTIVE: To identify which telerehabilitation treatment options patients with chronic pain are most likely to accept as alternatives to conventional rehabilitation and assess which treatment attributes are most important to them. METHODS: A discrete choice experiment with 15 choice tasks, combining 6 telerehabilitation treatment characteristics, was designed. Each choice task consisted of 2 hypothetical treatment scenarios and 1 opt-out scenario. Relative attribute importance was estimated using a bivariate probit regression analysis. One hundred and thirty surveys were received, of which 104 were usable questionnaires; thus, resulting in a total of 1547 observations. RESULTS: Physician communication mode, the use of feedback and monitoring technology (FMT), and exercise location were key drivers of patients' treatment preferences (P<.001). Patients were willing to accept less frequent physician consultation offered mainly through video communication, provided that they were offered FMT and some face-to-face consultation and could exercise outside their home environment at flexible exercise hours. Home-based telerehabilitation scenarios with minimal physician supervision were the least preferred. A reduction in health care premiums would make these telerehabilitation scenarios as attractive as conventional clinic-based rehabilitation. CONCLUSIONS: "Intermediate" telerehabilitation treatments offering FMT, some face-to-face consulting, and a gym-based exercise location should be pursued as promising alternatives to conventional chronic pain rehabilitation. Further research is necessary to explore whether strategies other than health care premium reductions could also increase the value of home telerehabilitation treatment.
[Mh] Termos MeSH primário: Dor Crônica/reabilitação
Internet
Preferência do Paciente
Assistência Centrada no Paciente/métodos
Telerreabilitação/métodos
[Mh] Termos MeSH secundário: Adulto
Comportamento de Escolha
Feminino
Seres Humanos
Masculino
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170811
[Lr] Data última revisão:
170811
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170122
[St] Status:MEDLINE
[do] DOI:10.2196/jmir.5951


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[PMID]:28101620
[Au] Autor:Keidel M; Vauth F; Richter J; Hoffmann B; Soda H; Griewing B; Scibor M
[Ad] Endereço:Abteilung Akutneurologie, Stroke Unit und Neurologische Intensivmedizin, Neurologische Klinik, Rhön-Klinikum AG, Campus Bad Neustadt, Von-Guttenberg-Straße 10, Bad Neustadt/Saale, 97616, Deutschland. matthias.keidel@neurologie-bad-neustadt.de.
[Ti] Título:[Home-based telerehabilitation after stroke].
[Ti] Título:Telerehabilitation nach Schlaganfall im häuslichen Umfeld..
[So] Source:Nervenarzt;88(2):113-119, 2017 Feb.
[Is] ISSN:1433-0407
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:The use of modern information and telecommunication technologies enables telerehabilitation of neurological deficits in the domestic environment. The current state of studies on rehabilitative teletherapy for improvement of motor function and mobility deficits due to stroke is reviewed. Two neurolinguistic proof of concept studies investigating the efficacy of online interactive telespeech therapy are reported, which compared virtual screen to screen interactive telerehabilitation of aphasia after stroke and dysarthrophonia in Parkinson's disease to conventional face to face rehabilitation. The results of the studies indicate that the neurological rehabilitation of motor and communicative deficits in the domestic environment of patients by means of teletherapy is just as efficient as conventional rehabilitation. Under home-based telerehabilitation patient transfer becomes unnecessary. Rehabilitative Teletherapy is a posthospital component of a cross-sector supply chain for patients with handicaps or impairments due to stroke and other neurological diseases.
[Mh] Termos MeSH primário: Biorretroalimentação Psicológica/métodos
Consulta Remota/métodos
Autocuidado/métodos
Distúrbios da Fala/reabilitação
Reabilitação do Acidente Vascular Cerebral/métodos
Telerreabilitação/métodos
[Mh] Termos MeSH secundário: Medicina Baseada em Evidências
Alemanha
Serviços de Assistência Domiciliar
Seres Humanos
Terapia Assistida por Computador/métodos
Resultado do Tratamento
Interface Usuário-Computador
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170916
[Lr] Data última revisão:
170916
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170120
[St] Status:MEDLINE
[do] DOI:10.1007/s00115-016-0275-x



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