ICT-Based Health Care Services for Individuals with Spinal Cord Injuries: A Feasibility Study (original) (raw)
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Objective: To assess multiple facets of awareness, understanding, value, needs, and desirability to resolve issues regarding unmet medical needs of individuals with a disability by adopting telerehabilitation. The survey included collection and analysis of current services as well as of supplementary and future services of rehabilitative interventions in South Korea. Study Design and Participants: Thirty-six health professionals who were members of the Korean Academy of Rehabilitation Medicine and 57 individuals with spinal cord injury responded to a survey of those belonging to two non-profit professional groups, one group belonging to the Korean Spinal Cord Injury Association and joining the National Spinal Cord Injury Wheelchair Games and the other group belonging to the Jeong-Sang-Hye (High Quad Spinal Cord Injury Association) and having joined one of the focus groups of the Korea National Rehabilitation Research Institute. The two surveys were designed specifically for investigating each group’s perspectives of awareness, understanding, value, needs, and desirability of telerehabilitation. Results: The survey responses indicated that there is great interest in the possibility of telerehabilitative services among individuals with spinal cord injury. In particular, there was a strong interest expressed in services that can be used to resolve issues on unmet medical needs of individuals with a disability related to health monitoring, sustaining health, rehabilitation interventions, and independence of activities of daily living. Conclusions: Telerehabilitation holds great promise as a bridge to traditional face-to-face clinical service delivery. From the results, there are a few categories in the survey that indicate notable differences between the two groups regarding the awareness, desirability, order of preference in rehabilitation service, and telerehabilitation expenses.
Improving quality of life after spinal cord injury in India with telehealth
Spinal Cord Series and Cases
Introduction Despite adequate inpatient rehabilitation, a number of spinal cord injury (SCI) individuals suffer from difficulties at home and in their local environments. This is mainly prevalent in low-middle-income countries (LMIC) due to a lack of qualified personal caregivers. This issue could be addressed with the help of telehealth technology, which may be used in LMICs without economic concerns. Case presentations A 44-year-old male with C3 AIS C SCI and a 35-year-old female with T12 AIS A SCI were discharged after successful rehabilitation from a tertiary care spinal center. The patients demonstrated gradual loss in their independence, which was evident by monitoring their home activities biweekly for 4 weeks via a combination of telephone calls, live video chat, and WhatsApp. Subsequently after 4 weeks of consistent guidance, pre-post scores after teletherapy were analyzed for the self-care and mobility subcomponents of the self-reported SCIM III. Discussion After consistent supervised guidance via telehealth, self-care scores improved in the C3 AIS C case from 3 to 15 and in the T12 AIS A case from 4 to 15, while mobility scores respectively improved from 14 to 27 and 4 to 16. Identification of individual competencies, performance, and capacity in activities of daily living and participation, selfassessment, caregiver training, and home integration contributed toward successful community integration. This case series documents the benefits of using telehealth and home goal planning in the aftercare of SCI individuals, in order to improve quality of life in their local environment.
Functional and Clinical Outcomes of Telemedicine in Patients With Spinal Cord Injury
Archives of Physical Medicine and Rehabilitation, 2008
Objective: To compare the 6-month outcomes of telerehabilitation intervention with those of standard care for spinal cord injury (SCI). Design: Multicenter randomized controlled trial. Setting: Home, nursing, or unspecialized hospital care provided after discharge from a spinal cord unit. Participants: Adult patients with nonprogressive, complete, or incomplete SCI discharged for the first time from the spinal cord unit to their homes (Belgium and Italy) or to their homes or another facility (England). Interventions: All patients received the standard care they would have normally received after discharge from the spinal cord unit. In addition, patients in the telemedicine group received 8 telemedicine weekly sessions in the first 2 months, followed by biweekly telemedicine sessions for 4 months. Main Outcome Measures: Functional status at 6 months, clinical complications during the postdischarge period, and patient satisfaction. Results: No significant differences in the occurrence of clinical complications were found between the study groups. A higher improvement of functional scores in the telemedicine group was found only at the Italian site: FIM total score 3.38Ϯ4.43 (controls) versus 7.69Ϯ6.88 (telemedicine group), FIM motor score 3.24Ϯ4.38 (controls) versus 7.55Ϯ7.00 (telemedicine group; PϽ.05). Items contributing to this difference were grooming, dressing upper body, dressing lower body, and bed/chair/wheelchair transfer. Higher satisfaction with care was reported by patients in the telemedicine group across all sites. Conclusions: Our study provides some of the first quantitative evidence, based on results from 1 site, that telerehabilitation may offer benefits to patients discharged from a spinal cord unit compared with standard care in terms of functional improvement. Further research is warranted to confirm or disprove this finding.
What's happening now! Telehealth management of spinal cord injury/disorders
The Journal of Spinal Cord Medicine, 2011
Context: Spinal cord injury and/or disorders (SCI/D) is a costly chronic condition. Impaired mobility, and lengthy travel distances to access specialty providers are barriers that can have adverse impact on expenses and quality of care. Although ample opportunities for use of telehealth technologies exist between medical facilities, and from clinical to home settings, field experience has largely been focused on home telehealth services to promote better patient self-management skills and improve clinical outcomes. Findings: This paper provides an overview of published literature on use of telehealth technologies with the SCI/D population. Presentation of case studies describe telehealth as a potential strategy for addressing disparities in providing quality care, and explore comprehensive management of multiple health issues in individuals with SCI/D. Experiences of providers in both private sector health-care systems and VHA medical facilities are described. Development of telehealth clinical protocols and adaptive devices that can be integrated with equipment to accommodate for the functional limitations in the SCI/D population are discussed as necessary for expansion of use of telehealth services. Rigorous research studies are lacking. As use of this technology spreads and issues surrounding implementation are addressed, we look forward to increased research to assess and evaluate its efficacy in the SCI/D population. Conclusion/clinical relevance: Telehealth in the home setting appears to be able to help persons with SCI/D remain in the community. As the use of telehealth increases, research will be necessary in both clinical and home settings to assess its efficacy in improving outcomes in the SCI/D population.
Spinal Cord, 2014
Study design: Prospective cohort study. Objectives: To compare the health-related quality of life (HRQoL) in people with spinal cord injury (SCI) who use the Internet versus those who don't and with a control group of able-bodied individuals. To investigate the frequency of Internet usage before and after injury. To evaluate the differences in terms of demographic features of both groups, analyze the variation in the Internet usage pattern of people with SCI before and after the injury. Setting: Istanbul, Turkey. Methods: A total of 60 people with SCI (38 Internet users, 22 nonusers) were included in the study. The control group consisted of 33 healthy persons of similar age and sex. The HRQoL was evaluated with the SF-36 Health Survey. Results: The scores of all the subscales of the SF-36, except vitality, were significantly lower in people with SCI than those of the controls'. The bodily pain subscale and physical component scores were found to be significantly higher in people with SCI using the Internet than the nonuser group with SCI (Po0.05). The Internet usage frequency increased significantly in people with SCI after injury (Po0.05). A significant correlation was found between time since injury and Internet use (r ¼ 0.365, P ¼ 0.007). Conclusion: Although HRQoL scores were lower in people with an SCI, the physical status component score was better in the Internet user SCI group. As there is a significant increase in the time spent online after injury, the Internet could be an effective modality to contact and educate people with an SCI.
Telehealth for people with spinal cord injury: a narrative review
Spinal cord, 2018
Narrative review. To find and discuss what has been published about the use of telehealth, on people with spinal cord injury (teleSCI). International. Cochrane Library, Ovid Medline, EMBASE and CINAHL, from 1996 till June 2017 have been searched. Searches in PsycINFO, from 1996 till September 2017, were included afterwards. Extracted data include studies in English language, containing information about spinal cord injury and disorders, and telehealth. Literature reviews, systematic reviews, and studies containing other types of neurological disorders, were excluded. Studies were grouped based on how and to whom telehealth was offered. Twenty nine studies were included in the review. They were categorized according to the way teleSCI was provided, and to what modality was used. Some studies utilized more than one modality. TeleSCI seems to be favorable concerning treatment and follow-up, as well as favorable socioeconomically and environmentally. The studies spanned across several ...
Clinical and Experimental Health Sciences, 2021
Objective: This study was conducted to determine the effect of web-based training on complication control and quality of life of spinal cordinjured patients. Methods: A pre-test-post-test, experimental study including a control group. A total of 62 men participated from two different physical therapy and rehabilitation hospitals. The training, monitoring, and data collection steps were provided via a webpage (www.omurgahemsirelikegitim. com) and telephone. Results: It was determined that there was a statistically significant difference between the experimental and control groups regarding the complications related to respiration, circulation, gastrointestinal, urinary, and musculoskeletal systems. Regarding the complications related to sexual life, comparing experimental and control groups the pre and post evaluations, detected an increase in difficulty in sexual life after the injury both experimental and control groups. There was no statistically significant difference between the two groups in terms of quality of life scale subscale scores. Conclusion: These results show that telephone monitoring plus web-based training is effective in controlling disease complications in patients with spinal cord injury. However, to improve the quality of life, it is important to establish interventions involving individuals and families, and physical, social and mental health services.
A pilot study of a telehealth intervention for persons with spinal cord dysfunction
Spinal Cord, 2013
Study design: Single-blind randomized controlled trial of 6 months' duration. Objectives: To evaluate the efficacy of a novel telehealth intervention, 'CareCall', on reducing pressure ulcers and depression and enhancing the use of appropriate health care. Setting: General community, Massachusetts and Connecticut, United States Methods: 'CareCall' is an automated, interactive voice response system that combines patient education, cognitive behavioral interventions, screening and referrals, with alerts to a nurse telerehabilitation coordinator for direct non-emergent phone follow up. Participants consisted of a convenience sample of 142 persons with multiple sclerosis or spinal cord injury using a wheelchair 46 h per day. The intervention group received CareCall (n ¼ 71) The control group received usual care (n ¼ 71). The main outcome measures were: The pressure ulcer scale for healing tool, Patient Health Questionnaire-9 depression scale, Cornell Services Index and Craig Hospital Inventory of Environmental Factors-Short Form Question 5. Results: CareCall achieved a reduction in presence of pressure ulcers at 6 months in women (Po0.0001). Among those with baseline depression, CareCall reduced 6-month severity of depression, adjusting for age and gender (Po0.047). CareCall did not have a significant impact on health-care utilization (OR ¼ 1.8, P ¼ 0.07), but did significantly improve participants' report of health-care availability (OR ¼ 2.03, Po0.04). Conclusion: This is the first study to demonstrate the efficacy of a largely automated telehealth intervention for adults with spinal cord dysfunction. Future research needs to replicate this study in a larger, multisite trial.