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Purpose: Musculoskeletal strength can be impaired in pediatric solid organ transplant recipients. Exercise training programs can be beneficial but in-person delivery can be challenging; virtual exercise programs can alleviate some of these challenges. This feasibility study aimed to deliver an 8-week virtual exercise program in pediatric solid organ transplant recipients. Method: Program delivery occurred 3 times per week for 30 minutes. An exercise stress test was completed prior to program start. The Bruininks-Oseretsky Test of Motor Proficiency strength subtest and self-report surveys were used to assess musculoskeletal strength, quality of life, fatigue, and physical activity. Contact was maintained through a text messaging platform. Z scores were calculated using standardized normative data. Medians (interquartile range) are reported for all other data. Results: Eleven participants completed the program (2 liver, 5 kidney, 4 heart; 58% females; median age = 11.5 [10.3–13.8] y). Six participants attended ≥60% of classes, 5 participants attended <50% of classes. After 8 weeks, strength scores improved (Z score, Pre: −1.0 [−1.65 to −0.60] to Post: −0.2 [−1.30 to 0.40]; P =.007) with no change in other outcome measures. Conclusion: The virtual exercise program was delivered without technical issues and received positive participant feedback. Engagement and costs need to be considered. [ABSTRACT FROM AUTHOR]

Context: Mindfulness interventions (yoga, meditation) in traumatic brain injury populations show promising improvements in injury outcomes. However, most studies include all injury severities and use in-person, general programming lacking accessibility and specificity to the nuance of concussion. Therefore, this study investigated the feasibility and preliminary effectiveness of an online, concussion-focused meditation intervention among young adults with a concussion history. Design: Unblinded, single-arm, pilot intervention. Methods: Fifteen young adults aged 18 to 30 with a concussion history within the past 5 years completed 10 to 20 minutes per day of online, guided meditations for 6 weeks. Feasibility was assessed using the Feasibility of Intervention Measure. Concussion symptoms were measured using the Rivermead Post-Concussion Symptom Questionnaire, perceived stress the Perceived Stress Scale-10, and mindfulness the Five Facet Mindfulness Questionnaire. Descriptive statistics described the study sample and determined intervention adherence and feasibility. Paired sample t tests were used to examine preintervention/postintervention changes in concussion symptoms, perceived stress, and mindfulness, with descriptive statistics further detailing significant t tests. Results: Fifteen participants were enrolled, and 12 completed the intervention. The majority completed 5+ days per week of the meditations, and Feasibility of Intervention Measure (17.4 [1.8]) scores indicated high feasibility. Concussion symptom severity significantly decreased after completing the meditation intervention (11.3 [10.3]) compared with before the intervention (24.5 [17.2]; t[11] = 3.0, P =.01). The number of concussion symptoms reported as worse than before their concussion significantly decreased after completing the meditation intervention (2.7 [3.9]) compared with before the intervention (8.0 [5.7]; t[11] = 3.7, P =.004). Postintervention, 83.33% (n = 10) reported lower concussion symptom severity, and 75.00% (n = 9) reported less concussion symptoms as a mild, moderate, or severe problem (ie, worse than before injury). Conclusions: Findings suggest positive adherence and feasibility of the meditation intervention, with the majority reporting concussion symptom improvement postintervention. Future research is necessary to expand these pilot findings into a large trial investigating concussion-specific meditation programming. [ABSTRACT FROM AUTHOR]

SignificanceA majority of visually impaired older adults were able to learn to proficiently use visual-assistive iPhone applications (apps) following a median 1 hour and/or multiple training sessions, which should be considered when planning vision rehabilitation service delivery, including the option for remote telerehabilitation for those who prefer that modality.PurposeOlder adults with low vision are increasingly using technology to improve their visual functioning. We examined whether age-related comorbidities were potential barriers to success in learning to use visual-assistive apps on a smartphone.MethodsA clinical trial assessed visual-assistive apps in 116 older adults aged 55+ years (mean [standard deviation], 72 [10] years). Subjects were randomized to use an app (SuperVision+, Seeing AI, or Aira) preloaded to a loaner iPhone and completed one-on-one training. App proficiency was measured by the participant's ability to use the iPhone/app without cueing at the end of training sessions. Training time was recorded for the initial session and totaled after subsequent sessions. Multiple regression models explored significant factors associated with training time and proficiency.ResultsMedian initial and total training times were 45 and 60 minutes, respectively. Increased initial and total training times were both significantly related to increased age (p

In general, COVID-19-related adaptations that transitioned in-person assessments and interventions to a virtual format were not routinely evaluated. We aimed to conduct a process evaluation to examine the impact of COVID-19-related adaptations on a behavior change intervention designed to increase exercise adherence among Veterans with mobility difficulty. We used secondary data from a nonrandomized study to complete a process evaluation examining the intervention's reach, recruitment, fidelity, dose delivered by physical therapists, and the dose received by the 14 participating Veterans. The physical therapist delivered 95% (133/140) of the study's 10 sessions. Sessions with the lowest delivery dose included Sessions 1 and 10 (86%; n = 12/14). The elements with the lowest dose received included using an exercise journal and developing a postintervention plan (86%; n = 12/14). Our COVID-19 adaptations allowed us to provide our intervention to the majority (67%) of eligible participants without a negative impact on fidelity, dose delivered, or dose received. [ABSTRACT FROM AUTHOR]

BACKGROUND: Foot drop in people with multiple sclerosis (MS) commonly leads to decreased mobility and quality of life (QOL). Functional electrical stimulation (FES) of the peroneal nerve can improve the gait of people with foot drop, yet various barriers restrict widespread use. The purpose of this case series was to examine the feasibility of a telerehabilitation-monitored FES device and report changes in functional mobility and QOL in people with moderate MS-related disability. METHODS: FES use was progressed over 8 weeks via 3 telerehabilitation sessions. Feasibility of telerehabilitation was assessed by percentage of telerehabilitation visits completed and participant-reported satisfaction. At baseline and study completion, functional mobility with and without FES were assessed by the Timed 25-Foot Walk (T25FW), Timed Up and Go (TUG), and 2-Minute Walk Test (2MWT), Multiple Sclerosis Impact Scale (MSIS-29), and the 12-item Multiple Sclerosis Walking Scale (MSWS-12). Fatigue was assessed via the Modified Fatigue Impact Scale (MFIS) before and after the intervention. RESULTS: Eleven participants (mean age = 50.4 years [SD 10.8]; 2 males) completed the study. All (33/33) telerehabilitation visits were completed and participants attained high levels of satisfaction with no adverse events. At 8 weeks, compared to baseline, there were clinically meaningful improvements on the T25FW, 2MWT, and TUG for 45%, 55%, and 82% of participants, respectively. Clinically meaningful improvements on the MSIS-29 and MSWS-12 were also recorded for 64% and 36% of participants, respectively. CONCLUSIONS: Telerehabilitation was safe and feasible for FES intervention, and improvements in functional mobility and QOL were observed. Telerehabilitation to monitor FES may improve access and reduce patient burden; therefore, studying its efficacy is warranted.

Long COVID, or post-acute sequelae of COVID-19 (PASC), represents a complex condition with persistent symptoms following SARS-Cov-2 infection. The symptoms include fatigue, dyspnoea, cognitive impairment, decreased quality of life in variable levels of severity. Potential mechanisms behind long COVID include vascular damage, immune dysregulation and viral persistence. Diagnosing long COVID involves medical evaluation by multidisciplinary team and assessment of persistent symptoms with scoring systems in development. Treatment strategies are symptom-focused, encompassing multidisciplinary care, rehabilitation and tailored exercise programmes. Pulmonary rehabilitation, an effective and critical component of long COVID management, has shown promise, particularly for patients with respiratory symptoms such as dyspnoea. These programmes, which combine exercise, breathing techniques, education and psychological support, improve symptoms, quality of life and overall recovery. Innovative technologies, such as telemedicine, wearable devices, telerehabilitation, are transforming long COVID management. Telemedicine facilitates consultations and interventions, eliminating healthcare access barriers. Wearable devices enable remote and continuous monitoring of patients during their rehabilitation activities. Telerehabilitation has proven to be safe and feasible and to have high potential for COVID-19 recovery. This review provides a concise overview of long COVID, encompassing its definition, prevalence, mechanisms, clinical manifestations, diagnosis and management approaches. It emphasizes the significance of multidisciplinary approach in diagnosis and treatment of long COVID, with focus on pulmonary rehabilitation and innovative technology advances to effectively address the management of long COVID.

PurposeAn evidence basis is lacking but needed to compare reading ability outcomes after magnification device training remotely via telerehabilitation versus in office.MethodsA multicenter randomized controlled trial at academic centers and vision rehabilitation private practices randomized 61 visually impaired adults to telerehabilitation or in-office training 1 to 4 months after dispensing new portable electronic, hand-held, or stand optical magnifiers. Telerehabilitation included loaner equipment for Zoom videoconferencing with remote control access software. Using a multilevel regression model, changes in Activity Inventory responses using Rasch analysis estimated reading ability in dimensionless log odds units (logits) (0.14-logit change corresponds with ability change expected from a one-line change in visual acuity).ResultsAcross 47 participants who completed the trial, reading ability with new magnifiers improved significantly by 0.61 logits on average (95% confidence interval [CI], 0.36-0.86; P < 0.001) from baseline to 1 month, and by an additional 0.44 logits on average (95% CI, 0.19-0.69; P < 0.001) from 1 to 4months (i.e., after magnifier training), with very similar significant findings for both telerehabilitation (n = 29; mean improvement = 0.44 logits; 95% CI, 0.08-0.80; P = 0.018) and in-office training (n = 18; mean improvement = 0.43 logits; 95% CI, 0.15-0.71; P = .003), and no significant difference between randomized groups across both follow-ups (95% CI, -0.43 to 0.61; P = .73). Vision, demographics, and health factors were nonsignificantly related to reading ability changes from 1 to 4 months.ConclusionsReading ability improved after the provision of newly dispensed magnifiers, with further improvements following additional magnifier training via either telerehabilitation or in-office usual care.Translational relevanceThese findings provide support for the use of telerehabilitation to enhance reading ability with newly prescribed magnifiers as an alternative modality of care delivery.

Purpose: The study aimed to compare the effects of home exercise alone and telerehabilitation combined with home exercise in individuals with transtibial amputation. Materials and methods: The telerehabilitation group (n = 24) received telerehabilitation combined with home exercise, while the control group (n = 24) received home exercise alone. Outcomes included the timed up-and-go (TUG) test and the 30-second chair-stand test (30CST), the Activities-specific Balance Confidence (ABC) Scale, the Trinity Amputation and Prosthesis Experience Scales (TAPES), the Amputee Body Image Scale (ABIS), and the Nottingham Health Profile (NHP). The analysis used a 2 × 2 mixed repeated measures ANOVA. Results: The group-by-time interactions were significant for TUG (p = 0.002, F[1;41] = 10.74) and 30CST (p = 0.001, F[1;41] = 11.48). The mean difference (6th week-baseline) was −0.49 for TUG and 0.95 for 30CST in the telerehabilitation group and −0.14 for TUG and 0.13 for 30CST in the control group. There were statistically meaningful group-by-time interactions on the ABC (p = 0.0004, F[1;41] = 14.47), the TAPES-activity restriction (p = 0.0001, F[1;41] = 28.96), TAPES-prosthesis satisfaction (p = 0.004, F[1;41] = 9.19), and the NHP (p = 0.0002, F[1;41] = 16.07) favoring the telerehabilitation group. Conclusions: Telerehabilitation combined with home exercise can offer greater benefits in improving gait, muscle strength, balance confidence, activity restriction, prosthesis satisfaction, and quality of life compared to home exercise alone for individuals with transtibial amputation. Implications for rehabilitation: Exercise helps individuals with lower limb amputation overcome their physical limitations and enables them to use their prostheses effectively. Physiotherapy and rehabilitation after amputation are not at the desired level, and individuals with lower limb amputation encounter various difficulties in accessing physiotherapy. Telerehabilitation has great potential to facilitate access to physiotherapy for individuals with amputation and reduce resource utilization. In a relatively small sample of amputees, this study shows that telerehabilitation-based exercise improves physical health and quality of life. [ABSTRACT FROM AUTHOR]

Purpose: To understand the perceptions and meaning of the experience of individuals with Parkinson's disease (PD) when participating in a telerehabilitation protocol during COVID-19 pandemic. Methods: This is a qualitative descriptive analytical study with a phenomenological basis, regarding the individuals' perceptions of telerehabilitation. The interviews were conducted by a semi-structured interview guide and carried out via recorded phone calls, which were later transcribed, categorized, and analyzed based on the principles of phenomenology according to the propositions of Martins and Bicudo. Results: From the qualitative analysis, four themes that configure the structure of the phenomenon emerged: 1) Expectations regarding physical therapy through telerehabilitation during the pandemic; 2) Experiences of the new routine; 3) Perceptions about oneself in the light of the proposed telerehabilitation program; 4) A view of the protocol. Conclusion: Apprehension and fear were present during the implementation of the protocol, however, previous experience with face-to-face physical therapy and the team allowed feelings of happiness, contentment, welcomeness, and satisfaction with the possibility of resuming the activities. The individuals actively participated in the program with commitment and co-responsibility, but the lack of physical contact, limited equipment, and constant concern for the safety and individuality of the participants must be emphasized. IMPLICATIONS FOR REHABILITATION: The use of telerehabilitation was a necessary therapeutic alternative during the COVID-19 pandemic period and has currently been consolidated as a complementary resource in the treatment of individuals with Parkinson's disease (PD). The perceptions of people with PD who have experienced telerehabilitation treatment can influence clinical decision-making regarding the use of this tool in this population. Telerehabilitation is useful when distance separates the patient from the healthcare team, it reduces travel time and expenses and can intensify the amount of treatment. According to our interpretation, telerehabilitation requires a good internet connection and restricts physical contact, so hybrid use of rehabilitation modalities (in-person and remote) could be an interesting option. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the test-retest reliability and construct validity of the LCADL scale applied via online form in individuals after hospitalization for COVID-19. Methods: Methodological study. After hospitalization for COVID-19 individuals completed the LCADL via online form at two separate times. They also answered the post-COVID-19 Functional Status Scale (PCFS), dyspnea, fatigue, and health perception scales, modified Medical Research Council (MRCm), Short Form Health Survey 36 (SF-36). Hospitalization data were collected from the individual's medical record. Results: 104 individuals participated in the study (57 men, 45.2 ± 11.9 years). The LCADL showed moderately to high test-retest reliability (ICC: 0.73–0.86; p < 0.001), there was no difference in scores between test and retest (p > 0.05), the mean difference between the applications was smaller than the standard error of measurement and the internal consistency was adequate (Cronbach's α = 0.70–0.94). In addition, it demonstrated adequate construct validity, showing correlations with PCFS, dyspnea perception, fatigue and health scales, mMRC, SF-36, and length of stay in the Intensive Care Unit (p < 0.05). The LCADL as percentage of the total score presented a significant floor effect (25%). Conclusion: The LCADL applied online was reliable and valid for assessing limitations due to dyspnea in ADL in individuals after hospitalization for COVID-19. IMPLICATIONS FOR REHABILITATION: The London Chest Activity of Daily Living Scale applied online is a method of evaluation of dyspnea-related ADL limitations that is valid and reliable after hospitalization for COVID-19 and can be used both in the telerehabilitation environment and in-person rehabilitation; The online form provides a more sustainable means of data storage, since no paper is needed, and saves time during in-person rehabilitation. [ABSTRACT FROM AUTHOR]

Background: The steep increase in knee arthroplasties in lower- and middle-income countries has increased demand for personalised rehabilitation care. Technology-based rehabilitation programs offer potential to replace or augment conventional face-to-face rehabilitation for providing continuum of care. We aimed to systematically develop a theory, evidence-driven, contextualised, and user-centred mobile health platform for people undergoing knee arthroplasty to facilitate monitoring progress during rehabilitation. Methods: We followed the UK Medical Research Council's framework and adopted a behaviour design thinking approach, consisting of five steps; (1) conduct multiple literature reviews and cross-sectional surveys to determine the needs and problems experienced during the rehabilitation phase by healthcare professionals and individuals with replaced knees, (2) identify target behaviours along with barriers and facilitators, integrated within the Capability, Opportunity, Motivation-Behaviour (COM-B) framework, (3) identify intervention functions and components, behaviour change techniques, and features for the mobile application, selected after discussions with orthopaedic surgeons, physiotherapists and behavioural experts, (4) develop a prototype application for end-users, and a web-based platform for healthcare professionals, and (5) pilot test the intervention for end-users' feedback on usability of the application and to identify possible strategies for implementing the intervention package. Results: Using the COM-B model, education, training, persuasion, enablement, and modelling were chosen as intervention functions for improving adherence to exercise protocol during early-phase of rehabilitation. The application featured five interlinked components; education, training, goal setting and self-management, communication, and a personalized therapy plan utilising 13 behaviour change techniques. An education booklet, exercise videos, text messaging, video consultation, and a digital tool for measuring range of motion were incorporated into the application. Feedback on the interactive prototype and education material was sought from ten patient volunteers and a physiotherapist. Pilot testing in a convenient sample with broad eligibility criteria (n = 30) indicated importance of digital literacy and dedicated time for remote consultation by healthcare provider within the existing clinical work. Overall, the intervention was well received and valued by the end users. Conclusion: This paper demonstrates the development of a contextualised digital behavioural intervention grounded in behavioural theory and evidence from literature to improve end-user's engagement with rehabilitation protocols after knee arthroplasty in lower- and middle-income country context. Trial registration: Study registered prospectively (on 16 February 2023) at Clinical Trials Registry of India (CTRI/2023/02/049792). [ABSTRACT FROM AUTHOR]

Introduction: Upper extremity deficits (UED) is a common and impactful complication among stroke survivors. Virtual reality (VR)-based rehabilitation holds potential for enhancing rehabilitation intensity and engagement by stimulating tasks. While several clinical studies have examined the effectiveness and safety of VR-based rehabilitation, there is a need for further research to improve consistency in outcomes. Materials and methods: The study will incorporate randomized controlled trials (RCTs) concerning the effects of VR-based rehabilitation on upper extremity (UE) function in stroke survivors. A comprehensive search of databases including PubMed, Embase, Cochrane Library, Web of Science, Scopus, Cinahl, China National Knowledge Infrastructure (CNKI), Wan-fang, and Chinese Biology Medicine Database will be performed from inception to the start of the study. Primary outcomes will focus on upper limb motor function assessments such as the Fugl-Meyer Upper Extremity (FMUE), Box and Block Test (BBT), Wolf Motor Function Test (WMFT), and Action Research Arm Test (ARAT). Secondary outcomes related to activities of daily living will include the Barthel Index (BI) and Functional Independence Measure (FIM). Research selection, data extraction, and quality assessment will be independently conducted by two researchers. The recently revised Cochrane risk of bias tool will be employed to evaluate study quality. Meta-regression and subgroup analyses will be utilized to identify effective therapy delivery modes and patterns. The assessment, development, and evaluation of recommendations approach will be applied to achieve a robust conclusion. Discussion: This study provides a rigorous synthesis to evaluate optimal parameters—specifically intensity and duration—for VR-based rehabilitation interventions aimed at enhancing UE function in stroke survivors. Our secondary objective is to assess the impact of these parameters on rehabilitation outcomes. We anticipate an accurate, transparent, and standardized review process that will yield evidence-based recommendations for integrating VR technology into treating upper extremity dysfunction in stroke patients, offering clinicians effective strategies to enhance upper limb function. [ABSTRACT FROM AUTHOR]

Background: Studies comparing the effectiveness of telerehabilitation and spinal manual therapy (SMT) for chronic non-specific low-back pain (NSLBP) are limited. This study aimed to compare the efficacy of the telerehabilitation-based McKenzie therapy (TBMT) and SMT among patients with NSLBP. Methods: Forty-nine consenting patients randomised into either TBMT (n = 28) or SMT (n = 21) group completed the study. TBMT is a mobile phone-based telerehabilitation involving the 'McKenzie extension protocol'. SMT is a grade II (10 oscillations) posterior-anterior central vertebral pressure on the offending spinous process. Both interventions were applied thrice weekly for eight weeks, and outcomes were assessed on Pain Intensity (PI), Activity Limitation (AL), Participation Restriction (PR), and Health-related Quality of Life (HRQoL) in the fourth and eighth weeks. Results: Within-group comparison across baseline, 4th and 8th week indicate that SMT had a significant effect on PI (F = 132.804, p = 0.001), AL (F = 75.984, p = 0.001), PR (F = 99.428, p = 0.001) and for all the scales of SF-12 except for mental health domain (p > 0.05). Similarly, TBMT had a significant effect on PI (F = 243.631; p = 0.001), AL (F = 85.930; p = 0.001), PR (F = 48.425; p = 0.001), and for all the scales except also for mental health domain (p > 0.05). However, there were no significant differences (p > 0.05) in the treatment effects between SMT and TBMT, except for the 'health perception' (p = 0.045) scale at week four and the 'mental health' scale (p = 0.023) at week eight. Conclusion: Telerehabilitation-based McKenzie method and SMT are effective in chronic NSLBP, with TBMT leading to significantly higher long-term health perception improvement. Trial Registration: Pan African Clinical Trial Registry (PACTR202010667228786), Registered 27 October 2020-Retrospectively registered. [ABSTRACT FROM AUTHOR]

Introduction: Physiotherapy services have been typically provided in-person since the profession usually involves a therapist providing hands-on assessment and treatments. The COVID-19 pandemic provided an opportunity to study physiotherapists' adaptation to telerehabilitation (phone or videoconference). Objective: This study aimed: (1) to explore how physiotherapists adapted to the transition to delivering telerehabilitation, (2) to assess physiotherapists' perceptions of implementing telerehabilitation, and (3) to identify the challenges and facilitators of delivering telerehabilitation. Methods: This study used an online survey distributed to physiotherapists within a large Canadian health authority. Closed-ended questions were analyzed with descriptive statistics. Results: Seventy-five physiotherapists responded and data were collected. Compared prior to the pandemic to time during the pandemic, the use of a phone for delivering physiotherapy increased from 24.0% to 73.3% of physiotherapists while videoconference increased from 5.3% to 77.3%. Overall, the physiotherapists found videoconference to be a more effective delivery method than phone. Less than half felt that they could use videoconference to effectively treat pain (49.3%), upper extremity function (40.0%) or strength/range of motion (48.0%). Only 29.3% felt that they could effectively treat walking balance or mobility by videoconference. Technical barriers were identified with client comfort with the equipment reported by 90.7% of physiotherapists and positioning of the webcam by 76.0% of physiotherapists. A large proportion of physiotherapists agreed that they would continue the practice of telerehabilitation via phone (54.7%) and videoconference (68.0%). Conclusion: The pandemic resulted in a dramatic shift to telerehabilitation for a profession that typically provides hands-on assessments and treatments. While there was increased uptake of telerehabilitation, many physiotherapists questioned their effectiveness using telerehabilitation to undertake activities that traditionally involve manual treatments or hands-on guidance/supervision. However, physiotherapists were committed to continuing telerehabilitation to meet patients' needs after the pandemic. [ABSTRACT FROM AUTHOR]

ABSTRACT:BackgroundMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONOlder adults live with chronic conditions worldwide. The aim of this systematic review was to determine the effectiveness of physiotherapist-led (PT-led) tele-rehabilitation on various health outcomes.Six databases were searched. Eligible studies were randomized controlled trials that included older adults (≥65 years) who had ≥1 chronic condition, and evaluated tele-rehabilitation (e.g., video, telephone) that was PT-led or overseen. Screening and data extraction were performed in duplicate. Meta-analyses were performed where appropriate. Cochrane’s Risk of Bias 2.0 tool was used.Fifteen studies were included. A meta-analysis of studies of knee osteoarthritis demonstrated that tele-rehabilitation is more effective than usual care for functional mobility (MD= −2.72, 95% CI= −3.56, −1.88, p < 0.001), quadriceps strength (MD= 15.54, 95% CI= 10.14, 20.95, p < 0.001), pain (MD= −1.2, 95% CI= −2.09, −0.39, p = 0.004) and physical function (MD= −5.95, 95% CI= −8.32, −3.58, p < 0.001). No clear differences were found between tele-rehabilitation and usual care or comparator interventions for outcomes related to physical activity level, gait speed, mental health, and quality of life.PT-led tele-rehabilitation appears to be comparable to traditional methods at improving outcomes in older adults with various chronic conditions. However, high-quality trials are needed so future conclusions on the effectiveness of tele-rehabilitation can be made.CRD42023428048Physiotherapist-led tele-rehabilitation appears to be more effective than usual care related to functional mobility, quadriceps strength, self-reported pain and physical function for older adults living with knee osteoarthritis.No other significant differences were found indicating that either tele-rehabilitation or traditional methods of rehabilitation can be used by clinicians to improve health outcomes for older adults living with various chronic conditions.Clinicians should familiarize themselves with the available modes, user operations, and advantages of tele-rehabilitation so that tele-rehabilitation can be better incorporated into clinical practice.Physiotherapist-led tele-rehabilitation appears to be more effective than usual care related to functional mobility, quadriceps strength, self-reported pain and physical function for older adults living with knee osteoarthritis.No other significant differences were found indicating that either tele-rehabilitation or traditional methods of rehabilitation can be used by clinicians to improve health outcomes for older adults living with various chronic conditions.Clinicians should familiarize themselves with the available modes, user operations, and advantages of tele-rehabilitation so that tele-rehabilitation can be better incorporated into clinical practice. [ABSTRACT FROM AUTHOR]

Nowadays studies using Virtual Reality (VR) are gaining high popularity due to VR being a better approximation of the ecological environment for visual experiments than standard 2D display settings. VR technology has been already applied in medicine in the therapy of mental disorders, neurorehabilitation, and neurofeedback. However, its effectiveness compared to the standard 2D procedure is still not fully documented and limited information about the neurophysiological underpinnings of VR is provided. In this study, we tested participants' performance during several sessions of the computer game in two different environments, VR vs. 2D monitor display. Participants performed three 25 min gaming sessions of adapted Delay Match-To-Sample task during EEG recording. The results showed that the VR group outperformed the 2D display group in the first session and then maintained its performance level throughout the remaining two sessions while the 2D group increased performance in each session eventually leveling up in the last one. Also group differences in the EEG activity were most profound only in the first session. In this session, the VR group was characterized by stronger and more synchronized neuronal activity, especially in delta, theta, and gamma bands. The VR group was less impacted by visual arousals as indicated by the theta/beta2 ratio in parietal electrodes. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to evaluate the distribution of virtual voice therapy during the coronavirus disease 2019 (COVID-19) lockdown in Italy via the collection of opinions of speech-language pathologists (SLPs). Methods: All SLPs who regularly carried out their professional activity in public hospitals, private hospitals, or private practices in Italy were asked to fill out an online survey consisting of two sections: (1) demographic information (age, gender, work setting, seniority, working time, and regular use of virtual voice therapy) and (2) opinions regarding telerehabilitation (motivation, personal satisfaction, effectiveness, and future needs and uses). Results: A total of 299 SLPs (mean age 39.1 ± 12.4 years) completed the survey. Overall, a regular use of virtual voice therapy was declared by 31.1% (93/299) of SLPs, with the highest prevalence for SLPs working in fully private facilities (46.7%; p < 0.001). Among all respondents, 25.4% had a highly positive opinion on the possible use of virtual voice therapy, even in nonemergency situations, and 55.8% planned to maintain this rehabilitation modality in the future. Discussion: Italian SLPs, regardless of age, had a positive impact with the new telerehabilitation practices. Investments in training and updating SLPs through specific courses would help to break down the strong barriers to telepractice acceptance, such as lack of familiarity with new technologies and lack of adequate preparation. Virtual voice therapy, which had never been experienced in such a way in Italy before the COVID-19 pandemic, promises to be a valuable future addition to the current traditional rehabilitation approaches. [ABSTRACT FROM AUTHOR]

and strain are the usual causes of Osteoarthritis (OA), sometimes referred to as degenerative joint disease. India had roughly 200,000 knee arthroplasty procedures in 2020 in which nearly 72% were because of OA. Rebuilding the knee joint through knee arthroplasty is a great alternative for treating symptomatic OA in patients who have not responded to conservative treatment. Aim: To determine the effect of Virtual Reality (VR)- based rehabilitation and high-intensity exercise program for Total Knee Arthroplasty (TKA). Materials and Methods: In this double-blinded randomised controlled trial, 36 participants matched the inclusion criteria who underwent Total Knee Replacement (TKR) at the Department of Physiotherapy, Saveetha College of Physiotherapy, SIMATS, Chennai, Tamil Nadu, India. The study was started in the month of October 2023 and ended in January 2024. Then the participants were randomly allotted to an experimental group-VR (n=18) and a conventional group-high-intensity exercises (n=18). Outcome measures used are the Numeric Pain Universities Osteoarthritis Index (WOMAC) and Timed Up and Go (TUG) test. A paired t-test was utilised to evaluate significant variations between the pre- and post-test measurements. In order to find any meaningful differences between the two groups, an unpaired t-test was employed. Result: The average mean±Standard Deviation (SD) of age and Body Mass Index (BMI) was found to be 51.2±5.2 yearsand 28.3±2.0 kg/m². The experimental group and the conventional group both exhibited notable changes in terms of within-group differences. Numeric Pain Rating Scale (NPRS) significantly showed the same between the groups, but the range of motion showed better output in VR-based rehabilitation than indifferently supporting the pain outcome of the experimental group (p≥0.0001). Balance, gait and functional activities were improved in the experimental group compared to the conventional group and in the VR-based rehabilitation, the functional independence of the patient was achieved in nine weeks compared to the High-intensity (HI) exercises. Conclusion: The VR-based rehabilitation showed better outcomes in pain, range of motion, balance, gait and functional independence than a high-intensity exercise programme. [ABSTRACT FROM AUTHOR]

Purpose: This scoping review was conducted to understand the barriers, facilitators, and education and training needs of rehabilitation clinicians in their use of mainstream wireless technologies (MWT) to support people with disabilities and older adults. It was also conducted to understand the functional skills of clients that were targeted with MWT use. Materials and methods: This scoping review was reported using PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) and the Population (or Participants)/Concept/Context) framework. We searched PubMed; ProQuest to access APA PsycINFO; Web of Science Core Collection; and EBSCOhost to access Cumulated Index to Nursing and Allied Health Literature (CINAHL), Ovid MEDLINE ALL, and Education Resources Information Center (ERIC). Articles published between 2015–2022 were retrieved. Results: A total of 90 articles were included. Most interventions were apps, smartphones, and tablets; were geared toward adults; and targeted motor, cognitive and speech skills. An infographic on barriers and facilitators was generated as a decision support tool for clinicians when implementing MWT. The topic, format, timing, and source of information clinicians need are also delineated. Conclusion: MWT such as apps, smartphones and tablets are being used by rehabilitation clinicians to address motor, cognitive, and speech skills, most commonly in adults. Clinicians voice a need for more education and training. Barriers and facilitators exist at the clinician-, technology-, client-, institution-, and policy levels. IMPLICATIONS FOR REHABILITATION: A total of 90 articles from 2015–2022 were included in this scoping review Most interventions were apps, smartphones, and tablets; were geared toward adults; and targeted motor, cognitive and speech skills. An infographic was generated as a decision support tool for clinicians when implementing mainstream wireless technologies in clinical practice. Clinicians' education and training needs with regard to mainstream wireless technologies are broad. Materials on a variety of topics, in different formats, from multiple sources are needed. This review also discusses implications of findings on policy, technology development, and future research. [ABSTRACT FROM AUTHOR]

Purpose: To assess the inter-reliability of the Short Physical Performance Battery (SPPB), the 1-min Sit to Stand test (1-MSTS), and the Chester Step Test (CST) via remote assessment in post-COVID-19 patients after hospitalization. Methods: Twenty-five post-COVID-19 patients randomly performed the functional tests via remote assessment using a software platform at home and via face-to-face assessment at the rehabilitation center 24–72 h apart. One day before the remote assessment, all participants had a 1-h guidance session regarding the platform use, safety instructions, and home equipment preparation. Results: Participants completed all tests for both assessment procedures without experience of adverse events. The mean age was 53 (SD = 10) years old, and the median days of hospitalization were 23 (IQR = 10–33). The inter-reliability was moderate for the total score in the SPPB: Cohen's kappa = 0.545 (95% CI: 0.234 to 0.838), excellent for the number of repetitions in the 1-MSTS: ICC = 0.977 (95% CI: 0.948 to 0.990) and good for the total number of steps in the CST: ICC = 0.871 (95% CI: 0.698 to 0.944). Conclusion: Remote functional assessments for SPPB, 1-MSTS, and CST indicated moderate to excellent inter-reliability in post-COVID-19 patients after hospitalization. IMPLICATIONS FOR REHABILITATION: Functional performance assessment in post-COVID-19 patients is considered important throughout the whole process of rehabilitation. The face-to-face assessment is the standard practice in the rehabilitation clinical setting however, new approaches by distance assessment are proposed when physical attendance is not feasible. The Short Physical Performance Battery (SPPB), the 1-minute Sit to Stand test (1-MSTS), and the Chester Step Test (CST) showed moderate to excellent reliability when performed remotely at home in post-COVID-19 patients after hospitalization. [ABSTRACT FROM AUTHOR]

Background: The efficacy of various supervision methods for stabilization exercises in patients with chronic low back pain (CLBP) remains uncertain. Objective: To evaluate the impact of supervised and unsupervised stabilization exercises in patients with CLBP. Methods: Sixty-six participants were assigned to the in-person-supervised, tele-supervised, or unsupervised groups. All participants received a 20–30-minute exercise program three times a week for 4 weeks. We assessed functionality (Oswestry Disability Index), pain intensity (Numeric Rating Scale), and kinesiophobia (Tampa Scale of Kinesiophobia) before and after the 4 weeks. The outcomes were analyzed using effect size, minimum clinically important difference (MCID), minimal detectable change (MDC), Wilcoxon test, and post hoc analyses. Results: While the unsupervised group improved in all measures (p <.05) both the tele-supervised (p =.001) and in-person-supervised (p <.001) groups achieved superior functionality exceeding MDC. The in-person-supervised group demonstrated greater functionality (p <.001) than the tele-supervised group, exceeding MCID. Pain intensity decreased in the tele-supervised (p =.011) and in-person-supervised groups (p <.001) compared to the unsupervised group, exceeding MCID and MDC. No significant difference was found in post-treatment NRS score changes between the supervised groups (p =.071). The in-person-supervised group displayed a greater reduction in kinesiophobia than the tele-supervised (p <.001) and unsupervised groups (p <.001) but not exceeding MCID or MDC. Effect sizes were large within and between groups except for a small effect size between the tele-supervised and unsupervised groups in kinesiophobia. Conclusion: While tele-supervised stabilization exercises alleviate pain and enhance functionality, in-person-supervised exercises may be more effective in improving functionality and reducing kinesiophobia in patients with CLBP. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to explore the usability of and satisfaction with tele rehabilitation services provided to rehabilitation patients with various diagnoses at two large urban medical facilities during the COVID-19 pandemic. Design: This was a usability study and all patients that received tele rehabilitation services from March 2020 to November 2021 were included. Of the 4070 surveys sent via mail or email links to RED Cap, 405 were completed (10% response rate). Participants completed demographic surveys, surveys on the tele rehabilitation visit characteristics, tele rehabilitation usability, and overall satisfaction with the visit. Results: Patients were mostly women (64.4%), White, non-Hispanic (74.3%), and English-speaking (99%). Most patients were seen via tele rehabilitation due to COVID-19 restrictions (37.1%). Patients were generally satisfied with their tele rehabilitation visit (3.64 out of 4). Additionally, patients generally found telerehab to be useful (6.4 out of 7), easy to use (6.3 out of 7), effective (6.2 out of 7), satisfactory (6.3 out of 7), and comparable to in-person visits (6.5 out of 7). Conclusions: Patients generally reported feeling satisfied and comfortable with tele rehabilitation visits and felt that they were comparable to in-person visits. Future research should examine the impact of socioeconomic factors on tele rehabilitation use, with a focus on education level and non-English speaker. [ABSTRACT FROM AUTHOR]

Telerehabilitation has been suggested to be equally effective than in-person rehabilitation, and could be helpful to increase participation and reduce barriers. People with multiple sclerosis (MS) often present urogenital dysfunctions, impairing independence and quality of life (QoL). Since the different available telerehabilitation protocols, the present study aimed to compare a live video urogenital rehabilitation intervention protocol (REMOTE) with a home-based pre-recorded video protocol (SELF). A randomized-controlled trial was performed, with 14 females with MS being allocated in the REMOTE group (36 ± 9 y) and 14 females in the SELF group (37 ± 7 y). Both telerehabilitation protocols were identical in terms of contents (including pelvic floor training and relaxation exercises), frequency and duration, consisting of 10 sessions of 45 min each, every 5 days. Questionnaires were administered at the beginning and the end of the study: Short Form Health Survey 36 (SF-36), Beck Depression Inventory (BDI), Female Sexual Function Index (FSFI), International Consultation on Incontinence Questionnaire (ICIQ) symptoms and related QoL, the main outcome being ICIQ incontinence score. Despite most of the outcomes improved in both groups, REMOTE was found to be more effective than SELF in most of the SF-36 domains (from p < 0.001 pη2 0.555 to p = 0.044 pη2 0.147), FSFI (p = 0.001 pη2 0.373), ICIQ (p = 0.003 pη2 0.291). Despite the home-based pre-recorded videos could be effective in improving urogenital symptoms, live video urogenital rehabilitation results in larger improvements. Telerehabilitation should be encouraged for urogenital dysfunctions in females with MS, and pre-recorded videos could represent an alternative when live sessions are not available. Clinical trial registration This randomized controlled trial was registered on ClinicalTrials.gov with the number NCT05984095. [ABSTRACT FROM AUTHOR]

Background: Home-based rehabilitation is a cost-effective means of making services available for patients. The aim of this study is to determine the evidence in the literature on the effects of home-based neurostimulation in patients with stroke. Method: We searched PubMED, Embase, Web of Science, Scopus, and CENTRAL for randomized controlled trials on the subject matter using keywords such as stroke, electrical stimulation and transcranial direct current stimulation. Information on participants' characteristics and mean scores on the outcomes of interest were extracted. Risks of bias and methodological quality of the included studies were assessed using Cochrane Risks of bias tool and PEDro scale respectively. The data was analyzed using both narrative and quantitative syntheses. In the quantitative synthesis, meta-analysis was carried out using random effect model analysis. Result: The results showed that, home-based neurostimulation is superior to the control at improving upper limb muscle strength (SMD = 0.72, 95% CI = 0.08 to 1.32, p = 0.03), functional mobility (SMD = -0.39, 95% CI = -0.65 to 0.14, p = 0.003) and walking endurance (SMD = 0.33, 95% CI = 0.08 to 0.59, p = 0.01) post intervention; and upper limb motor function (SMD = 0.9, 95% CI = 0.10 to 1.70, p = 0.03), functional mobility (SMD = -0.30, 95% CI = -0.56 to -0.05, p = 0.02) and walking endurance (SMD = 0.33, 95% CI = 0.08 to 0.59, p = 0.01) at follow-up. Conclusions: Home-based neurostimulation can be used to improve upper and lower limb function after stroke. [ABSTRACT FROM AUTHOR]

Aims: To investigate the effects of a telerehabilitation program on walking performance, lower and upper extremity function, fall frequency, respiratory function, and satisfaction in individuals with Duchenne muscular dystrophy (DMD). Methods: Thirty children (mean age 8.8 ± 4.2 years) were ambulant (Group 1), and 12 youth (18.5 ± 4.7 years) were non-ambulant (Group 2). The telerehabilitation program was applied by physiotherapists for 24 sessions (3 days/week). The 10-meter walking test, stand up from the supine position test, the modified upper extremity performance test, repetition of Lower and upper extremity movements, and the single breath count (SBC) test were administered. Fall frequency and satisfaction level were also recorded. Results: Significant improvement was found after telerehabilitation in upper extremity performance, repetition of lower and upper extremity movements, fall frequency, and SBC scores in Group 1. Changes in the 10-minute Walk and Stand Up from the Supine Position tests were not significant. There was a significant improvement in SBC scores in Group 2. Satisfaction with the service was 88%. Conclusions: The 8-week telerehabilitation program was effective in improving aspects of upper and lower extremity function, fall frequency, pulmonary function, and satisfaction levels in individuals with DMD. [ABSTRACT FROM AUTHOR]

A growing number of total knee arthroplasty (TKA) patients are candidates for same-day discharge (SDD). Previous research has shown that internet-based remote physical therapy (RPT) can produce equivalent outcomes to supervised outpatient physical therapy (OPT) after TKA. We sought to compare outcomes between RPT and OPT in patients undergoing SDD TKA using an electronic remote perioperative management (ERPM) program. Patients undergoing SDD TKA were enrolled in an ERPM program and randomized to ERPM + RPT or ERPM + OPT. Preoperative and 6-week functional assessments included knee range of motion, timed up and go, and 4-meter gait speed. Numerical Rating Scale pain scores were evaluated preoperatively, at 6 and 12 weeks, and satisfaction was assessed at 6, 12, and 52 weeks postoperatively. Participants completed the Veterans Rand 12 Item Health Survey and Knee Injury and Osteoarthritis Outcome Score preoperatively and at 6, 12, and 52 weeks postoperatively. OPT utilization was collected 90 days postoperatively. Of 197 initially randomized patients, 76 remained in the ERPM + RPT group and 95 in the ERPM + OPT group after withdrawals and crossovers. Baseline characteristics showed no differences between the 2 groups. No clinically relevant differences were observed in knee range of motion, Numerical Rating Scale pain, patient-reported outcomes, functional assessments, or satisfaction at any follow-up time. Participants in the ERPM + OPT group attended an average of 11.57 physical therapy sessions, incurring a total cost of $462.8 and 133 minutes of travel. Conversely, the ERPM + RPT group experienced no expenses or travel time. Patients in the ERPM + RPT group had similar outcomes, lower costs, and saved time compared to patients in the ERPM + OPT group after SDD TKA. Further analysis is needed to determine predictive indicators for crossovers. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) is a common, costly, and morbid condition. Pulmonary rehabilitation, close monitoring, and early intervention during acute exacerbations of symptoms represent a comprehensive approach to improve outcomes, but the optimal means of delivering these services is uncertain. Logistical, financial, and social barriers to providing healthcare through face-to-face encounters, paired with recent developments in technology, have stimulated interest in exploring alternative models of care. The Healthy at Home study seeks to determine the feasibility of a multimodal, digitally enhanced intervention provided to participants with COPD longitudinally over 6 months. This paper details the recruitment, methods, and analysis plan for the study, which is recruiting 100 participants in its pilot phase. Participants were provided with several integrated services including a smartwatch to track physiological data, a study app to track symptoms and study instruments, access to a mobile integrated health program for acute clinical needs, and a virtual comprehensive pulmonary support service. Participants shared physiologic, demographic, and symptom reports, electronic health records, and claims data with the study team, facilitating a better understanding of their symptoms and potential care needs longitudinally. The Healthy at Home study seeks to develop a comprehensive digital phenotype of COPD by tracking and responding to multiple indices of disease behavior and facilitating early and nuanced responses to changes in participants' health status. This study is registered at Clinicaltrials.gov (NCT06000696). [ABSTRACT FROM AUTHOR]

Background: Spinal cord injury (SCI) is a common neurological condition marked by damage to the spinal cord. In the field of neurological rehabilitation, virtual reality (VR) is increasingly employed for evaluating and addressing the physical limitations caused by SCI. This study aimed to describe and calculate the effect sizes of virtual reality intervention (VR) on the functional performance of SCI. Methods: We searched PubMed, Embase, Web of Science, and Cochrane Library to identify articles published before October 30, 2023, that addressed the intervention of SCI using virtual reality technology. We excluded from the meta-analysis articles that did not provide enough data to evaluate the association between virtual reality intervention and spinal cord injury. The RevMan 5.4 statistical software was used for data analysis. Results: We included 16 articles in the systematic review and pooled 9 for the meta-analysis, which were 5 randomized controlled trials (RCTs) and 4 non-RCTs, including 248 subjects. The outcome measure of the walking index for spinal cord injury, limits of stability testing and berg balance scale scores improved in non-RCTs. Conclusion: VR has shown promise in enhancing walking ability and balance function in individuals with SCI. However, the existing evidence for VR interventions in SCI patients remains limited, highlighting the necessity for future studies in this area. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultConclusionThis meta-analysis to assess the effectiveness of telerehabilitation for heart failure compared to either usual medical care or centre-based rehabilitation on 6-minutes walking distance (6MWD) and peak oxygen uptake (VO2 peak). At the same time, we wanted to explore the effects of different telerehabilitation strategies on exercise capacity in heart failure patients.We conducted a search in five databases, namely PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and CBM. The search was conducted up until 4th, 2024. The quality of the included studies was assessed using the Revised Cochrane Risk-of-bias Tool for Randomised Trials. Statistical analysis was performed using Review Manager 5.4. The study included a total of 11 articles.We included 11 randomised controlled trials that incorporated 13 different rehabilitation strategies. We found that a randomised controlled trial providing tele-rehabilitation was more effective than usual care in improving patients’ 6MWD (p<0.00001; MD 18.43, 95%CI 14.63, 22.21), as well as VO2 peak (p<0.0001; MD1.23, 95%CI 0.67, 1.78).The review suggests that remote rehabilitation enhances exercise capacity and cardiopulmonary function in heart failure patients who have been discharged. In the future, such rehabilitation measures could be an effective alternative to hospital-based rehabilitation. [ABSTRACT FROM AUTHOR]

BackgroundPurposeMethodsResultsConclusionFor people with Parkinson’s disease (PwPD), high-intensity exercise in individual or group format can improve function and quality of life (QoL). Individualized virtual exercise programs have been effective for people with PD, but the feasibility and impact of group exercise in the virtual format has not been investigated.To compare the effect of individual and group virtual exercise on functional mobility and QoL for PwPD.Twenty PwPD were randomized to individualized (n = 10) or group (n = 10) virtual exercise 2 times per week for 8 weeks. Exercises were multi-dimensional, and intensity was monitored with a wrist-worn heart rate (HR) monitor. Outcomes were assessed before and after the program, including standing balance, gait speed, gait endurance, motor function, QoL, and self-efficacy. Within-and between-group changes were analyzed using a mixed model analysis of variance (ANOVA) and nonparametric tests were used for analysis.Participants attended over 75% of scheduled sessions. Within-group analysis showed statistically significant improvements in Five Times Sit-to-Stand (p < .01), mini-BESTest (p = .03), comfortable (p < .01) and fast gait speeds (p = .02), and gait endurance (p < .01) with large effect sizes (partial eta squared > 0.25). There were no statistically significant differences between groups on any outcomes (p > .09). In more than 70% of sessions, participants reached an exercise intensity ≥ 65% HR maximum.This high-intensity, virtual exercise program was safe and effective at improving balance and functional mobility for community-dwelling PwPD in individual and group format. Virtual exercise programs, either in an individual or group format, can increase access to high-quality programs for PwPD. [ABSTRACT FROM AUTHOR]

AbstractObjectivesMetchodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONMaintenance hemodialysis patients’ psychology and physiology will have negative effects. Adherence to exercise can effectively enhance the physical function of maintenance hemodialysis patients and reduce the negative psychological emotions. In recent years, virtual reality technology has been gradually applied to the hemodialysis group, providing a new way for the rehabilitation training and healthy life of maintenance hemodialysis patients.To understand the real experience of maintenance hemodialysis patients participating in virtual reality rehabilitation training, and to make reference for the future clinical development of a more perfect virtual reality rehabilitation training program.Phenomenological research method was used to conduct semi-structured interviews with 10 maintenance hemodialysis patients, and the interview data were compiled and analyzed using Colaizzi’s seven-step analysis.Four themes were distilled: (1) Maintenance hemodialysis patients’ overall perceptual experience of the virtual reality rehabilitation system; (2) Physical and psychological improvement of maintenance hemodialysis patients with virtual reality rehabilitation system; (3) Individualized needs of maintenance hemodialysis patients during virtual reality rehabilitation training; (4) Future improvements and recommendations for the virtual reality rehabilitation system.The results of the study suggest that virtual reality improves patients’ motivation to recover and shows positive results and potential benefits in improving physical functioning and negative emotions in maintenance hemodialysis patients.Regular and continuous rehabilitation training is a very effective non-pharmacological treatment to improve the physical functioning and mental health of maintenance hemodialysis patients.Virtual reality technology can stimulate the underlying motivation of maintenance hemodialysis patients to undergo rehabilitation, thus, they are guided to adopt a healthy lifestyle.Virtual reality technology can be an effective aid in the rehabilitation of maintenance hemodialysis patients, thus reducing the workload of rehabilitation clinicians.Regular and continuous rehabilitation training is a very effective non-pharmacological treatment to improve the physical functioning and mental health of maintenance hemodialysis patients.Virtual reality technology can stimulate the underlying motivation of maintenance hemodialysis patients to undergo rehabilitation, thus, they are guided to adopt a healthy lifestyle.Virtual reality technology can be an effective aid in the rehabilitation of maintenance hemodialysis patients, thus reducing the workload of rehabilitation clinicians. [ABSTRACT FROM AUTHOR]

The recommended rehabilitation procedures for Developmental Dyslexia (DD) are not well defined, and there is currently a large debate on which therapeutic approaches are shown to be more useful and effective. Among the trainings focused on general dysfunctional cognitive processes associated with a reading disorder, recent studies suggested the efficacy of trainings on Rapid Automatized Naming (RAN) compared to others. The present study was aimed at confirming the effectiveness of RAN training (RANt) to improve the reading performances of children with DD (n = 32) compared to children on a waiting list (WL, n = 25) and to children in different treatment groups, one following a text reading training (RT, n = 26) and the other combining RAN and text reading exercises (RANt+RT, n = 20), through an online platform that allows intensive and self-adaptive activities. Results confirmed the efficacy of RANt in improving reading speed and accuracy compared to the WL group (r2 ranging from small (.16) to medium (.48)) and found the absence of differences with the other active control groups. The single-subject level analysis confirmed the results, a high inter-subject variability in treatment response and pre-post differences were found. Further studies could consider such variability in the functional profile of the DD subjects, but RANt was confirmed to be a valid tool for improving decoding skills. [ABSTRACT FROM AUTHOR]

Introduction: Approximately 75% of caregivers providing unpaid care to family members or friends experience persistent pain. Simultaneously, individuals who require caregiving commonly experience pain. The inherent complexity of pain is enhanced by relationship dynamics of two closely tied individuals (i.e., caregiving dyad = caregivers and care recipients). Currently there are no proven pain interventions that target the caregiving dyad. Thus, the purpose of this pilot study was to assess the feasibility of a new behavioral multimodal intervention, the Merging Yoga and self-management to develop Skills (MY-Skills) intervention. Methods: Each participant was part of a caregiving dyad and all participants had moderate to severe musculoskeletal pain, a score of =4 of 6 on the short minimental status exam, were =18 years old, sedentary, able to speak English, able to stand, and living at home. Participants were randomized to MY-Skills or the control group. MY-Skills was offered twice a week for eight weeks and each two-hour session included yoga and self-management education developed specifically for caregiving dyads experiencing persistent pain. MY-Skills was group based and developed as an in-person intervention. Due to Covid-19, the intervention was moved online and data are presented for in-person and online cohorts. Benchmarks for feasibility were set a priori, addressing: recruitment, attrition, attendance, safety, acceptability/satisfaction, and study completion. Results: Thirteen participants completed the in-person MY-Skills intervention (caregivers n = 7, care-receivers n = 6) and 18 individuals completed the online MY-Skills intervention (9 dyads). Most participants had pain for =10 years. Recruitment and attrition benchmarks for the in-person intervention were not met; yet they were met for the online version. In-person and online MY-Skills intervention attendance, safety, acceptability/satisfaction, and completion exceeded benchmark criteria. Discussion: The MY-Skills intervention appears feasible and acceptable, however changes to recruitment criteria are necessary. Additional testing and larger sample sizes are required to test efficacy. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effectiveness of current strategies oriented to increase adherence to physical therapy in subjects with knee and hip osteoarthritis (OA). Material and methods: A systematic review of electronic databases was conducted from inception until March 2023. Studies with experimental interventions using strategies to increase adherence to physical therapy programs in subjects with knee or hip OA were included. A meta-analysis compared the effects of such interventions with usual care for adherence-related measures (primary outcome), and functional and pain outcomes, using standardized mean differences (SMD) with a 95% confidence interval (CI). GRADE was used to determine the strength of the resultant evidence and the external validity of the findings. Results: Fifteen articles, assessing 1,818 participants, were included. The interventions included cognitive-behavior strategies, telephone calls, internet-based interventions, communication technologies, and booster sessions. A meta-analysis revealed that the experimental interventions increased adherence over usual care with a moderate effect size of SMD = 0.39 (95%CI = 0.08–0.71) and moderate certainty in this evidence Conclusion: Overall, this review supports that the strategies to promote adherence to physical therapy in individuals with knee and hip OA are effective. However, the positive impact on adherence rates does not always translate into improved clinical outcomes. IMPLICATIONS FOR REHABILITATION: Strategies such us behavioral programs, phone reminders, telerehabilitation and equipment based on new technologies can be employed to enhance adherence to physical therapy among individuals with knee and hip osteoarthritis. These interventions may be also beneficial for improving self-reported functionality; however, their impact on performance-based function and pain appears to be limited. The potential for longer-duration interventions to enhance adherence in the long-term is a subject of speculation but requires further reinforcement through additional studies. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study was conducted to develop information and communication technology (ICT)-based oral functional rehabilitation exercise (OFRE) program content to effectively improve the oral function of the elderly people. Methods: After selecting evidence-based effective OFRE items through systematic review, the final items were constructed through the validity evaluation of detailed items through an expert Delphi survey. The items were composed in a simple content form that can be performed directly and applied to ICT-based mobile applications. Results: The final content items consisted of an oral functional motor-ability measurement, oral Pilates videos, and games. The first is to measure the maximum opening amount before and after exercise, and the opening amount was designed to be measured by eating the fruit displayed on the screen by opening and closing the lips. The second one consisted of eight exercises in the video, and each exercise was to be performed at least three times a day, with a total of two sets. The third is a salivary secretion function exercise that stimulates the salivary glands to stimulate the user's interest and enable them to perform oral movements on their own. It consists of a lip and respiratory muscle exercise that inflates the cheeks and bursts a balloon, and the image disappears when the word in the image presented on the screen is pronounced correctly. It consists of pronunciation exercises. Conclusions: This content development attempt can be expanded into new convergence research linked to ICT and can be used as basic data when developing related content as part of digital care for the elderly in the future. [ABSTRACT FROM AUTHOR]

BackgroundObjectivesMethodsResultsConclusionFace-to-face access to exercise programs, including standard exercises (SE) and core stability exercises (CSE), can be challenging for many total knee arthroplasty (TKA) patients.To investigate the effects of adding CSE to SE on patient-reported and performance-based outcomes in TKA patients using telerehabilitation (TR).Group 1 (SE, n = 21) and Group 2 (SE+CSE, n = 21). Follow-up included videoconferences (1–8 weeks) and telephone calls (9–12 weeks). Assessments (preoperatively and at 1st, 2nd, and 3rd postoperative months) included; Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): functional level, Visual Analogue Scale (VAS): pain intensity, Copenhagen Knee Range of Motion (ROM) Scale (CKRS): knee ROM, Short Form-12 (SF-12) and World Health Organization Quality of Life Brief Version (WHOQOL-BREF): quality of life, 30-s Chair-Stand Test: muscle strength, and Stair Climb Test: locomotor performance.All assessments showed a significant improvement after treatment in group 1 (p < .001, Cohen’s d = 0.315 to 0.959) and group 2 (p < .001, d = 0.445 to 0.901). There was no significant difference between groups in knee flexion ROM (p > .05). Group 2 achieved better results in functional level (p = .001 to 0.003,d = −0.334 to 1.207), pain intensity (p = .030,d = −0.334), knee extension ROM (p = .015,d = −0.374), quality of life (p = .001 to 0.046,d = −0.308 to −1.366), muscle strength (p = .002 to 0.016,d = −0.779 to −1.030), and locomotor performance (p = .004 to 0.009, d = 0.404 to 0.954).SE and SE+CSE via TR enhance patient-reported and performance-based outcomes in post-operative TKA patients, with CSE providing additional benefits. These results support using CSE in TR programs for TKA and encourage further research on TR. [ABSTRACT FROM AUTHOR]

Background: Chronic pain is reported by between 30 and 71% of people with haemophilia (PWH). Exercise is shown to be effective for pain management in other arthritides, but it remains unclear if such an approach is effective or acceptable to PWH. The aim of this study was to evaluate the feasibility and acceptability of a telerehabilitation exercise intervention for PWH living with chronic pain. Methods: This was a multisite, non-randomised, pre-post feasibility design, with a nested qualitative study. People with severe haemophilia > 18 years, living with chronic pain, were recruited. The intervention comprised 12 low-impact/moderate intensity, individualised exercise sessions and 3 knowledge-sharing and discussion sessions. Primary objectives assessed according to predefined progression criteria were as follows: (a) recruitment rate (5 participants enrolled per site over 8 weeks), (b) adherence (≥ 75% participants would adhere to ≥ 75% of sessions), (c) follow-up rate (≥ 75% completion of self-reported measures), (d) fidelity (intervention delivered as described in protocol) and (e) safety (≤ 30% participants would report adverse events). Acceptability was evaluated from thematic analysis of post-intervention participant interviews. Preliminary evaluation of self-reported pain, function and quality of life (QoL) was a secondary objective. Results were reported using descriptive statistics integrated with qualitative findings. Results: Ten PWH were recruited and completed the intervention. Nine agreed to be interviewed post intervention. Attendance at individual sessions was 84.5% compared to 52.1% for the group sessions. Outcome measures were successfully completed for 100% at baseline, 70% at intervention end and 60% at 3-month follow-up. No serious adverse events were recorded. Group median values in outcome measures (pain, function, QoL) showed minimal change post intervention. Participant interviews highlighted high levels of enjoyment, confidence in continuing exercises independently and positive views of virtual delivery and condition-specific exercise. Conclusions: Recruitment rate and safety met the predefined progression criteria. Fidelity partially met the progression criteria, but the follow-up rate for self-reported measures did not. The study was acceptable to both participants and physiotherapists. Further intervention development is needed to review approaches to outcome measure collection and refine the usefulness of the knowledge-sharing sessions. Trial registration : The study was prospectively registered on 9 July 2021: International Standard Randomised Controlled Trial Number ISRCTN 17454597. [ABSTRACT FROM AUTHOR]

Aim: To examine studies involving the impact of telerehabilitation (TLR), tele‐training and tele‐support on the dyad stroke survivor and caregiver in relation to psychological, physical, social and health dimensions. Design: A systematic review was conducted. Data Sources: The following electronic databases were consulted until September 2023: PsycInfo, CINAHL, Eric, Ovid, PubMed, Scopus, Cochrane Central and Web of Science. Review Methods: It was conducted and reported following the checklists for Reviews of PRISMA 2020 Checklist. Critical evaluation of the quality of the studies included in the review was performed with the Joanna Briggs Institute Checklists. Data Synthesis: A total of 2290 records were identified after removing duplicates, 501 articles were selected by title and abstract and only 21 met the inclusion criteria. It included 4 quasi‐experimental studies, 7 RCTs, 1 cohort study and 9 qualitative studies. The total number of participants between caregivers and stroke survivors was 1697, including 858 stroke survivors and 839 caregivers recruited from 2002 to 2022. For a total of 884 participants who carried out TLR activities in the experimental groups,11 impact domains were identified: cognitive/functional, psychological, caregiver burden, social, general health and self‐efficacy, family function, quality of life, healthcare utilization, preparedness, quality of care and relationship with technology. Conclusions: The results support the application of telehealth in the discharge phase of hospitals and rehabilitation centres for stroke survivors and caregivers. TLR could be considered a substitute for traditional rehabilitation only if it is supported by a tele‐learning programme for the caregiver and ongoing technical, computer and health support to satisfy the dyad's needs. Impact: Designing a comprehensive telemedicine programme upon the return home of the dyad involved in the stroke improves the quality of life, functional, psychological, social, family status, self‐efficacy, use of health systems and the dyad's preparation for managing the stroke. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Objective Conventional total knee arthroplasty (TKA) rehabilitation has little impact on sedentary lifestyles that have negative long-term health consequences. The purpose of this trial was to determine the effect of telehealth-based physical activity behavior change intervention on physical activity and functional outcomes following TKA. Methods This study was a 2-arm, parallel randomized controlled superiority trial at a regional Veterans Affairs medical center. The participants were 92 US military veterans (mean age = 65.7 [SD =7.8] y) undergoing unilateral TKA. The Physical Activity Behavior Change (PABC) intervention included telehealth-based self-management training (10 30-minute sessions) delivered over 12 weeks. The control intervention included telehealth-based health education sessions that matched PABC frequency and duration. Both groups participated in standardized conventional outpatient rehabilitation. Physical activity, measured as average daily step count, was the primary outcome. Secondary outcomes were Life-Space Assessment questionnaire, 30-Second Chair-Stand test, Timed "Up & Go" Test, 6-Minute Walk Test, Western Ontario and McMaster Universities Osteoarthritis Index, and Veterans RAND 12-Item Health Survey. The Self Efficacy for Exercise scale and daily time spent in different postures (sitting/lying, standing, stepping) were exploratory variables. Outcomes were measured at baseline (before surgery), mid-intervention (8 weeks after surgery), after the intervention (14 weeks after surgery; primary endpoint), and follow-up (38 weeks after surgery). Results The PABC group had an estimated 931 (95% CI = 42–1819) more daily steps than the control group from baseline to 14 weeks, though a between-group effect was not sustained at 38 weeks. There were no group differences in secondary outcomes. Participants included only military veterans using Veterans Health Administration services. The intervention targeted self-management and did not include peer support. Conclusion The PABC intervention improved physical activity for veterans recovering from unilateral TKA at 14 weeks after surgery, though the effect was not sustained at 38 weeks. Physical function improved with rehabilitation but was not different between groups, indicating that physical function was not a primary driver of physical activity behavior. Impact Conventional TKA rehabilitation has a negligible effect on free-living physical activity, which is relevant to long-term health outcomes. This trial identified telehealth physical activity self-management as effective in addressing activity behaviors, separate from conventional rehabilitation strategies. [ABSTRACT FROM AUTHOR]

Introduction: Neck Pain (NP), a major global disability, disproportionately affects women, especially homemakers performing repetitive domestic tasks with poor ergonomics. Regular exercise helps, but access might be limited. Telerehabilitation, using technology for remote care, emerges as a potential solution. Homemakers with NP often lack access to exercise programmes. This study tests if telerehabilitation with exercises and ergonomics improves their function. Aim: The aim of this study was to assess the effectiveness of a combined tele-rehabilitation programme incorporating structured neck exercises and ergonomic advice for the sustainable management of NP among homemakers experiencing nonspecific NP. Materials and Methods: This experimental study was carried out at BV(DU), School of Physiotherapy on 63 female homemakers residing at Sangli city, Maharashtra. The duration of study was one year from March 2023 to April 2024. Participants aged 25-55, with moderate NP (VAS 2-5) and performing tasks like chopping, mopping, and lifting for more than 4 hours a day, were included. A 30-day telerehabilitation programme with daily supervised exercises and ergonomic advice was carried out. Wilcoxon Matched Pairs test was used to compare pretest and post-test VAS, Neck Disability Index (NDI), performance, and Manual Muscle Testing (MMT) scores. The p-value: 0.001 (at 5% level of significance). Results: The combined intervention significantly improved pain, strength, quality of life, and all components of the ICF Core Set, a standardised outcome measure for disability. 68.46% reduction was seen in VAS scores; 83.68% reduction was seen in NDI scores with effect size 0.9570. Maximum improvement of 100% was seen in code d4103 (sitting) and a minimum improvement of 40.86% was seen in code d4105 (bending). Conclusion: Telerehabilitation with structured neck exercises and ergonomic advice can effectively reduce pain, improve strength and quality of life, and enhance function in homemakers with NP. This study also highlights the ICF Core Set's usefulness in evaluating NP interventions. Telerehabilitation offers a promising, accessible treatment option for individuals facing barriers to in-person care. [ABSTRACT FROM AUTHOR]

Background Falls have high socioeconomic costs. Information and communication technologies may support provision and monitoring of multisensory (MSR) physiotherapy programmes. The HOLOBalance platform used augmented reality holograms to provide patient-centred, individualised MSR. Objectives To determine the platform's safety, acceptability and feasibility, investigate functional gait and dynamic balance benefits and provide data for a definitive trial. Design and setting Single-blinded pilot randomised controlled feasibility study. Interventions were conducted at clinical sites or participants' homes in three European countries. Participants Community-dwelling older adults (median age 73 years; 64.2% female) at risk of falls were enrolled (May 2020-August 2021). Methods Participants were randomised to an 8-week clinic or home-based telerehabilitation MSR or OTAGO (control group) programme. Compliance, satisfaction, and adverse events determined feasibility. Clinical outcomes, assessed (blinded) within one-week prior to and post-intervention, included functional gait assessment (FGA), Mini BESTest and cognitive function. Results Randomisation to completion rate was 76.15% with 109 participants recruited (n = 289 screened). Drop-out rate was similar between groups. Adverse events were reported (n = 3) in the control group. Sixty-nine percent would recommend the HOLOBalance intervention. Findings were similar for the home and clinic-based arms of each intervention; data was combined for analysis. FGA (95%CI [1.63, 4.19]) and Mini-BESTest (95%CI [1.46, 3.93]) showed greater improvement in the HOLOBalance group with a clinically meaningful change of 4/30 noted for the FGA. Conclusions HOLObalance was feasible to implement and acceptable to older adults at risk of falls, with FGA and Mini-BEST improvements exceeding those for the OTAGO programme. A definitive trial is warranted. [ABSTRACT FROM AUTHOR]

With the rapid growth of the elderly population, dementia has become a global challenge that governments must address. Given the incurable nature of dementia, rehabilitation interventions starting in the mild cognitive impairment (MCI) stage may offer a solution. For a rehabilitation intervention to be implemented as early as possible, existing problems of identification of MCI and development of MCI-specific forms of rehabilitation must be addressed. Use of computer technologies such as virtual reality and artificial intelligence might be helpful in overcoming these problems. Multi-disciplinary integrated approaches to rehabilitation should be the direction that dementia-related rehabilitation takes in the future. In addition to early rehabilitation, prevention of cognitive decline through the development of public community-based services for the elderly might be a more reasonable approach. [ABSTRACT FROM AUTHOR]

In this editorial, Massimiliano Polastri discusses the potential of artificial intelligence in healthcare. [ABSTRACT FROM AUTHOR]

Objective: To examine the effects of the transitional tele-rehabilitation programme on quality of life of adult burn survivors. Design: A prospective, single centre, randomised controlled trial and reported according to the Consolidated Standards of Reporting Trials (CONSORT) guidelines. Participants: Adult burn survivors aged ≥18 years with burn size ≥10% total body surface area irrespective of the depth was considered eligible to participate. Intervention: The intervention was in two phases: pre-discharge and active follow-up phase (which occurred via WeChat). In both phases, comprehensive assessment and intervention guided by the Omaha System and evidenced-based protocols guided the care delivery over an 8-week period. Main measures: The outcome of interest was quality of life. Two outcome measures were used to assess the outcome of interest: Burn Specific Health Scale-Brief (BSHS-B) and the EQ-5D-5L tools. The outcome was assessed at three time points: T0 (baseline), T1 (immediate post-intervention) and T2 (4 weeks from T1). Results: In total, 60 adult burn survivors were randomly allocated to undergo the new programme. The transitional tele-rehabilitation programme elicited statistically significant improvement in simple abilities, affect, interpersonal relationship (T2) and overall quality life (T1 and T2) measured on the BSHS-B. Conclusion: Ongoing rehabilitative care is essential to support the recovery process of burn survivors considering that some quality-of-life subscales may improve faster than others. The study findings highlight the potential of employing a social media platform to improve post-burn quality of life outcomes. Trial registration: ClinicalTrials.govNCT04517721. Registered on 20 August 2020 [ABSTRACT FROM AUTHOR]

Objective: To assess the added value of caregiver-mediated exercises combined with telerehabilitation in addition to usual care compared to usual care alone on the self-reported mobility outcome after subacute stroke. Design: Multicentre, observer-blinded, parallel randomised controlled trial. An off-site researcher allocated treatments using minimisation. Setting: Four rehabilitation centres in the Netherlands. Participants: Forty-one patient–caregiver dyads within 3 months poststroke. Intervention: Eight-week blended care program with caregiver-mediated mobility exercises for 2.5 h per week supported by telerehabilitation and four face-to-face sessions in addition to usual care. Main measures: Self-reported mobility domain of the Stroke Impact Scale postintervention. Secondary outcomes were functional outcome, dyads' psychosocial wellbeing, care transition to the community postintervention and after 6 months. Results: Forty-one dyads (21 intervention, 20 control) were randomised, and 37 (N = 18; N = 19) were analysed following intention-to-treat. The Stroke Impact Scale mobility was not significantly different between groups postintervention (B 0.8, 95% CI –6.8–8.5, p = 0.826). The secondary outcomes, namely, (a) caregivers' quality of life postintervention (p = 0.013), (b) caregivers' symptoms of depression postintervention (p = 0.025), and (c) independence in leisurely activities at 6 months (p = 0.024), showed significant benefits in favour of caregiver-mediated exercises with telerehabilitation. A significant difference favouring controls was found in self-reported muscle strength at 6 months (p = 0.002). Conclusions: Caregiver-mediated exercises combined with telerehabilitation yielded no differential effect on our primary outcome self-reported mobility. Although the trial is underpowered, current findings are in line with previous trials. Future studies should further explore beneficial effects of caregiver involvement in stroke rehabilitation targeting psychosocial wellbeing. [ABSTRACT FROM AUTHOR]

Background and Purpose: To our knowledge, there is currently no research on telerehabilitation concerning artists. This study aims to assess the feasibility, acceptability, and effectiveness of utilizing video‐based telerehabilitation in physiotherapy among artists during the COVID‐19 pandemic. Methods: Fifty‐one artists who accessed virtual physiotherapy between November 2020 and February 2022 at a healthcare center that provides specialized healthcare services to artists of all disciplines who reside or work in Ontario, Canada were asked to complete a 26‐item online questionnaire about their experience with virtual physiotherapy. Results: The 51 respondents were from a range of artistic disciplines, with the largest portion being musicians (n = 22; 43%). Of the respondents, 86% (n = 44) felt the virtual physiotherapy met their expectations in therapeutic benefits, 78% (n = 40) were confident in performing all the exercises that the physiotherapist demonstrated on the virtual platform, 80% (n = 41) did not run into many technological challenges when booking or attending virtual sessions, and 54% (n = 20) reported similar treatment outcomes between virtual and in‐person sessions. Although artists liked the convenience of accessing physiotherapy from home, 53% (n = 17) of respondents rated the lack of physical contact as a major limitation in telerehabilitation. Conclusion: Telerehabilitation for artists during the COVID‐19 pandemic has shown potential to be an effective and viable alternative to in‐person physiotherapy, as demonstrated by high satisfaction levels and comparable treatment outcomes, especially when public health restrictions were in place. Future research can explore hybrid models (mix of in‐person and virtual sessions) in physiotherapy to meet the needs for physical contact during sessions. [ABSTRACT FROM AUTHOR]

Introduction: Center‐based rehabilitation is limited by COVID‐19 infectivity and social distancing policy. We hypothesized that discharged patients benefit from 8‐week home‐based tele‐rehabilitation (tele‐PR) using mobile phones and low‐cost instruments. Methods: The TERCOV (Tele‐rehabilitation in COVID‐19 survivors) is an investigator‐initiated, prospective, multi‐center, real‐world study. After proper assessment, 186 discharge patients received tele‐PR by smartphone, including breathing exercise, respiratory muscle training, aerobic exercise, and resistance training. Physicians, physiotherapists, and nurses provided guidance through smartphone applications. The primary outcome was six‐minute walk distance (6MWD). The secondary outcomes included hand grip, short physical performance battery, maximal inspiratory pressure, maximal expiratory pressure, self‐rating anxiety/depression scale (SAS/SDS), 36‐item short‐form health survey (SF‐36) and international physical activity questionnaire. Results: Dyspnea subgroups were more functionally impaired. After tele‐PR, improvements were observed in exercise capacity(∆6MWD: 16.80 m, 95% CI 1.18–32.42, p < 0.0001), limb muscle function (∆SPPB 0.25 points, 95% CI 0.05–0.46), respiratory muscle strength (∆MIP 16.50 cm H2O, 95% CI 9.22–23.78, p < 0.0001; ∆MEP: 12.09 cm H2O, 95% CI 3.48–20.70, p = 0.0002), health‐related quality of life (∆SF‐36 49.85, 95% CI: 21.01–78.69, p < 0.0001), physical activity(∆HEPA 13.01%, p = 0.0029). Anxiety reduced in patients with mMRC ≥ 2 (∆SAS = −4.19 points, CI −8.16 to −0.22, p = 0.03). Greater change was seen in dyspnea patients. Implications on Physiotherapy Practice: Supervised/semi‐supervised tele‐PR is a promising option during the pandemic. Patients with Dyspnea benefit more. [ABSTRACT FROM AUTHOR]

Background and purpose: In the evolving landscape of healthcare, telerehabilitation is emerging as a pivotal modality, especially in delivering services to vulnerable populations. With the increasing reliance on digital health solutions, there is a pressing need for physiotherapists to be adequately trained in telerehabilitation. This training is essential for them to adapt to new technologies and methodologies, ensuring effective and efficient patient care. The aim of this study was to evaluate the effect of a telerehabilitation educational intervention on physiotherapists' knowledge and perceptions in Bucaramanga and its metropolitan area. Methods: A group of 27 physiotherapists underwent an educational intervention focused on telerehabilitation. Before‐ and after‐intervention assessments were conducted to gauge their perceptions and knowledge. Results: Participants generally held a positive perception of telerehabilitation both before and after the intervention [Before Median (Md) and interquartile range (IQR): Md = 2.5 (IQR = 2.1–3); after: Md = 2.7 (IQR = 2.4–3.1), p = 0.256]. A significant increase in their knowledge after‐intervention was observed [Before: Md = 55.5 (IQR = 33.3–66.6)]; after: Md = 77.7 (IQR = 66.6–88.8), p = <0.001, emphasizing the potential benefits of targeted educational interventions. Conclusions: The educational intervention significantly improved physiotherapists' knowledge of telerehabilitation, underscoring the importance of professional training in this domain. While perceptions remained consistently positive, the notable increase in knowledge suggests that such educational programs are crucial for enhancing the adoption and effective use of telerehabilitation in physiotherapy practice. [ABSTRACT FROM AUTHOR]

Background and Purpose: Assessing lower limb strength, balance, and fall risk are crucial components of rehabilitation, especially for the older adult population. With the growing interest in telehealth, teleassessment has been investigated as an alternative when in‐person assessments are not possible. The Five Times Sit‐to‐Stand test (5TSTS) provides a quick measure of balance during chair transfers, muscle power, endurance, and the hability to change and maintain body position, and is highly recommended by guidelines. However, the literature is unclear about the viability and safety of teleassessment using the 5TSTS in older adults with and without Parkinson's disease (PD). This study aimed to evaluate the reliability of teleassessment using the 5TSTS and to determine its feasibility and safety for older adults with and without PD. Methods: This cross‐sectional study included older adults with and without PD who were evaluated remotely through a videoconference platform. To ensure effective and comprehensive instructions for the test, we developed a guideline called OMPEPE (an acronym for: Objective; Materials; Position‐Start; Execution; Position‐End; Environment). We assessed the 5TSTS intra‐ and inter‐rater reliability by comparing scores obtained from the same examiner and from different examiners, respectively. Participants and examiners completed online surveys to provide information about feasibility and safety. Results: Twelve older adults with PD and 17 older adults without PD were included in this study (mean ages 69.0 and 67.6 years, respectively). Based on the participants' perspectives and the absence of adverse effects, teleassessment using the 5TSTS is feasible and safe for older adults with and without PD. Excellent intra‐ and inter‐rater reliability (intraclass correlation coefficient >0.90) was found for all measurements of the 5TSTS. Discussion: This study demonstrated the feasibility, safety, and reliability of teleassessment using the 5TSTS. The guidelines developed may help health professionals minimize barriers and safely conduct an online assessment that includes a physical test such as the 5TSTS in older adults with or without PD. In addition to addressing technological barriers, the OMPEPE guideline might ensure the optimal execution of evaluations. Conclusion: Teleassessment using the 5TSTS for older adults with and without PD is feasible and safe. Both synchronous (i.e., live) and asynchronous (i.e., recorded) online 5TSTS tests demonstrate excellent intra‐ and inter‐rate reliability. [ABSTRACT FROM AUTHOR]

Background: Many individuals with progressive multiple sclerosis (PMS) are challenged by reduced manual dexterity and limited rehabilitation options. Transcranial direct current stimulation (tDCS) during motor training can improve rehabilitation outcomes. We developed a protocol for remotely supervising tDCS to deliver sessions of stimulation paired with training at home. Objective: This study evaluated the effectiveness of at-home tDCS paired with manual dexterity training for individuals with PMS. Methods: Sixty-five right-hand dominant participants with PMS and hand impairment were randomized to receive either active or sham M1-SO tDCS paired with manual dexterity training over 4 weeks. Clinical outcomes were measured by the changes in Nine-Hole Peg Test (9-HPT) and Dellon-Modified-Moberg-Pick-Up Test (DMMPUT). Results: The intervention had high rates of adherence and completion (98% of participants completed at least 18 of 20 sessions). The active tDCS group demonstrated significant improvement for the left hand compared with baseline in 9-HPT (−5.85 ± 6.19 vs −4.23 ± 4.34, p = 0.049) and DMMPUT (−10.62 ± 8.46 vs −8.97 ± 6.18, p = 0.049). The active tDCS group reported improvements in multiple sclerosis (MS)-related quality of life (mean increase: 5.93 ± 13.04 vs −0.05 ± −8.27; p = 0.04). Conclusion: At-home tDCS paired with manual dexterity training is effective for individuals with PMS, with M1-SO tDCS enhancing training outcomes and offering a promising intervention for improving and preserving hand dexterity. [ABSTRACT FROM AUTHOR]