Telerehabilitation Solution Conceptual Paper for Community-Based Rehabilitation of Patients Discharged after Critical Illness
A novel service oriented platform has been developed under the framework of the Telerehabilitation Service funded by the Cross Border Cooperation Programme Greece Cyprus 2007 – 2013 to support tele-supervised exercise rehabilitation for patients after hospitalization in intensive care units (ICU). The platform enables multiparty, interregional bidirectional audio/visual communication between clinical practitioners and post-ICU patients. It also enables patient group-based vital sign real time monitoring, patients’ clinical record bookkeeping, and individualized and group-based patient online exercise programs. The exercise programs intended for the service are based on successful cardiorespiratory rehabilitation programs, individualized and monitored by a multidisciplinary team. The eligibility study of former ICU patients to participate in such a service as well as a cost benefit analysis are presented to support the cost effectiveness of the telerehabilitation program in addition to the expected health benefits to a large proportion of former ICU patients.
Batterham, A. M., Bonner, S., Wright, J., Howell, S. J., Hugill, K., & Danjoux, G. (2014). Effect of supervised aerobic exercise rehabilitation on physical fitness and quality-of-life in survivors of critical illness: an exploratory minimized controlled trial (PIX study). British Journal of Anaesthesia, 113, 130-137. doi: 10.1093/bja/aeu051
Berney, S., Haines, K., Skinner, E. H., & Denehy, L. (2012). Safety and feasibility of an exercise prescription approach to rehabilitation across the continuum of care for survivors of critical illness. Physical Therapy, 92, 1524-1535. doi: 10.2522/ptj.20110406
Connolly, B., Denehy, L., Brett, S., Elliott, D., & Hart, N. (2012). Exercise rehabilitation following hospital discharge in survivors of critical illness: An integrative review. Critical Care, 16, 226. doi: 10.1186/CC11219
Connolly, B., Douiri, A., Steier, J., Moxham, J., Denehy, L., & Hart, N. (2014). A UK survey of rehabilitation following critical illness: Implementation of NICE Clinical Guidance 83 (CG83) following hospital discharge. British Medical Journal Open, 4(5), e004963. doi: 10.1136/bmjopen-2014-004963
Connolly, B., Thompson, A., Douiri, A., Moxham, J., & Hart, N. (2015). Exercise-based rehabilitation after hospital discharge for survivors of critical illness with intensive care unit-acquired weakness: A pilot feasibility trial. Journal of Critical Care, 30, 589-598. doi: 10.1016/j.jcrc.2015.02.002
Dasta, J. F., McLaughlin, T. P., Mody, S. H., & Piech, C. T. (2005). Daily cost of an intensive care unit day: The contribution of mechanical ventilation. Critical Care Medicine, 33, 1266-1271.
Demiris, G., Shigaki, C. L., & Schopp, L. H. (2005). An evaluation framework for a rural home-based telerehabilitation network. Journal of Medical Systems, 29, 595-603.
Denehy, L., Skinner, E. H., Edbrooke, L., Haines, K., Warrillow, S., Hawthorne, G., . . . Berney, S. (2013). Exercise rehabilitation for patients with critical illness: a randomized controlled trial with 12 months follow up. Critical Care, 17(4), R156. doi: 10.1186/cc12835
Elias, K. M., Moromizato, T., Gibbons, F. K., & Christopher, K. B. (2015). Derivation and validation of the acute organ failure score to predict outcome in critically ill patients: A cohort study. Critical Care Medicine, 43(4), 856-864. doi: 10.1097/CCM.0000000000000858
Elliott, D., McKinley, S., Alison, J., Aitken, L. M., King, M., Leslie, G. D., . . . Burmeister, E. (2011). Health-related quality of life and physical recovery after a critical illness: A multi-centre randomised controlled trial of a home-based physical rehabilitation program. Critical Care, 15(3), R142. doi: 10.1186/cc10265
Flaatten, H. (2010). Mental and physical disorders after ICU discharge. Current Opinion in Critical Care, 16, 510-515. doi: 10.1097/MCC.0b013e32833cc90b
Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I. M., Nieman, D. C., Swain, D. P. (2011). American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Medicine & Science in Sports & Exercise, 43, 1334-1359. doi: 10.1249/MSS.0b013e318213fefb
Griffiths, R. D., & Hall, J. B. (2010). Intensive care unit-acquired weakness. Critical Care Medicine, 38, 779-787. doi: 10.1097/CCM.0b013e3181cc4b53
Hailey, D., Roine, R., Ohinmaa, A., & Dennett, L. (2013). The status of telerehabilitation in neurological applications. Journal of Telemedicine and Telecare, 19, 307-310. doi: 10.1177/1357633X13501775
Herridge, M. S., Moss, M., Hough, C. L., Hopkins, R. O., Rice, T. W., Bienvenu, O. J., & Azoulay, E. (2016). Recovery and outcomes after the acute respiratory distress syndrome (ARDS) in patients and their family caregivers. Intensive Care Medicine, 42, 725-738. doi: 10.1007/s00134-016-4321-8
Izawa, K. P., Watanabe, S., Oka, K., Hiraki, K., Morio, Y., Kasahara, Y., . . . Iijima, S. (2010). Age-related differences in physiologic and psychosocial outcomes after cardiac rehabilitation. American Journal of Physical Medicine & Rehabilitation, 89, 24-33. doi: 10.1097/PHM.0b013e3181c5607d
Johansson, T., & Wild, C. (2011). Telerehabilitation in stroke care-a systematic review. Journal of Telemedicine and Telecare, 17, 1-6. doi: 10.1258/jtt.2010.100105
Jones, C., Skirrow, P., Griffiths, R. D., Humphris, G. H., Ingleby, S., Eddleston, J., . . . Gager, M. (2003). Rehabilitation after critical illness: A randomised, controlled trial. Critical Care Medicine, 31, 2456-2461.
Judson, J. A., & Fisher, M. M. (2006). Intensive care in Australia and New Zealand. Critical Care Clinics, 22, 407-423, vii-viii. doi: 10.1016/j.ccc.2006.03.012
Lau, H. M.-C., Ng, G. Y.-F., Jones, A. Y.-M., Lee, E. W.-C., Siu, E. H.-K., & Hui, D. S.-C. (2005). A randomised controlled trial of the effectiveness of an exercise training program in patients recovering from severe acute respiratory syndrome. Australian Journal of Physiotherapy, 51, 213-219.
Laver, K. E., Schoene, D., Crotty, M., George, S., Lannin, N. A., & Sherrington, C. (2013). Telerehabilitation services for stroke. The Cochrane Database of Systematic Reviews, 12, CD010255. doi: 10.1002/14651858.CD010255.pub2
Loyalka, P., Liu, L., Chen, G., & Zheng, X. (2014). The cost of disability in China. Demography, 51, 97-118. doi: 10.1007/s13524-013-0272-7
McWilliams, D. J., Atkinson, D., Carter, A., Foex, B. A., Benington, S., & Conway, D. H. (2009). Feasibility and impact of a structured, exercise-based rehabilitation programme for intensive care survivors. Physiotherapy Theory and Practice, 25, 566-571. doi: 10.3109/09593980802668076
McWilliams, D. J., Benington, S., & Atkinson, D. (2016). Outpatient-based physical rehabilitation for survivors of prolonged critical illness: A randomized controlled trial. Physiotherapy Theory and Practice, 32, 179-190. doi: 10.3109/09593985.2015.1137663
Meynaar, I. A., Van Den Boogaard, M., Tangkau, P. L., Dawson, L., Sleeswijk Visser, S., & Bakker, J. (2012). Long-term survival after ICU treatment. Minerva Anestesiologica, 78, 1324-1332.
Moody, G. B., Mark, R. G., Zoccola, A., & Mantero, S. (1985). Derivation of respiratory signals from multi-lead ECGs. . Computers in Cardiology, 12, 113-116.
Morey, M. C., Peterson, M. J., Pieper, C. F., Sloane, R., Crowley, G. M., Cowper, P. A., . . . Pearson, M. P. (2009). The Veterans Learning to Improve Fitness and Function in Elders Study: A randomized trial of primary care-based physical activity counseling for older men. Journal of American Geriatric Society, 57, 1166-1174. doi: 10.1111/j.1532-5415.2009.02301.x
Neubeck, L., Redfern, J., Fernandez, R., Briffa, T., Bauman, A., & Freedman, S. B. (2009). Telehealth interventions for the secondary prevention of coronary heart disease: A systematic review. European Journal of Cardiovascular Prevention and Rehabilitation, 16, 281-289. doi: 10.1097/HJR.0b013e32832a4e7a
NICE. (2009). NICE clinical guideline 83. Rehabilitation after critical care. London: NICE.
Rees, K., Taylor, R. S., Singh, S., Coats, A. J., & Ebrahim, S. (2004). Exercise based rehabilitation for heart failure. Cochrane Database of Systematic Reviews, 3, CD003331. doi: 10.1002/14651858.CD003331.pub2
Ries, A. L., Kaplan, R. M., Limberg, T. M., & Prewitt, L. M. (1995). Effects of pulmonary rehabilitation on physiologic and psychosocial outcomes in patients with chronic obstructive pulmonary disease. Annals of Internal Medicine, 122, 823-832.
Salisbury, L. G., Merriweather, J. L., & Walsh, T. S. (2010). The development and feasibility of a ward-based physiotherapy and nutritional rehabilitation package for people experiencing critical illness. Clinical Rehabilitation, 24, 489-500. doi: 10.1177/0269215509360639
Sartori, D., Catalano, G., Genco, M., Pancotti, C., Sirtori, E., Vignetti, S., & Del Bo, C. U. d. S. d. M. (2015). Guide to cost benefit analysis of investment projects. Economic appraisal tool for Cohesion Policy 2014-2020. Italy: European Commission.
Shukla, H., Nair, S. R., & Thakker, D. (2016). Role of telerehabilitation in patients following total knee arthroplasty: Evidence from a systematic literature review and meta-analysis. Journal of Telemedicine and Telecare. doi: 10.1177/1357633X16628996
Snook, S. H., & Webster, B. S. (1987). The cost of disability. Clinical Orthopaedics and Related Research, 221, 77-84.
Stylianides, N., Papadopoulos, A., Constantinou, I., Tsavourelou, A., Dikaiakos, M., & Kyprianou, T. (2013). TeleRehabilitation: A novel service oriented platform to support tele-supervised rehabilitation programs for ICU patients. Paper presented at the IEEE 13th International Conference, Chania.
Sugarman, H., Dayan, E., Weisel-Eichler, A., & Tiran, J. (2006). The Jerusalem TeleRehabilitation System, a new low-cost, haptic rehabilitation approach. CyberPsychology & Behavior, 9, 178-182. doi: 10.1089/cpb.2006.9.178
Tousignant, M., Boissy, P., Corriveau, H., & Moffet, H. (2006). In home telerehabilitation for older adults after discharge from an acute hospital or rehabilitation unit: A proof-of-concept study and costs estimation. Disability and Rehabilitation Assistive Technology, 1, 209-216.
Winters, J. M. (2002). Telerehabilitation research: Emerging opportunities. Annual Review of Biomedical Engineering, 4, 287-320. doi: 10.1146/annurev.bioeng.4.112801.121923
Zanaboni, P., Dinesen, B., Hjalmarsen, A., Hoaas, H., Holland, A. E., Oliveira, C. C., & Wootton, R. (2016). Long-term integrated telerehabilitation of COPD Patients: A multicentre randomised controlled trial (iTrain). BMC Pulmonary Medicine, 16, 126. doi: 10.1186/s12890-016-0288-z
Zanaboni, P., Hoaas, H., Aaroen Lien, L., Hjalmarsen, A., & Wootton, R. (2016). Long-term exercise maintenance in COPD via telerehabilitation: A two-year pilot study. Journal of Telemedicine and Telecare. doi: 10.1177/1357633X15625545
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