Practice Considerations for Adapting In-Person Groups to Telerehabilitation
Keywords:Clinical practice, Group, Implementation, Multi-participant, Telehealth, Telerehabilitation
The Coronavirus-2019 (COVID-19) pandemic has shifted research and healthcare system priorities, stimulating literature on implementation and evaluation of telerehabilitation for a variety of patient populations. While there is substantial literature on individual telerehabilitation, evidence about group telerehabilitation remains limited despite its increasing use by rehabilitation providers. Therefore, the purpose of this manuscript is to describe our expert team’s consensus on practice considerations for adapting in-person group rehabilitation to group telerehabilitation to provide rapid guidance during a pandemic and create a foundation for sustainability of group telerehabilitation beyond the pandemic’s end.
Atsma, F., Elwyn, G., & Westert, G. (2020). Understanding unwarranted variation in clinical practice: A focus on network effects, reflective medicine and learning health systems. International Journal for Quality in Health Care, 32(4), 271–274. https://doi.org/10.1093/intqhc/mzaa023
Banbury, A., Nancarrow, S., Dart, J., Gray, L., & Parkinson, L. (2018). Telehealth interventions delivering home-based support group videoconferencing: systematic review. Journal of Medical Internet Research, 20(2), e25. https://doi.org/10.2196/jmir.8090
Brandt, J., Spencer, M., & Folstein, M. (1988). The telephone interview for cognitive status. Neuropsychiatry, Neuropsychology, & Behavioral Neurology, 1(2), 111–117.
Brennan, D., Tindall, L., Theodoros, D., Brown, J., Campbell, M., Christiana, D., Smith, D., Cason, J., & Lee, A. (2010). A blueprint for telerehabilitation guidelines. International Journal of Telerehabilitation, 2(2), 31–34. https://doi.org/10.5195/IJT.2010.6063
Cox, N. S., McDonald, C. F., Alison, J. A., Mahal, A., Wootton, R., Hill, C. J., Bondarenko, J., Macdonald, H., O’Halloran, P., Zanaboni, P., Clarke, K., Rennick, D., Borgelt, K., Burge, A. T., Lahham, A., Wageck, B., Crute, H., Czupryn, P., Nichols, A., & Holland, A. E. (2018). Telerehabilitation versus traditional centre-based pulmonary rehabilitation for people with chronic respiratory disease: Protocol for a randomised controlled trial. BMC Pulmonary Medicine, 18(1), 71. https://doi.org/10.1186/s12890-018-0646-0
Falvey, J. R., Burke, R. E., Levy, C. R., Gustavson, A. M., Price, L., Forster, J. E., & Stevens-Lapsley, J. E. (2019). Impaired physical performance predicts hospitalization risk for participants in the program of all-inclusive care for the elderly. Physical Therapy, 99(1), 28–36. https://doi.org/10.1093/ptj/pzy127
Falvey, J. R., Krafft, C., & Kornetti, D. (2020). The essential role of home- and community-based physical therapists during the COVID-19 pandemic. Physical Therapy, 100(7), 1058–1061. https://doi.org/10.1093/ptj/pzaa069
Gill, T. M., Han, L., Gahbauer, E. A., Leo-Summers, L., & Allore, H. G. (2018). Prognostic Effect of changes in physical function over prior year on subsequent mortality and long-term nursing home admission: Prognostic effect of changes in function. Journal of the American Geriatrics Society, 66(8), 1587–1591. https://doi.org/10.1111/jgs.15399
Guralnik, J. M., Simonsick, E. M., Ferrucci, L., Glynn, R. J., Berkman, L. F., Blazer, D. G., Scherr, P. A., & Wallace, R. B. (1994). A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology, 49(2), M85–M94. https://doi.org/10.1093/geronj/49.2.M85
Guralnik, J.M., Ferrucci, L., Simonsick, E. M., Salive, M. E., & Wallace, R. B. (1995). Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. New England Journal of Medicine, 332(9), 556–562. https://doi.org/10.1056/NEJM199503023320902
Gustavson, A. M., Danilovich, M. K., Lessem, R., & Falvey, J. R. (2020). Addressing rehabilitation needs during a pandemic: Solutions to reduce burden on acute and post-acute care. Journal of the American Medical Directors Association, 21(7), 995–997. https://doi.org/10.1016/j.jamda.2020.06.007
Gustavson, A. M., Toonstra, A., Johnson, J. K., & Ensrud, K. E. (2021). Reframing hospital to home discharge from “Should we?” to “How can we?”: COVID‐19 and beyond. Journal of the American Geriatrics Society, jgs.17036. https://doi.org/10.1111/jgs.17036
Hale-Gallardo, J. L., Kreider, C. M., Jia, H., Castaneda, G., Freytes, I. M., Cowper Ripley, D. C., Ahonle, Z. J., Findley, K., & Romero, S. (2020). Telerehabilitation for rural veterans: A qualitative assessment of barriers and facilitators to implementation. Journal of Multidisciplinary Healthcare, Volume 13, 559–570. https://doi.org/10.2147/JMDH.S247267
Hoyer, E. H., Needham, D. M., Atanelov, L., Knox, B., Friedman, M., & Brotman, D. J. (2014). Association of impaired functional status at hospital discharge and subsequent rehospitalization: FIM at discharge and rehospitalization. Journal of Hospital Medicine, 9(5), 277–282. https://doi.org/10.1002/jhm.2152
Hoyer, E. H., Needham, D. M., Miller, J., Deutschendorf, A., Friedman, M., & Brotman, D. J. (2013). Functional status impairment is associated with unplanned readmissions. Archives of Physical Medicine and Rehabilitation, 94(10), 1951–1958. https://doi.org/10.1016/j.apmr.2013.05.028
Hwang, R., Bruning, J., Morris, N. R., Mandrusiak, A., & Russell, T. (2017). Home-based telerehabilitation is not inferior to a centre-based program in patients with chronic heart failure: A randomised trial. Journal of Physiotherapy, 63(2), 101–107. https://doi.org/10.1016/j.jphys.2017.02.017
Jennings, S. C., Manning, K. M., Bettger, J. P., Hall, K. M., Pearson, M., Mateas, C., Briggs, B. C., Oursler, K. K., Blanchard, E., Lee, C. C., Castle, S., Valencia, W. M., Katzel, L. I., Giffuni, J., Kopp, T., McDonald, M., Harris, R., Bean, J. F., Althuis, K., … Morey, M. C. (2020). Rapid transition to telehealth group exercise and functional assessments in response to COVID-19. Gerontology and Geriatric Medicine, 6, 233372142098031. https://doi.org/10.1177/2333721420980313
Jones, C. J., Rikli, R. E., & Beam, W. C. (1999). A 30-s Chair-Stand Test as a measure of lower body strength in community-residing older adults. Research Quarterly for Exercise and Sport, 70(2), 113–119. https://doi.org/10.1080/02701367.1999.10608028
Kirk, M. A., Moore, J. E., Wiltsey Stirman, S., & Birken, S. A. (2020). Towards a comprehensive model for understanding adaptations’ impact: The model for adaptation design and impact (MADI). Implementation Science, 15(1), 56. https://doi.org/10.1186/s13012-020-01021-y
Kyrdalen, I. L., Moen, K., Røysland, A. S., & Helbostad, J. L. (2014). The Otago Exercise Program performed as group training versus home training in fall-prone older people: A randomized controlled trial: Otago Exercise Program as group or home training. Physiotherapy Research International, 19(2), 108–116. https://doi.org/10.1002/pri.1571
Lee, A. C. (2020). COVID-19 and the advancement of digital physical therapist practice and telehealth. Physical Therapy, 100(7), 1054–1057. https://doi.org/10.1093/ptj/pzaa079
Lin, K.-H., Chen, C.-H., Chen, Y.-Y., Huang, W.-T., Lai, J.-S., Yu, S.-M., & Chang, Y.-J. (2014). Bidirectional and multi-user telerehabilitation system: Clinical effect on balance, functional activity, and satisfaction in patients with chronic stroke living in long-term care facilities. Sensors, 14(7), 12451–12466. https://doi.org/10.3390/s140712451
Pendlebury, S. T., Welch, S. J. V., Cuthbertson, F. C., Mariz, J., Mehta, Z., & Rothwell, P. M. (2013). Telephone assessment of cognition after transient ischemic attack and stroke: Modified telephone interview of cognitive status and telephone Montreal Cognitive Assessment versus face-to-face Montreal Cognitive Assessment and neuropsychological battery. Stroke, 44(1), 227–229. https://doi.org/10.1161/STROKEAHA.112.673384
Pitt, R., Theodoros, D., Hill, A. J., & Russell, T. (2019). The impact of the telerehabilitation group aphasia intervention and networking programme on communication, participation, and quality of life in people with aphasia. International Journal of Speech-Language Pathology, 21(5), 513–523. https://doi.org/10.1080/17549507.2018.1488990
Prvu Bettger, J., & Resnik, L. J. (2020). Telerehabilitation in the age of COVID-19: An opportunity for learning health system research. Physical Therapy, 100(11), 1913–1916. https://doi.org/10.1093/ptj/pzaa151
Quinn, L., Macpherson, C., Long, K., & Shah, H. (2020). Promoting physical activity via telehealth in people with Parkinson Disease: The path forward after the COVID-19 pandemic? Physical Therapy, 100(10), 1730–1736. https://doi.org/10.1093/ptj/pzaa128
Richmond, T., Peterson, C., Cason, J., Billings, M., Terrell, E. A., Lee, A. C. W., Towey, M., Parmanto, B., Saptano, A., Cohn, E. R., & Brennan, D. (2017). American Telemedicine Association’s principles for delivering telerehabilitation services. International Journal of Telerehabilitation, 9(2), 63–68. https://doi.org/10.5195/IJT.2017.6232
Roque, N. A., & Boot, W. R. (2018). A new tool for assessing mobile device proficiency in older adults: The Mobile Device Proficiency Questionnaire. Journal of Applied Gerontology, 37(2), 131–156. https://doi.org/10.1177/0733464816642582
Saleem, J. J., Read, J. M., Loehr, B. M., Frisbee, K. L., Wilck, N. R., Murphy, J. J., Vetter, B. M., & Herout, J. (2020). Veterans’ response to an automated text messaging protocol during the COVID-19 pandemic. Journal of the American Medical Informatics Association, 27(8), 1300–1305. https://doi.org/10.1093/jamia/ocaa122
Tsai, L. L. Y., McNamara, R. J., Moddel, C., Alison, J. A., McKenzie, D. K., & McKeough, Z. J. (2017). Home-based telerehabilitation via real-time videoconferencing improves endurance exercise capacity in patients with COPD: The randomized controlled TeleR Study: Telerehabilitation in patients with COPD. Respirology, 22(4), 699–707. https://doi.org/10.1111/resp.12966
VanRavenstein, K., & Davis, B. H. (2018). When more than exercise is needed to increase chances of aging in place: Qualitative analysis of a telehealth physical activity program to improve mobility in low-income older adults. JMIR Aging, 1(2), e11955. https://doi.org/10.2196/11955
Venkataraman, K., Amis, K., Landerman, L. R., Caves, K., Koh, G. C., & Hoenig, H. (2020). Teleassessment of gait and gait aids: Validity and interrater reliability. Physical Therapy, 100(4), 708–717. https://doi.org/10.1093/ptj/pzaa005
Wong, D., Grace, N., Baker, K., & McMahon, G. (2019). Measuring clinical competencies in facilitating group-based rehabilitation interventions: Development of a new competency checklist. Clinical Rehabilitation, 33(6), 1079–1087. https://doi.org/10.1177/0269215519831048
Woolf, S. H., Grol, R., Hutchinson, A., Eccles, M., & Grimshaw, J. (1999). Clinical guidelines: Potential benefits, limitations, and harms of clinical guidelines. BMJ, 318(7182), 527–530. https://doi.org/10.1136/bmj.318.7182.527
Wu, G., & Keyes, L. M. (2006). Group tele-exercise for improving balance in elders. Telemedicine and E-Health, 12(5), 561–570. https://doi.org/10.1089/tmj.2006.12.561
Yalom, I. D. and Leszcz, M. (2020). The Theory and Practice of Group Psychotherapy. Basic Books, ISBN-13: 9781541617568
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