Teaching Self-Management Skills in Persons with Chronic Lower Limb Swelling and Limited Mobility: Evidence for Usability of Telerehabilitation

Becky L. Faett, David M. Brienza, Mary Jo Geyer, Leslie A Hoffman


The purpose of this study was to evaluate the usability of telerehabilitation as a method of teaching self-management for chronic swelling of the lower limbs in persons with limited mobility. An in-home telerehabilitation self-management education protocol for chronic swelling of the lower limbs, termed Telerehabilitation to Empower You to Manage and Prevent Swelling (TR-PUMPS), was implemented using the Versatile and Integrated System for Telerehabilitation (VISYTER) software platform. Participants (n=11) were 36-79 years old, predominately female (72.7%) and diagnosed with a variety of health conditions. Participants’ perceived usability scores of the remote delivery of TR-PUMPS was high with a median score of 6.67 (range 4.90 - 7.00) on a Likert scale: 1= disagree to 7= agree. There was no correlation between participants’ familiarity with information technology and their perception of telerehabilitation usability. These results support telerehabilitation as a viable method for teaching a home-based, self-management


Baddour, L. (2006). Recent considerations in recurrent cellulitis. Current Infections and Disease Reports, 3, 461-465.

Bogan, L., Powell, J., & Dudgeon, B. (2007). Experiences of living with non-cancer related lymphedema: Implications for clinical practice. Qualitative Health Research 17, 213- 224.

Brennan, M., & Miller, L. (1998). Overview of treatment options and review of the current role and use of compression garments, intermittent pumps, and exercise in management of lymphedema. Cancer Supplement, 83, 2822-2827.

Bourbeau, J., Julien, M., Maltais, F., Rouleau, M., Beaupré, A., Bégin, R.,…Collet, J.P. (2003). Reduction of hospital utilization in patients with chronic obstructive pulmonary disease: A disease-specific self-management intervention. Archives of Internal Medicine, 163, 585-591.

Cavorsi, J. (2000). Venous ulcers of the lower extremities: Current and newer management techniques. Topics in Geriatric Rehabilitation, 16(2), 24-34.

DeWalt, D., Pignone, M., Malone, R., Rawls, C., Kosnar, M.,…Angel, B. (2004). Development and pilot testing of a disease management program for low literacy patients with heart failure. Patient Education and Counseling, 55, 78-86.

Dupuy, A., Benchikhi, H., Roujeau, J-C., Bernard, P., Vaillant, L., Chosidow, O.,…Bastuji-Garin S. (1999). Risks factors for erysipelas of the leg: A case control study. British Medical Journal, 318, 1591-1594.

Drainoni, M, Lee-Hood, Tobias, C., Bachman, S., Andrew, J., & Maisels, L. (2006). Cross- disability experiences of barriers to health-care access. Journal of Disability Policy Studies, 17, 101-115.

Faett, B., Geyer, M.J., Hoffman, L., & Brienza, D. (2012). Design and development of a telerehabilitation self- management program for persons with chronic lower limb swelling and mobility limitations: Preliminary evidence. Nursing Research and Practice, 2012, 1-10. doi: 10.1155/2012/608059 Retrieved from: http://www. hindawi.com/journals/nrp/2012/608059/

Finkelstein, J., Lapshin, O., Castro, H., Cha, E., & Provance, P. (2008). Home-based physical telerehabilitation in patients with multiple sclerosis: A pilot study. Journal of Rehabilitation Research and Development, 45, 1136-1137. doi: 10.1682/JRRD.2008.01.0001

Foldi, E. (1998). The treatment of lymphedema. Cancer, 83, 2833-2844.

Foldi, E., Foldi, M., & Clodius, L. (1989). The lymphedema chaos: A lancet. Annals of Plastic Surgery, 22, 505-515.

Geyer, M. J. (2010) Chronic edema in wheelchair- dependent persons. Presented at the 2nd International Lymphoedema Framework Conference, Brighton, UK.

Holden, M.K., Dyar, T.A., & Dayan-Cimardoro, L. (2007). Telerehabilitation using a virtual environment improves upper extremity function in patients with strokes. IEEE Transactions on Neural Systems and Rehabilitation, 15(1), 36-42.

Iezzoni, L.I., Killeen, M.B., & O’Day, B.L. (2006). Rural residents with disabilities confront substantial barriers to obtaining primary care. Health Services Research, 41, 1258- 1275. doi:10.1111/j.1475-6773.2006.00534.x

Iezzoni, L., McCarthy, E., Davis, R., & Siebens, H. (2000). Mobility impairments and use of screening and preventive services. American Journal of Preventive Health, 90, 955-961.

International Society of Lymphology (2009) The diagnosis and treatment if peripheral lymphedema: 2009 consensus document of the International Society of Lymphology. Lymphology, 42, 51-60. Retrieved from http://www. solarismed.com/rr/journal.pdf

Kaye, S., Kang, T., & LaPlante, M. (2000). Mobility device use in the United States. Disability Statistics Report, (14). Washington, D.C.: U.S. Department of Education, National Institute on Disability and Rehabilitation Research. Retrieved from http://dsc.ucsf.edu/pub_listing. php?pub_type=report

Kerchner, K., Fleischer, A., & Yosipovitch, G. (2008). Lower extremity lymphedema update: Pathophysiology, diagnosis, and treatment guidelines. Journal of American Academy of Dermatology, 59, 324-331. doi: 10.1016/j. jaad.2008.04.013.

Ko., D., Learner,R., Klose, G., & Cosimi, A. (1998). Effective treatment of lymphedema of the extremities. Archives of Surgery, 133, 452-458.

Kunimoto, B., Cooling, M., Gulliver, W., Houghton, P., Orsted, H., & Sibbald, R.G. (2001). Best practices for the prevention and treatment of venous leg ulcers. Ostomy/ Wound Management, 47(2), 34-50.

DOI: https://doi.org/10.5195/ijt.2013.6114



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