The Effectiveness of Exercise Interventions Supported by Telerehabilitation For Recently Hospitalized Adult Medical Patients: A Systematic Review
Keywords:Exercise training, General medicine, Physical therapy, Physiotherapy, Telehealth, Telerehabilitation
Objective: To evaluate the effectiveness of exercise interventions delivered via telerehabilitation (via videoconference) for recently hospitalized adult medical patients. Data sources: A search was undertaken across six databases for English language publications from inception to May 2020. Methods: Studies were selected if they included an exercise intervention for recently hospitalized adults, delivered by a physiotherapist via videoconference. Two reviewers independently screened 1,122 articles (21 full text screening) and assessed methodological quality using the Downs and Black Checklist. A narrative synthesis of the included studies was undertaken. Results: Three studies met eligibility criteria involving 201 participants with chronic heart failure or chronic obstructive pulmonary disease. Findings demonstrated limited evidence supporting the effectiveness of exercise delivered via telerehabilitation in improving physical function and patient reported quality of life outcomes in recently hospitalized medical patients. Telerehabilitation in this setting was also associated with high attendance rates and patient satisfaction. Conclusions: Findings provide preliminary support for the benefits of exercise interventions delivered via telerehabilitation for recently hospitalized medical patients. Results do need to be interpreted with caution as further high-quality studies specific to this method of exercise intervention delivery are needed.
Ali, N. A., & Khoja, A. (2020). Telehealth: An important player during the COVID-19 pandemic. Ochsner Journal, 20(2), 113-114. https://doi.org/10.31486/toj.20.0039
Amatya, B., Galea, M. P., Kesselring, J., & Khan, F. (2015). Effectiveness of telerehabilitation interventions in persons with multiple sclerosis: A systematic review. Multiple Sclerosis and Related Disorders, 4(4), 358-369. https://doi.org/10.1016/j.msard.2015.06.011
Anderson, L., Sharp, G. A., Norton, R. J., Dalal, H., Dean, S. G., Jolly, K., Cowie, A., Zawada, A., & Taylor, R. S. (2017). Home‐based versus centre‐based cardiac rehabilitation. Cochrane Database of Systematic Reviews (6). https://doi.org/10.1002/14651858.CD007130.pub4
Brennan, D. M., Mawson, S., & Brownsell, S. (2009). Telerehabilitation: enabling the remote delivery of healthcare, rehabilitation, and self management. Stud Health Technol Inform, 145(231), 48. PMID: 19592797
Cottrell, M. A., Galea, O. A., O’Leary, S. P., Hill, A. J., & Russell, T. G. (2017). Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clinical Rehabilitation, 31(5), 625-638. https://doi.org/10.1177/0269215516645148
Covinsky, K. E., Palmer, R. M., Fortinsky, R. H., Counsell, S. R., Stewart, A. L., Kresevic, D., Burant, C. J., & Landefeld, C. S. (2003). Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age. Journal of the American Geriatrics Society, 51(4), 451-458. https://doi.org/10.1046/j.1532-5415.2003.51152.x
Dharmarajan, K., Han, L., Gahbauer, E. A., Leo‐Summers, L. S., & Gill, T. M. (2020). Disability and Recovery After Hospitalization for Medical Illness Among Community‐Living Older Persons: A Prospective Cohort Study. Journal of the American Geriatrics Society, 68(3), 486-495. https://doi.org/10.1111/jgs.16350
Downs, S. H., & Black, N. (1998). The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. Journal of Epidemiology & Community Health, 52(6), 377-384. https://doi.org/10.1136/jech.52.6.377
Fisk, M., Livingstone, A., & Pit, S. W. (2020). Telehealth in the context of COVID-19: changing perspectives in Australia, the United Kingdom, and the United States. Journal of Medical Internet Research, 22(6), e19264. https://doi.org/10.2196/19264
Greenhalgh, T., Knight, M., A’Court, C., Buxton, M., & Husain, L. (2020). Management of post-acute covid-19 in primary care. BMJ, 370, m3026. https://doi.org/10.1136/bmj.m3026
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
Johansson, T., & Wild, C. (2011). Telerehabilitation in stroke care–a systematic review. Journal of Telemedicine and Telecare, 17(1), 1-6 https://doi.org/10.1258/jtt.2010.100105.
Klompstra, L., Jaarsma, T., & Strömberg, A. (2015). Physical activity in patients with heart failure: barriers and motivations with special focus on sex differences. Patient Preference and Adherence, 9, 1603. https://doi.org/10.2147/PPA.S90942
Kortebein, P. (2009). Rehabilitation for hospital-associated deconditioning. American Journal of Physical Medicine & Rehabilitation, 88(1), 66-77. https://doi.org/10.1097/PHM.0b013e3181838f70
Larson, J. L., Rosen, A. B., & Wilson, F. A. (2020). The effect of telehealth interventions on quality of life of cancer survivors: a systematic review and meta-analysis. Health Informatics Journal, 26(2), 1060-1078. https://doi.org/10.1177/1460458219863604
Laver, K. E., Adey‐Wakeling, Z., Crotty, M., Lannin, N. A., George, S., & Sherrington, C. (2020). Telerehabilitation services for stroke. Cochrane Database of Systematic Reviews (1). https://doi.org/10.1002/14651858.CD010255.pub3
Miller, S., Mandrusiak, A., & Adsett, J. (2018). Getting to the heart of the matter: what is the landscape of exercise rehabilitation for people with heart failure in Australia? Heart, Lung and Circulation, 27(11), 1350-1356. https://doi.org/10.1016/j.hlc.2017.08.016
Minet, L. R., Hansen, L. W., Pedersen, C. D., Titlestad, I. L., Christensen, J. K., Kidholm, K., Rayce, K., Bowes, A., & Møllegård, L. (2015). Early telemedicine training and counselling after hospitalization in patients with severe chronic obstructive pulmonary disease: a feasibility study. BMC Medical Informatics and Decision Making, 15(1), 1-11. https://doi.org/10.1186/s12911-014-0124-4
Moffet, H., Tousignant, M., Nadeau, S., Mérette, C., Boissy, P., Corriveau, H., Marquis, F., Cabana, F., Ranger, P., & Belzile, E. L. (2015). In-home telerehabilitation compared with face-to-face rehabilitation after total knee arthroplasty: a noninferiority randomized controlled trial. The Journal of Bone and Joint Surgery, 97(14), 1129-1141. https://doi.org/10.2106/JBJS.N.01066
Moschny, A., Platen, P., Klaaßen-Mielke, R., Trampisch, U., & Hinrichs, T. (2011). Barriers to physical activity in older adults in Germany: a cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity, 8(1), 1-10. https://doi.org/10.1186/1479-5868-8-
Oates, G. R., Niranjan, S. J., Ott, C., Scarinci, I. C., Schumann, C., Parekh, T., & Dransfield, M. T. (2019). Adherence to pulmonary rehabilitation in COPD: a qualitative exploration of patient perspectives on barriers and facilitators. Journal of Cardiopulmonary Rehabilitation and Prevention, 39(5), 344-349. https://doi.org/10.1097/HCR.0000000000000436
Parisien, R. L., Shin, M., Constant, M., Saltzman, B. M., Li, X., Levine, W. N., & Trofa, D. P. (2020). Telehealth utilization in response to the novel coronavirus (COVID-19) pandemic in orthopaedic surgery. The Journal of the American Academy of Orthopaedic Surgeons. https://doi.org/10.5435/JAAOS-D-20-00339
Peng, X., Su, Y., Hu, Z., Sun, X., Li, X., Dolansky, M. A., Qu, M., & Hu, X. (2018). Home-based telehealth exercise training program in Chinese patients with heart failure: a randomized controlled trial. Medicine, 97(35). https://doi.org/10.1097/MD.0000000000012069
Puhan, M. A., Gimeno‐Santos, E., Cates, C. J., & Troosters, T. (2016). Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews (12). https://doi.org/10.1002/14651858.CD005305.pub4
Rizzi, A. M., Polachek, W. S., Dulas, M., Strelzow, J. A., & Hynes, K. K. (2020). The new ‘normal’: Rapid adoption of telemedicine in orthopaedics during the COVID-19 pandemic. Injury, 51(12), 2816-2821. https://doi.org/10.1016/j.injury.2020.09.009
Russell, T. G. (2007). Physical rehabilitation using telemedicine. Journal of Telemedicine and Telecare, 13(5), 217-220. https://doi.org/10.1258/135763307781458886
Russell, T. G., Buttrum, P., Wootton, R., & Jull, G. A. (2011). Internet-based outpatient telerehabilitation for patients following total knee arthroplasty: a randomized controlled trial. The Journal of Bone and Joint Surgery, 93(2), 113-120. https://doi.org/10.2106/JBJS.I.01375
Sager, M. A., Franke, T., Inouye, S. K., Landefeld, C. S., Morgan, T. M., Rudberg, M. A., Siebens, H., & Winograd, C. H. (1996). Functional outcomes of acute medical illness and hospitalization in older persons. Archives of Internal Medicine, 156(6), 645-652. PMID: 8629876
Sharareh, B., & Schwarzkopf, R. (2014). Effectiveness of telemedical applications in postoperative follow-up after total joint arthroplasty. The Journal of Arthroplasty, 29(5), 918-922. e911. https://doi.org/10.1016/j.arth.2013.09.019
Taylor, R. S., Sagar, V. A., Davies, E. J., Briscoe, S., Coats, A. J. S., Dalal, H., Lough, F., Rees, K., Singh, S. J., & Mordi, I. R. (2014). Exercise‐based rehabilitation for heart failure. Cochrane Database of Systematic Reviews (4). https://doi.org/10.1002/14651858.CD003331.pub4
Tchero, H., Tabue-Teguo, M., Lannuzel, A., & Rusch, E. (2018). Telerehabilitation for stroke survivors: systematic review and meta-analysis. Journal of Medical Internet Research, 20(10), e10867. https://doi.org/10.2196/10867
Van Egmond, M., Van Der Schaaf, M., Vredeveld, T., Vollenbroek-Hutten, M., van Berge Henegouwen, M., Klinkenbijl, J., & Engelbert, R. (2018). Effectiveness of physiotherapy with telerehabilitation in surgical patients: a systematic review and meta-analysis. Physiotherapy, 104(3), 277-298. https://doi.org/10.1016/j.physio.2018.04.004
World Health Organization. (2020). Rehabilitation. Retrieved 18 September 2020 from https://www.who.int/news-room/fact-sheets/detail/rehabilitation
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