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ABSTRACT Purpose: to analyze the telehealth speech therapy approach in patients with oropharyngeal dysphagia and determine the applications and effects of this practice. Methods: the following descriptors were used for selection: Telerehabilitation, Telemedicine, "Remote Consultation", "Healthcare Delivery", "Distance Counseling", "Therapy, Computer-Assisted", "Speech-Language Pathology", "Speech Therapy", "Swallowing Disorders", Dysphagia, "Bottle Feeding" and "Enteral Nutrition" in PubMed, MedLine, Scopus and Web of Science databases and in the gray literature, by Google Scholar and ProQuest. Studies were selected without time limits, in Portuguese, English and Spanish, that described the applicability and/or effects of telehealth in speech therapy practice in patients with swallowing disorders/dysphagia, regardless of gender and age. For analysis, the following were considered: level of scientific evidence and recommendation, telehealth modality, objectives, methods and results/conclusion. Literature Review: 490 articles were found and, after exclusion of duplicates, analysis of titles, abstracts and reading of full articles, 22 studies were selected. The articles were classified into telehealth modalities: tele-education, telediagnosis, teleconsulting, teleregulation and telemonitoring. Conclusion: the telehealth modalities described had a great potential to promote significant improvements in patients presented with swallowing disorders/dysphagia, suggesting them as viable for speech therapy services. Among them, teleconsultation was the least addressed.
RESUMO Objetivo: analisar a abordagem fonoaudiológica por meio da telessaúde em pacientes com disfagia e determinar as aplicações e efeitos desta prática. Métodos: para seleção foram utilizados os descritores: Telerehabilitation, Telemedicine, "Remote Consultation", "Delivery of Health Care", "Distance Counseling", "Therapy, Computer-Assisted", "Speech-Language Pathology", "Speech Therapy", "Deglutition Disorders", Dysphagia, "Bottle Feeding" e "Enteral Nutrition" nas bases de dados PubMed, MedLine, Scopus e Web of Science e na literatura cinzenta, por meio do Google Acadêmico e ProQuest. Foram selecionados estudos sem delimitação de tempo, nas línguas português, inglês e espanhol, que descrevessem a aplicabilidade e/ou efeitos da telessaúde na prática fonoaudiológica junto à pacientes com alteração da deglutição/disfagia, sem restrição de sexo e idade. Para análise considerou-se: nível de evidência científica e recomendação, modalidade de telessaúde, objetivos, métodos e resultados/conclusão. Revisão da Literatura: foram encontrados 490 artigos e, após exclusão de duplicatas, análise dos títulos, resumos e leitura completa dos artigos, 22 estudos foram selecionados. Os artigos foram classificados nas modalidades da telessaúde: tele-educação, telediagnóstico, teleconsultoria, telerregulação e telemonitoramento. Conclusão: as modalidades de telessaúde descritas tiveram grande potencial para promover melhoras significativas em pacientes com alteração de deglutição/disfagia, sugerindo-as como viáveis para serviços fonoaudiológicos. Entre elas, a teleconsulta foi a menos explorada.
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Abstract: Cognitive stimulation activities for older adults are generally carried out in face-to-face workshops. However, during the COVID-19 pandemic, these activities and consultations became remote due to social isolation, enabling care to continue safely. This study aims to analyze the remote cognitive stimulation and/or telerehabilitation activities for older people that were carried out as an intervention during the COVID-19 pandemic. This is a systematic review study with five selected articles, conducted according to the PRISMA statement methodology. Among the main results, the feasibility and acceptance of remote cognitive stimulation activities using technologies during the pandemic stand out, reflecting on future and expanded use for different realities and cultures. the studies reviewed also indicate the stabilization and improvement of the cognitive state and of depressive and anxious feelings, as well as the maintenance of independence of these participants, with an increase in scores on scales applied before and after the interventions. In conclusion, the activities carried out in cognitive stimulation and/or telerehabilitation therapies for older adults as an intervention during the COVID-19 pandemic had an average of 47 participants; the technologies used for the activities were tablet and personal computer; pre-installed programs were the most used strategy; and the interventions lasted from 1 to 3 months, with activities 2 to 3 times per week. The reinvention of techniques aimed at stimulating and rehabilitating the cognitive health of the older adults, via technologies as a strategy to replace or complement face-to-face activities, promotes the cognitive and mental health and independence of the older population.
Resumo: As atividades de estímulo cognitivo em idosos são geralmente realizadas por meio de oficinas presenciais; porém durante a pandemia da COVID-19, com o isolamento social, as atividades e consultas passaram a ser remotas para não interromper os cuidados. O objetivo deste estudo é analisar as atividades de estímulo cognitivo remoto e/ou telerreabilitação em idosos como intervenção durante a pandemia da COVID-19. Esta é uma revisão sistemática de cinco artigos selecionados, conduzida segundo a metodologia PRISMA. Os principais resultados incluem a viabilidade e aceitação de atividades de estímulo cognitivo remoto utilizando tecnologias durante a pandemia, refletindo em uso futuro e ampliado para diferentes realidades e culturas. Estudos também apontam para a estabilização e melhoria do estado cognitivo, dos sentimentos de depressão e ansiedade e da manutenção da independência desses participantes, com aumento nas pontuações nas escalas aplicadas depois das intervenções. Conclui-se que as atividades realizadas em terapias de estímulo cognitivo e/ou telerreabilitação em idosos como intervenção durante a pandemia da COVID-19 tiveram em média 47 participantes, os dispositivos tecnológicos utilizados foram o tablet e o computador, os programas pré-instalados foram a estratégia mais utilizada, com duração da intervenção de 1 a 3 meses e atividades realizadas 2 a 3 vezes por semana. A reinvenção de técnicas que visam estimular e reabilitar a saúde cognitiva dos idosos, incluindo o uso de tecnologias como estratégia para substituir ou complementar as atividades presenciais, promove a saúde cognitiva e mental e a independência dos idosos.
Resumen: Las actividades de estimulación cognitiva en ancianos generalmente se realizan mediante talleres presenciales; pero, durante la pandemia de COVID-19, con el aislamiento social, las actividades y consultas se volvieron remotas para no interrumpir los cuidados. El objetivo de este estudio es analizar las actividades de estimulación cognitiva remota o telerrehabilitación en ancianos como intervención durante la pandemia de COVID-19. Se trata de una revisión sistemática de cinco artículos seleccionados, realizada según la metodología PRISMA. Los principales resultados incluyen la viabilidad y aceptación de actividades de estimulación cognitiva remota utilizando tecnologías durante la pandemia, lo que refleja un uso futuro y ampliado para diferentes realidades y culturas. Los estudios también apuntan a la estabilización y mejora del estado cognitivo, de los sentimientos de depresión y ansiedad y de la conservación de la independencia de estos participantes, con un aumento en las puntuaciones en las escalas aplicadas tras las intervenciones. Se concluye que las actividades realizadas en terapias de estimulación cognitiva o telerrehabilitación en ancianos como intervención durante la pandemia de COVID-19 tuvieron un promedio de 47 participantes, los dispositivos tecnológicos utilizados fueron la tableta y la computadora, los programas preinstalados fueron la estrategia más utilizada, con una duración de la intervención de 1 a 3 meses y actividades realizadas de 2 a 3 veces por semana. La reinvención de técnicas que tienen como objetivo estimular y rehabilitar la salud cognitiva de los ancianos, incluido el uso de tecnologías como estrategia para reemplazar o complementar las actividades presenciales, promueve la salud cognitiva y mental y la independencia de los ancianos.
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Introducción. La dismenorrea primaria afecta la calidad de vida de mujeres jóvenes. Este estudio investiga los efectos de un protocolo de ejercicios y educación en dolor mediante telerehabilitación. Objetivo. Determinar los efectos de un protocolo de ejercicios y educación en dolor y su impacto en la calidad de vida mediante tele-rehabilitación en mujeres jóvenes con dismenorrea primaria. Métodos. Se realizó un estudio experimental pre y post test con un grupo control, utilizando tele-rehabilitación. Participaron 21 mujeres jóvenes con dismenorrea primaria, asignadas aleatoriamente a dos grupos: el grupo experimental (10 mujeres) y el grupo control (11 mujeres). Se utilizaron cuestionarios específicos de calidad de vida relacionada con la menstruación y dolor (cuestionario breve de McGill) para evaluar los efectos del programa de ejercicios y educación en dolor. Resultados. En el grupo control, no se observaron diferencias significativas en las puntuaciones de calidad de vida relacionada con la menstruación ni en la intensidad del dolor antes y después de la intervención (p>0,05). En contraste, el grupo experimental experimentó mejoras significativas en ambas áreas después de la intervención (todos los p<0,001). Conclusiones. Este estudio demuestra que un protocolo de ejercicios y educación en dolor realizado mediante telerehabilitación tiene un impacto positivo y significativo en la calidad de vida y la intensidad del dolor percibido en mujeres jóvenes con dismenorrea primaria. Estos resultados sugieren que la telerehabilitación puede ser una estrategia efectiva para abordar este problema de salud en esta población.
Background. Primary dysmenorrhea impacts the quality of life of young women. This study investigates the effects of an exercise and pain education protocol through telerehabilitation. Objective: To determine the effects of an exercise and pain education protocol and its impact on the quality of life through telerehabilitation in young women with primary dysmenorrhea. Methods: A pre and post-test experimental study with a control group was conducted using telerehabilitation. Twenty-one young women with primary dysmenorrhea participated, randomly assigned to two groups: the experimental group (10 women) and the control group (11 women). Specific questionnaires related to menstruation-related quality of life and pain (McGill short-form questionnaire) were used to assess the effects of the exercise and pain education program. Results: In the control group, no significant differences were observed in menstruation-related quality of life scores or pain intensity before and after the intervention (p>0.05). In contrast, the experimental group experienced significant improvements in both areas after the intervention (all p<0.001). Conclusion: This study demonstrates that an exercise and pain education protocol conducted through telerehabilitation has a positive and significant impact on the perceived quality of life and pain intensity in young women with primary dysmenorrhea. These results suggest that telerehabilitation can be an effective strategy for addressing this health issue in this population.
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Introdução: a dor lombar é um dos mais difundidos problemas de saúde pública enfrentados no mundo e, dessa forma, o acesso aos tratamentos baseados em evidências como educação em neurociência da dor e exercícios terapêuticos é frequentemente limitado devido a inúmeras barreiras. Objetivo: desenvolver um protocolo de intervenção que utilize um programa estruturado de educação em dor associado ao exercício terapêutico para o tratamento da dor lombar crônica, por meio de telerreabilitação. Método: este protocolo descreve um delineamento experimental do tipo ensaio clínico controlado, aleatorizado com avaliador e estatístico mascarados. Discussão: a hipótese aqui apresentada é a de que o programa de telerreabilitação beneficiará pacientes com dor lombar crônica, reduzindo a intensidade da dor, melhorando a função e fatores psicológicos.
Introduction: Low back pain is one of the most widespread public health problems faced in the world. The access to evidence-based treatment, such as pain neuroscience education and therapeutic exercises, is often limited due to numerous barriers. Objective: To develop an intervention protocol that uses a pain education program associated with therapeutic exercise for the treatment of chronic low back pain, through telerehabilitation. Method: This protocol describes an experimental design of the type controlled clinical trial, randomized with evaluator and blinded statistician. Discussion: Our hypothesis is that the telerehabilitation program will benefit patients with chronic low back pain, surprising pain intensity, improving function and psychological factors.
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Purpose: Coronavirus disease 2019 (COVID?19) pandemic affected the in?person rehabilitation/habilitation services in families with children with cerebral visual impairment (CVI) in India. This study aimed to develop a structured and family?centered telerehabilitation model alongside conventional in?person intervention in children with CVI to observe its feasibility in the Indian population. Methods: This pilot study included 22 participants with a median age of 2.5 years (range: 1–6) who underwent a detailed comprehensive eye examination followed by functional vision assessment. The visual function classification system (VFCS) was administered to the children and the structured clinical question inventory (SCQI) to the parents. Every participant underwent 3 months of telerehabilitation including planning, training, and monitoring by experts. At 1 month, the parental care and ability (PCA) rubric was administered to the parents. After 3 months, in an in?person follow?up, all the measures were reassessed for 15 children. Results: After 3 months of Tele?rehabilitation there were significant improvements noted in PCA rubric scores (P<0.05). Also, statistically significant improvements were noted in functional vision measured using SCQI and VFCS scores (P<0.05) compared to baseline. Conclusion: The outcomes of the study provide the first steps towards understanding the use of a novel tele?rehabilitation model in childhood CVI along?side conventional face?to?face intervention. The added role of parental involvement in such a model is highly essential.
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Resumen Objetivo: Sintetizar la evidencia existente sobre los principales resultados de programas de rehabilitación presenciales y/o mediante telerrehabilitación, sobre la funcionalidad en personas mayores con Enfermedad Pulmonar Obstructiva Crónica (EPOC). Materiales y método: Se realizó la búsqueda de artículos científicos en las bases de datos: Medline vía PubMed y BVS Lilacs que cumplan con los criterios de elegibilidad, entre la fecha del 1 de enero del 2019 hasta el 1 de enero de 2021, seleccionando 4 documentos. Para la identificaciónde artículos se utilizó las palabras clave "Aged", "Pulmonary Disease, Chronic Obstructive", "Rehabilitation - Telerehabilitation". Resultados: La edad promedio de las personas participantes, fue de 65.4, predominaron los estudios en género masculino y de las personas mayores incluidas con EPOC, el 50% lo padecía de forma severa. Sobre la descripción de los programas de rehabilitación, el 75% tuvo seguimiento de los resultados, desde los 3 a los 12 meses, el 50% de los programas tuvo una duración de 10 semanas, en el 50% de los casos se les proporcionó a los pacientes tecnología para el uso en domicilio y solo un 15% utilizó una aplicación móvil. Conclusión: Los resultados respaldan la opinión de que los proveedores de atención médica pueden usar la telerrehabilitación, para el tratamiento de las personas mayores con EPOC junto con la rehabilitación habitual.
Abstract Objective: To synthesize the existing evidence on the main results of face-to-face and/or telerehabilitation rehabilitation programs on functionality in elderly people with COPD. Materials and method: We searched for scientific articles in the following databases: Medline via PubMed and BVS Lilacs that met the eligibility criteria, between January 1, 2019 and January 1, 2021, selecting 4 documents. The keywords "Aged", "Pulmonary Disease, Chronic Obstructive", "Rehabilitation - Telerehabilitation" were used to identify articles. Results: The average age of the participants was 65.4, male studies predominated and of the elderly included with COPD, 50% suffered from severe COPD. Regarding the description of the rehabilitation programs, 75% had follow-up of the results, from 3 to 12 months, 50% of the programs had a duration of 10 weeks, in 50% of the cases the patients were provided with technology for home use and only 15% used a mobile application. Conclusion: The results support the view that health care providers can use telerehabilitation for the treatment of older persons with COPD in conjunction with usual rehabilitation.
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INTRODUÇÃO: As restrições durante a pandemia do COVID-19 limitaram o acesso a centros de reabilitação especializados para tratamento fisioterapêutico de pessoas com Doença de Parkinson (DP). Sabe-se que a falta de exercícios físicos pode agravar as condições de saúde, levar à piora dos sinais típicos da doença e promover o declínio funcional. A telerreabilitação é uma estratégia que pode restaurar o acesso e facilitar a continuidade de assistência fisioterapêutica. OBJETIVOS: Avaliar os efeitos de um programa de exercícios físicos por telerreabilitação no nível de atividade física, no desempenho funcional de Membros Inferiores (MMII), no desempenho nas atividades de vida diária (AVD's) e na qualidade de vida (QV) em idosos com DP. MATERIAIS E MÉTODOS: Trata-se de um estudo experimental, descritivo, longitudinal, em que foram avaliados os efeitos da intervenção por telerreabilitação composta por 12 sessões de 1 hora, feitas 3 vezes/semana, realizada estatística analítica para fins comparativos pelo Teste t de Student. RESULTADOS: 22 participantes concluíram o estudo. Foi observada mudança significativa no nível de atividade física (IPAQ inicial de 0,18 ±0,39 e final de 1,0 ± 0, p = 0,0001), no desempenho funcional dos MMII (teste de sentar e levantar cinco vezes (TSLCV) tempo médio pré 16,22 ± 7.41, e após 12.26 ± 2.83, p= 0,0197), no desempenho nas atividades de vida diária (Brazilian OARS Multidimensional Functional Assessment Questionnaire (BOMFAQ) de 26,13 ± 6,31 e após de 35,45 ± 5,16, p = 0,0001) e na QV dos idosos com DP (PDQ-39 inicial de 45,92 ±15,36 e final de 23,63 ± 10,19, p = 0,0001). CONCLUSÃO: Concluise que houve mudança no nível de atividade física, no desempenho funcional de MMII, no desempenho nas AVD's e na QV.
INTRODUCTION: Restrictions during the COVID-19 pandemic limited access to specialized rehabilitation centers for physical therapy treatment of people with Parkinson's disease (PD). It is known that lack of exercise can worsen health conditions, lead to worsening typical signs of the disease, and promote functional decline. Telerehabilitation is a strategy that can restore access and facilitate the continuity of physical therapy care. OBJECTIVES: To evaluate the effects of a telerehabilitation exercise program on the level of physical activity, functional capacity of lower limbs, performance of activities of daily living (ADLs) and quality of life (QoL) in elderly patients with PD. MATERIALS AND METHODS: This is an experimental, descriptive, exploratory, longitudinal study, in which the effects of intervention by telerehabilitation were evaluated, the program was composed of 12 sessions of 1 hour, 3 times a week. Analytical statistics was done for comparative purposes by Student's t test. RESULTS: 22 participants completed the study. Significant change was observed in physical activity level (IPAQ initial 0.18 ±0.39 and final 1.0 ± 0, p = 0.0001), in the functional capacity of lower limbs (5 times sit and stand test (TSLCV) mean time pre 16.22 ± 7.41, and post 12.26 ± 2. 83, p= 0.0197), in the performance in the activities of daily living (Brazilian OARS Multidimensional Functional Assessment Questionnaire (BOMFAQ) of 26.13 ± 6.31 and after of 35.45 ± 5.16, p = 0.0001) and in the QL of the elderly with PD (PDQ-39 initial of 45.92 ±15.36 and final of 23.63 ± 10.19, p = 0.0001). CONCLUSION: We conclude that there was a change in the level of physical activity, in the functional capacity of lower limbs, in the performance of ADLs and in QL.
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Parkinson Disease , Exercise , TelerehabilitationABSTRACT
Purpose: This study utilized virtual focus group discussions to document the facilitators and barriers reported by the parents as part of the tele?rehabilitation service delivery model in India. Methods: This study included 17 participants who were enrolled into the Tele?rehabilitation program (16 mothers, 1 father) and the virtual focus group discussion (V?FGD) were conducted through a WhatsApp video call. Three V?FGDs were conducted involving two moderators and a note taker. The V?FGD, focused at extracting the perceptions of parents pertaining to facilitators, barriers and coping mechanisms to barriers related to the tele?rehabilitation model. Results: Thematic analysis resulted in four themes for barriers that included: family and support, time, parent and care taker, child and place of living related; facilitators reported included: continuous monitoring, accessibility to professional services, provision of resource materials and parental empowerment. Themes “family and support” and “child” were most reported by parents with children >3 years and ?3 years respectively. Finally, the barriers and facilitators were aligned with the chapters and codes of International Classification of Functioning, children and youth version (ICF?CY) environment and personal factors. Conclusion: This V?FGD highlights the importance of parental?centred and structured Tele?rehabilitation among children with CVI in India. The outcome of this study opens avenues for creating effective intervention.
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Abstract Introduction Remote postural assessment, necessary during the pandemic, required strategies to replace its in-person counterpart. Objective Analyze the content validity of a protocol for Remote Static Posture Assessment (ARPE) that includes three items, postural checklist, rater's manual and ratee's manual. Methods Six experts in postural assessment were invited to validate the content of the three items of the ARPE protocol and 10 laypersons evaluated the ratee's Manual. The validity questionnaire encompassed the protocol in general and each individual item, containing an area for suggestions from experts and laypersons. The responses of these raters were used to calculate the Content Validity Indexes (CVI). Results Two rounds of evaluations were carried out with the experts and one with the laypersons. In the first round with the experts, the CVI ranged from 98.6 to 83%. Three aspects (description of head positioning, description of scapula and waist positioning in the frontal plane) required adjustments. In the first round with the laypersons and second round with the experts, the CVI was 100%. Conclusion The 100% agreement between experts and laypersons regarding the content of the ARPE protocol confirms its content validity.
Resumo Introdução A avaliação da postura por atendimento remoto, necessária durante o cenário pandêmico, exigiu estratégias para substituir a avaliação postural presencial. Objetivo Realizar a validação de conteúdo de um protocolo de Avaliação Remota da Postura Estática (ARPE) que contempla três itens: checklist postural, manual do avaliador e manual do avaliado. Métodos Seis especialistas em avaliação postural foram convi-dados para a validação de conteúdo dos três itens do protocolo ARPE e 10 leigos avaliaram o manual do avaliado. O questionário de validação englobava o protocolo em geral e cada item isolado, contendo espaço para sugestões dos especialistas e leigos. As respostas desses avaliadores foram utilizadas no cálculo dos índices de validade de conteúdo (IVCs). Resultados Foram realizadas duas rodadas de avaliações com especialistas e uma com leigos. Na primeira rodada com os especialistas, os IVCs variaram de 98,6 a 83%.Três aspectos (descrição do posicionamento da cabeça, do posicionamento das escápulas e da "cintura" no plano frontal de costas) necessitaram de ajustes. Na primeira rodada com os leigos, os IVCs foram de 100%. Na segunda rodada com os especialistas, os IVCs foram de 100%. Conclusão A concordância de 100% entre os especialistas e leigos sobre o conteúdo do protocolo ARPE confirma sua validade de conteúdo.
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ABSTRACT Objective: To assess postoperative rehabilitation patterns in patients who underwent Anterior Cruciate Ligament Reconstruction (ACLR) during the COVID-19 pandemic. Methods: A retrospective study of patients who underwent primary isolated ACLR between February 2019 and July 2020. Two different periods were evaluated. The "COVID group" represents the period from February 1st to July 1st of 2020 and the "non-COVID group" represents the equivalent period in 2019. Rehabilitation features and the effect of the COVID-19 pandemic on rehabilitation habits were assessed. Patient outcome scores were assessed using the Lysholm, Tegner, and International Knee Documentation Committee (IKDC) questionnaires. Subjective satisfaction, post-operative complications, and subsequent surgeries were recorded. Results: The groups did not differ significantly in demographics, functional outcome scores, or subjective satisfaction. There was no significant difference in rehabilitation patterns between the groups. In the COVID group, only one patient (4%) reported participation in online physiotherapy. Conclusions: There were no differences in the post-operative rehabilitation patterns, including duration, length, and environment of the training, between patients who underwent primary isolated ACLR during the COVID-19 pandemic and those who underwent the treatment in the preceding non-COVID year. Patient outcome scores, subjective satisfaction, and subsequent surgery rates did not differ between the groups. Level of evidence IV; Therapeutic studies - investigation of treatment results.
RESUMEN Objetivo: Evaluar los patrones de rehabilitación postoperatoria en pacientes sometidos a una reconstrucción del ligamento cruzado anterior (RLCA) durante la pandemia de COVID-19. Métodos: Se realizó un estudio retrospectivo de pacientes sometidos a RLCA aislada primaria entre febrero de 2019 y julio de 2020 evaluados en dos períodos distintos. El "grupo COVID" representa el período comprendido entre el 1de febrero y el 1 de julio de 2020 y el "grupo pre-COVID" representa el período equivalente en 2019. Se evaluaron los recursos de rehabilitación y el efecto de la pandemia de COVID-19 en los patrones de rehabilitación. Las puntuaciones de los resultados de los pacientes se evaluaron mediante los cuestionarios de Lysholm, Tegner y del International Knee Documentation Committee (IKDC). Se informaron datos de satisfacción subjetiva, complicaciones postoperatorias y cirugías posteriores. Resultados: En ambos grupos no se identificaron diferencias significativas en los datos demográficos, las puntuaciones funcionales y la satisfacción subjetiva, así como en los patrones de rehabilitación. En el "grupo COVID", sólo un paciente (4%) declaró haber participado en fisioterapia "online". Conclusiones: Los pacientes sometidos a RLCA aislada primaria durante la pandemia de COVID-19 no presentaron diferencias en los patrones de rehabilitación postoperatoria, incluida la duración, el alcance y el entorno del entrenamiento en comparación con los pacientes del grupo pre-COVID. Las puntuaciones de los resultados de los pacientes, la satisfacción subjetiva y las tasas de cirugía posterior no difirieron entre los grupos. Nivel de Evidencia IV; Estudios terapéuticos - Investigación de los resultados del tratamiento.
RESUMO Objetivos: Avaliar os padrões de reabilitação pós-operatória em pacientes submetidos à reconstrução do ligamento cruzado anterior (RLCA) durante a pandemia de COVID-19. Métodos: Foi realizado um estudo retrospectivo dos pacientes submetidos a RLCA isolada primária no período de fevereiro de 2019 a julho de 2020 avaliados em dois períodos distintos. O "grupo COVID" representa o período de 1 de fevereiro a 1 de julho 2020, e o "grupo pré-COVID" representa o período equivalente em 2019. Os recursos de reabilitação e o efeito da pandemia de COVID-19 sobre os padrões de reabilitação foram avaliados. Os escores dos resultados dos pacientes foram avaliados com os questionários Lysholm, Tegnes e pelo International Knee Documentation Committee (IKDC). Foram relatados os dados de satisfação subjetiva, complicações pós-operatórias e cirurgias subsequentes. Resultados: Em ambos os grupos não foram identificadas diferenças significativas nos dados demográficos, escores funcionais e na satisfação subjetiva, assim como nos padrões de reabilitação. No "grupo COVID", somente um paciente (4%) reportou participação em fisioterapia "on-line". Conclusões: Os pacientes submetidos à RLCA isolada primária durante a pandemia COVID-19 não apresentaram diferença nos padrões de reabilitação pós-operatória, incluindo duração, extensão e ambiente de treinamento em comparação com pacientes do grupo pré-COVID no ano anterior. Os escores dos resultados dos pacientes, a satisfação subjetiva e as taxas de cirurgia subsequentes não diferiram entre os grupos. Nível de Evidência IV; Estudos terapêuticos - Investigação dos resultados do tratamento.
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Resumo Fundamento A pandemia da COVID-19 teve um impacto sobre os programas de reabilitação cardiovasculares (RC) no Brasil. Objetivos Descrever características dos programas de RC no Brasil, os impactos da primeira onda epidemiológica da COVID-19 (primeiros 60 dias) sobre os programas, e apresentar as iniciativas usadas para superar esses impactos. Métodos Este estudo transversal e retrospectivo usou um questionário online específico. Os participantes eram coordenadores de programas de RC. As variáveis foram apresentadas por região geográfica do Brasil, como as seguintes categorias: característica demográficas, clínicas e operacionais. O nível de significância estatística foi definido em 5%. Resultados Cinquenta e nove programas de RC atendiam 5349 pacientes, dos quais somente 1817 eram pacientes após eventos cardiovasculares agudos, o que correspondia a 1,99% dos pacientes internados no mês anterior à pesquisa (n=91.231). O maior impacto foi a suspensão das atividades presenciais, o que ocorreu de maneira similar em áreas com as taxas mais altas e áreas com as taxas mais baixas de COVID-19 no período. Quarenta e quatro (75%) programas foram interrompidos de forma breve, e três (5%) foram encerrados. Todos os 42 programas que já utilizavam estratégias de reabilitação remota notaram aumento substancial nas atividades, baseadas principalmente no uso da mídia e chamadas por vídeo. Somente três (5%) consideraram seguro atender pacientes durante os primeiros 60 dias. Conclusões Houve redução no número de programas de RC devido a pandemia da COVID-19. Atividades de telerreabilitação aumentaram durante os primeiros dois meses da pandemia da COVID-19, mas que não foi suficiente para superar a redução nas atividades dos programas de RC no Brasil.
Abstract Background The COVID-19 pandemic had an impact on cardiovascular rehabilitation (CR) programs in Brazil. Objectives To describe the characteristics of CR programs in Brazil, the impacts of the first epidemiological wave of COVID-19 (first 60 days) on the programs and present the initiatives used to overcome the impacts. Method This cross-sectional and retrospective study utilized a specific online survey. Participants were coordinators of CR programs. Variables were presented by Brazilian geographic region and as the following categories: demographic, clinical and operational characteristics. The significance level for statistical analysis was set at 5%. Results Fifty-nine CR programs were responsible for 5,349 patients, of which only 1,817 were post-acute cardiovascular events, which corresponded to 1.99% of hospitalized patients in the month prior to the survey (n=91,231). The greatest impact was the suspension of on-site activities, which occurred similarly in areas with the highest and the lowest rates of COVID-19 in the period. Forty-five programs (75%) were shortly interrupted, while three (5%) were ended. All 42 programs that already used remote rehabilitation strategies noticed a substantial increase in activities, based primarily on the use of media and video calling. Only three (5%) considered safe to see patients during the first 60 days. Conclusions There was a reduction in the number of CR programs with the COVID-19 pandemic. Telerehabilitation activities increased during the first two months of the COVID-19 pandemic, but this was not enough to overcome the reduction in CR program activities across Brazil.
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ABSTRACT Objective: To compare the effects of a home-based pulmonary rehabilitation (PR) program with and without telecoaching on health-related outcomes in COVID-19 survivors. Methods: A total of 42 COVID-19 patients who completed medical treatment were randomly divided into two groups: the study (telecoaching) group (n = 21) and the control (no telecoaching) group (n = 21). Both groups participated in an 8-week home-based PR program including education, breathing exercises, strength training, and regular walking. The study group received phone calls from a physiotherapist once a week. Both groups of patients were assessed before and after the program by means of the following: pulmonary function tests; the modified Medical Research Council dyspnea scale; the six-minute walk test; extremity muscle strength measurement; the Saint George's Respiratory Questionnaire (to assess disease-related quality of life); the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36, to assess overall quality of life); and the Hospital Anxiety and Depression Scale. Results: In both groups, there were significant improvements in the following: FVC; the six-minute walk distance; right and left deltoid muscle strength; Saint George's Respiratory Questionnaire activity domain, impact domain, and total scores; and SF-36 social functioning, role-physical, role-emotional, and bodily pain domain scores (p < 0.05). Decreases in daily-life dyspnea, exertional dyspnea, and exertional fatigue were significant in the study group (p < 0.05), and the improvement in SF-36 social functioning domain scores was greater in the study group (p < 0.05). Conclusions: A home-based PR program with telecoaching increases social functioning and decreases daily-life dyspnea, exertional dyspnea, and exertional fatigue in COVID-19 survivors in comparison with a home-based PR program without telecoaching.
RESUMO Objetivo: Comparar os efeitos de um programa de reabilitação pulmonar (RP) domiciliar com e sem coaching por telefone (telecoaching) nos desfechos relacionados à saúde em sobreviventes da COVID-19. Métodos: Um total de 42 pacientes com COVID-19 que completaram o tratamento médico foram aleatoriamente divididos em dois grupos: o grupo com telecoaching (grupo de estudo; n = 21) e o grupo sem telecoaching (grupo controle; n = 21). Ambos os grupos participaram de um programa de RP domiciliar que teve 8 semanas de duração e incluiu educação, exercícios respiratórios, treinamento de força e caminhada regular. O grupo de estudo recebeu telefonemas de um fisioterapeuta uma vez por semana. Ambos os grupos foram avaliados antes e depois do programa por meio de testes de função pulmonar, escala modificada de dispneia do Medical Research Council, teste de caminhada de seis minutos, mensuração da força muscular dos membros superiores e inferiores, Saint George's Respiratory Questionnaire (para avaliar a qualidade de vida relacionada à doença), Medical Outcomes Study 36-item Short-Form Health Survey (SF-36, para avaliar a qualidade de vida global) e Hospital Anxiety and Depression Scale. Resultados: Em ambos os grupos, houve melhoria significativa da CVF; da distância percorrida no teste de caminhada de seis minutos; da força dos músculos deltoides direito e esquerdo; da pontuação obtida nos domínios "atividade" e "impacto" do Saint George's Respiratory Questionnaire, bem como da pontuação total no questionário; e da pontuação obtida nos domínios "aspectos sociais", "função física", "função emocional" e "dor corporal" do SF-36 (p < 0,05). A redução da dispneia na vida diária, da dispneia aos esforços e da fadiga aos esforços foi significativa no grupo de estudo (p < 0,05), e a melhoria da pontuação obtida no domínio "aspectos sociais" do SF-36 foi maior no grupo de estudo (p < 0,05). Conclusões: Um programa de RP domiciliar com telecoaching melhora os aspectos sociais e diminui a dispneia na vida diária, a dispneia aos esforços e a fadiga aos esforços em sobreviventes da COVID-19 em comparação com um programa de RP domiciliar sem telecoaching.
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Objective:To observe any effect of long-distance application of Oral Reading for Language with Aphasia (ORLA) training on patients with post-stroke aphasia.Methods:A total of 42 stroke survivors with aphasia were randomly divided into an inpatient group, and two online groups, each of 14. All three groups had their routine rehabilitation treatment supplemented with ordinary multimodal language therapy and ORLA. The inpatient group completed the routine in the rehabilitation treatment room, while the online groups completed it at home using Tencent video conferencing software. The conventional multimodal language therapy was conducted once daily, 5 days a week for 4 weeks. For the inpatient group and online group 2 the daily session lasted 30 minutes, while for the online 1 groups the daily length was doubled. The ORLA therapy was also conducted once daily, 5 days a week for 4 weeks, for the inpatient group and online group 2 the daily session lasted 1h, while for the online 1 groups the daily length was 30min.The speech function, reading ability and life quality of the three groups were evaluated before and after the intervention using the Western Aphasia Battery, the Chinese Standard Aphasia Examination Scale and the Chinese version of the Stroke Aphasia Quality of Life Scale.Results:After treatment, the average aphasia quotient (AQ), reading, naming and quality of life scores in all three groups had improved significantly compared with those before treatment. And related language ability scores (such as retelling, fluency, information volume, listening comprehension, etc.) had also improved significantly in all three groups. However, the average AQ, reading, and oral fluency scores of the inpatient group and online group 2 were significantly higher than those of online group 1. Significant improvement was also observed in the reading aloud and life quality of all three groups, but the average improvement in reading aloud was significantly greater in the inpatient group and in online group 2 compared to online group 1. The average life quality of the online groups was significantly superior to that of the inpatient group.Conclusion:Medium- and high-intensity ORLA synchronous remote speech rehabilitation can significantly improve the speech ability, reading ability and life quality of aphasic stroke survivors.
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De la mano del envejecimiento poblacional, la demencia o trastorno neurocognitivo mayor afecta a una cantidad cada vez mayor de personas, lo que implica un alto costo para los servicios de salud. Las guías de práctica clínica recomiendan ofrecer terapias de estimulación cognitiva a las personas afectadas y cada vez es más común el empleo de herramientas tecnológicas que permiten su aplicación a gran escala a pesar de la incertidumbre acerca de su beneficio.En este artículo revisamos la evidencia más actualizada sobre la eficacia de las herramientas computarizadas para el entrenamiento cognitivo de pacientes con demencia. Encontramos algunos estudios que sugieren que podría haber una posible mejora cognitiva en los pacientes con demencia y en la calidad de vida de sus cuidadores. Sin embargo, la mayoría de los estudios no fueron de buena calidad metodológica, fueron realizados con un número limitado de pacientes, en periodos poco prolongados, y los desenlaces fueron evaluados a través de múltiples pruebas de difícil interpretación. (AU)
With the increasing population aging, dementia or major neurocognitive disorder affects a growing number of people,incurring a substantial burden on healthcare services. Clinical practice guidelines recommend providing cognitive stimulation therapies to affected individuals, and the use of technological tools for implementing therapies on a large scale is increasingly common despite the uncertainty about their benefits.In this article, we reviewed the most up-to-date evidence on the effectiveness of computerized tools for cognitive training in patients with dementia. We found some studies that suggest that there could be a possible cognitive improvement in patients with dementia and in the quality of life of their caregivers. However, most studies were not of good methodological quality, were carried out with a limited number of patients, in short periods of time, and the outcomes were evaluated through multiple tests that were difficult to interpret. (AU)
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Humans , Female , Aged, 80 and over , Dementia/therapy , Alzheimer Disease/therapy , Telerehabilitation , Cognitive Training/methods , Randomized Controlled Trials as Topic , Personal Autonomy , Computers, Handheld , Mobile Applications , Memory, Short-TermABSTRACT
ObjectiveTo analyze the application of telerehabilitation in patients with coronary heart disease (CHD) based on the theories and methods of the International Classification of Functioning, Disability and Health (ICF). MethodsLiteratures on the application of telerehabilitation in patients with CHD from databases of PubMed, Web of Science, CNKI, and Wanfang data were retrieved from establishment to May 5th, 2022. Scoping review methods were used to analyze the intervention measures, evaluation methods and indicators, rehabilitation outcomes, and influencing factors on patients with CHD based on ICF. ResultsA total of 4 172 literatures were retrieved, and 15 of them from five countries were enrolled. They were almost published in journals on medical and public health, from 2015 to 2022. The main elements of telerehabilitation included nine items: the establishment of telerehabilitation group, the establishment of personal health profiles, physical activity, exercise monitoring, provision of relevant knowledge, communication and guidance from professionals, provision of psychological support, self-report and supervision and reminder of medical staff. According to the ICF framework, telerehabilitation promoted the function of patients with CHD mainly in body function (including b1 mental functions, b4 function of the cardiovascular, hematological, immunological and respiratory systems, b5 functions of the digestive, metabolic and endocrine systems, and b7 neuromusculoskeletal and movement-related functions) and activity and participation (including d2 general tasks and demands, d4 mobility, d7 interpersonal interactions and relationships, d8 major life areas, and d9 community, social and civic life). The factors affecting the activity and participation of patients with CHD contained environmental factors and personal factors, mainly including e1 products and technology, e3 support and relationships, e4 attitudes, and e5 service, systems and policies. ConclusionThis paper summarized nine items of telerehabilitation for patients with CHD, and analyzed the effects and related influencing factors of telerehabilitation on patients with CHD based on ICF.
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ABSTRACT Stroke is a chronic health condition that requires monitoring. In this sense, telehealth emerges as a tool to enable better access. However, since it is related to use of technology, this modality might face new barriers. Our goal was to identify, with a systematic literature review, the perceived barriers to telehealth access by stroke patients and conceptualize them within the Unified Theory of Acceptance and Use of Technology (UTAUT) model. The systematic review was carried out in the following electronic databases: PubMed, MEDLINE, SciELO, LILACS, and PEDro; and the combination of descriptors were: "Barriers to Access to Health Care," "Telerehabilitation," "Telehealth," "Stroke," and "Physical Therapy Modalities." The included studies focused on telehealth barriers perceived by stroke patients. Initially, 298 articles were found, 295 via databases search, and three via active search; of these, only six articles were included in this review. Overall, the articles revealed the perception of more than 220 stroke patients, with barriers categorized into eight types, most of them related to the dimensions of Effort Expectancy and Facilitating Conditions of the UTAUT model. The barriers of the Effort Expectation dimension that are related to the knowledge in the use of technologies are likely to be overcome since training can be carried out before the telehealth service. However, the barriers related to the Facilitating Conditions dimension regarding financial aspects, the internet, and home context are difficult to overcome, possibly interfering with user's acceptance of telehealth.
RESUMEN El accidente cerebrovascular (ACV) como una condición de salud requiere de monitoreo. En este contexto, la telesalud emerge como una posibilidad que permite un mejor acceso a los servicios de salud. Sin embargo, dado que esta modalidad está relacionada con el uso de la tecnología, se pueden surgir nuevas barreras. El objetivo de esta investigación fue identificar, mediante una revisión sistemática de la literatura, las barreras percibidas por los pacientes con ACV con respecto al acceso a la telesalud y conceptualizarlas dentro del modelo de la Teoría Unificada de Aceptación y Uso de la Tecnología (UTAUT). La revisión sistemática se realizó en las siguientes bases de datos electrónicas: PubMed, MEDLINE, SciELO, LILACS y PEDro; a partir de la combinación de los descriptores "barreras de acceso a la atención médica", "telerrehabilitación", "telesalud", "accidente cerebrovascular" y "modalidades de fisioterapia". Inicialmente, se encontraron 298 artículos, de los cuales se obtuvieron 295 mediante la búsqueda en la base de datos y tres por la búsqueda activa; de estos, solo seis artículos se incluyeron en la revisión. Los artículos revelaron la percepción de más de 220 sujetos que sufrieron ACV y ocho tipos de barreras; la mayoría de ellas relacionadas con las dimensiones Expectativa de Esfuerzo y Condiciones Facilitadoras del modelo UTAUT. Las barreras de la dimensión Expectativa de Esfuerzo, relacionadas con el conocimiento en el uso de tecnologías, se pueden superar mediante una capacitación previa antes de utilizar la telesalud. Sin embargo, las barreras asociadas con la dimensión de las Condiciones Facilitadoras respecto a los aspectos financieros, de Internet y el contexto del hogar son difíciles de superar y, por lo tanto, pueden interferir en la aceptación del uso de la telesalud por parte del usuario.
RESUMO O acidente vascular cerebral (AVC), como condição crônica de saúde, requer monitoramento. Nesse sentido, a telessaúde surge com o objetivo de possibilitar um melhor acesso aos serviços de saúde. Porém, por estar relacionada ao uso de tecnologia, essa modalidade pode enfrentar novas barreiras. O objetivo desta pesquisa foi identificar, por meio de uma revisão sistemática da literatura, as barreiras percebidas por pacientes com AVC quanto ao acesso à telessaúde e conceituá-las dentro do modelo da Teoria Unificada de Aceitação e Uso de Tecnologia (UTAUT). A revisão sistemática foi realizada nas seguintes bases de dados eletrônicas: PubMed, MEDLINE, SciELO, LILACS e PEDro; por meio da combinação dos descritores "barreiras de acesso aos cuidados de saúde", "telerreabilitação", "telessaúde", "acidente vascular cerebral" e "modalidades de fisioterapia". Inicialmente, foram encontrados 298 artigos, sendo 295 por meio da busca em bases de dados e três por meio de busca ativa, e, destes, apenas seis artigos foram incluídos na revisão. Somados, os artigos revelaram a percepção de mais de 220 indivíduos que sofreram AVC e oito tipos de barreiras, a maioria delas relacionadas às dimensões de Expectativa de Esforço e Condições Facilitadoras do modelo UTAUT. As barreiras da dimensão Expectativa de Esforço relacionadas ao conhecimento no uso de tecnologias são passíveis de serem superadas, pois treinamentos podem ser realizados previamente ao serviço de telessaúde. No entanto, as barreiras relacionadas à dimensão das Condições Facilitadoras no que se refere a aspectos financeiros, internet e contexto domiciliar são difíceis de superar, podendo, portanto, interferir na aceitação do usuário quanto ao uso da telessaúde.
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El confinamiento como medida sanitaria a causa del COVID-19 ha obligado la adopción de la modalidad virtual en los sistemas escolares del mundo. Los fonoaudiólogos/as que trabajan con niños/as preescolares que presentan alteraciones del lenguaje han debido modificar su metodología de trabajo usual para lograr los objetivos terapéuticos y educativos de los planes de intervención que aplican. En esta investigación se buscó describir la percepción que tienen los fonoaudiólogos/as acerca de la experiencia de realizar telerehabilitación a niños/as preescolares con trastorno del desarrollo del lenguaje en contexto de pandemia. Se diseñó un estudio cualitativo, con enfoque fenomenológico. A la muestra de 10 fonoaudiólogas, reclutadas por conveniencia, se les realizó entrevistas focalizadas semiestructuradas. El análisis fenomenológico de los datos obtenidos se realizó mediante la obtención de subcódigos, códigos y categorías, de forma manual. Del análisis surgen las siguientes categorías temáticas: valoración de la experiencia,efectividad de la intervención virtual, preparación de las sesiones y participación de los padres. Las vivencias expuestas en las entrevistas realizadas permiten señalar elementos críticos relacionados con el improvisado y repentino cambio de modalidad, la escasa formación y/o preparación de las terapeutas para implementar la telepráctica, la administración de recursos y la sensación de infectividad de la intervención. Si bien las intervenciones virtuales se han establecido como una alternativa a lo presencial, se concluye que esta fue poco aceptada entre las fonoaudiólogas entrevistadas, ya que se las considera demandantes y poco efectivas para niños/as tan pequeños/as. Se resalta que el compromiso de los padres, madres y/o cuidadores/as es fundamental para lograr un proceso exitoso.
Confinement, as a sanitary measure due to the COVID-19 pandemic, has forced school systems around the world to adapt their lessons to the virtual modality. Speech-language therapists working with preschool children who present language disorders have had to modify their usual work methodology to achieve their therapeutic and educational goals. This research sought to describe the perception speech-language therapists had of their experience providing telerehabilitation to preschool children with developmental language disorder during the pandemic. The study design was qualitative with a phenomenological approach. The sample was made up of 10 female speech-language therapists, recruited through convenience sampling, who were interviewed using semi-structured interviews. The data were analyzed phenomenologically, obtaining subcodes, codes, and categories manually. The following thematic categories emerged from the analysis: evaluation of the experience, effectiveness of the virtual intervention, session preparation, and parental participation. The experiences shared during the interviews allowed us to detect critical elements related to the improvised and sudden modality change, the lack of training and/or preparation of the therapists to implement telepractice, resource administration, and a perception of ineffectiveness regarding the intervention. Although virtual interventions have been established as an alternative to in-person intervention, it is concluded that it was not widely accepted among the speech-language therapists interviewed in this research, who deemed this modality demanding and ineffective for such young children. We emphasize the importance of parental and/or caregiver commitment to achieve success during the process of teletherapy.
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Humans , Male , Female , Child, Preschool , Adult , Telerehabilitation , COVID-19 , Language Development Disorders/rehabilitation , Interviews as Topic , Speech-Language Pathology , Qualitative Research , Pandemics , Specific Language Disorder/rehabilitationABSTRACT
ABSTRACT Objective: to validate a Technological Rehabilitation Nursing Program for people undergoing total knee arthroplasty. Methods: this is a qualitative study, carried out through a focus group, with 12 nurses, considered experts in the area of rehabilitation. The program was developed using digital technology, such as an application for a mobile device. Experts assessed the program structure, the content made available to people undergoing total knee arthroplasty pre-operatively and post-operatively and the follow-up and communication strategies with nurses. Results: after content validity by experts, the final version of the program integrated three thematic areas and their respective categories: Rehabilitation program (Program phases, Program operationalization, Exercise plans included in the program); Useful information (Preparation for surgery, Care to be taken during surgery recovery); and Communication channel with nurses (Talk to a rehabilitation nurse, Self-assessment of health condition and Help with decision-making). Conclusion: experts' contributions made it possible to achieve the content validity of the program and, consequently, improve patient literacy about the procedure, complication prevention and self-care; training patients to carry out exercise plans in the pre- and post-operative periods; and communication with nurses through application.
RESUMEN Objetivo: validar un Programa Tecnológico de Enfermería de Rehabilitación para personas sometidas a artroplastia total de rodilla. Métodos: estudio cualitativo, realizado a través de un focus group, con 12 enfermeros, considerados expertos en el área de rehabilitación. El programa fue desarrollado utilizando tecnología digital, como una aplicación para un dispositivo móvil. Los expertos evaluaron la estructura del programa, los contenidos puestos a disposición de las personas sometidas a artroplastia total de rodilla en el preoperatorio y postoperatorio, y las estrategias de seguimiento y comunicación con la enfermera. Resultados: luego de la validación de contenido por parte de expertos, la versión final del Programa integró tres áreas temáticas y sus respectivas categorías: Programa de rehabilitación (Fases del programa, Operacionalización del programa, Planes de ejercicio incluidos en el programa); Información útil (Preparación para la cirugía, Cuidados a tener durante la recuperación quirúrgica); y Canal de Comunicación con la Enfermera (Hablar con una enfermera de rehabilitación, Autoevaluación del estado de salud y Ayuda en la toma de decisiones). Conclusión: los aportes de los expertos permitieron lograr la validez de contenido del programa y, en consecuencia, mejorar la alfabetización de los pacientes sobre el procedimiento, la prevención de complicaciones y el autocuidado; entrenar al paciente para que lleve a cabo planes de ejercicios en los períodos pre y postoperatorios; y comunicación con la enfermera a través de la aplicación.
RESUMO Objetivo: validar um Programa de Enfermagem de Reabilitação Tecnológico para pessoas submetidas à artroplastia total do joelho. Métodos: estudo qualitativo, realizado por meio de focus group, com 12 enfermeiros, considerados peritos na área de reabilitação. O Programa foi desenvolvido com recurso de uma tecnologia digital, do tipo aplicativo para dispositivo móvel. Os peritos avaliaram a estrutura do Programa, os conteúdos disponibilizados às pessoas submetidas a artroplastia total do joelho no pré-operatório e pós-operatório e as estratégias de acompanhamento e comunicação com o enfermeiro. Resultados: após a validação de conteúdo pelos peritos, a versão final do Programa integrou três áreas temáticas e suas respectivas categorias: Programa de Reabilitação (Fases do Programa, Operacionalização do Programa, Planos de exercícios incluídos no Programa); Informação Útil (Preparação para a cirurgia, Cuidados a ter durante a recuperação cirúrgica); e Canal Comunicacional com o Enfermeiro (Fale com enfermeiro de reabilitação, Autoavaliação da condição de saúde e Ajuda na tomada de decisão). Conclusão: os contributos dos peritos permitiram alcançar a validade de conteúdo do Programa e, consequentemente, melhorar a literacia do paciente sobre o procedimento, prevenção de complicações e autocuidado; instrumentalização do paciente para a realização dos planos de exercícios nos períodos pré e pós-operatório; e a comunicação com o enfermeiro pelo aplicativo.
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Se ha reportado un importante daño sistémico de los pacientes afectados por COVID-19, y aún existen interrogantes sobre las secuelas a largo plazo. Surge ante esto la necesidad de plantear programas de rehabilitación de los sistemas primarios de atención, que respondan a estas necesidades. Se realizó un programa de 6 semanas de rehabilitación remota, con seguimiento y progreso semanal, posterior al alta hospitalaria por COVID-19 a 114 usuarios de 4 centros de atención primaria de la comuna de El Bosque, Santiago, R. Metropolitana. Se incluyó a pacientes de edades entre 21 y 93 años, combinando los principios del ejercicio terapéutico individualizado, una evaluación presencial previo y posterior a las 6 semanas de trabajo. Los indicadores evaluados fueron: Minimental Abreviado, 1 Minute Sit to Stand Test (1min STST), Timed Up and Go (TUG), índice de Barthel y FRAIL. Se hicieron análisis inferenciales y descriptivos y se encontraron mejoras favorables en los indicadores de condición física (TUG y 1'STST), Índice de Barthel y el Simple "FRAIL" Questionnaire Screening Tool (FRAIL). En conclusión, si bien la mayoría de los indicadores tuvieron resultados favorables, es necesario seguir estudiando herramientas de evaluación más sensibles e intervenciones específicas que se adapten a las necesidades de las personas.
Significant systemic damage has been reported in patients affected by COVID-19, and questions remain about long-term sequelae. Therefore, the need arises to propose rehabilitation programs for primary care systems that respond to these needs. A 6-week program of remote rehabilitation, with weekly follow-up and progress, after hospital discharge for COVID-19 was carried out on 114 users from 4 primary care centers in the commune of El Bosque, Santiago, Chile. The program included patients from 21 to 93 years-old, combining the principles of individualized therapeutic exercise, a face-to-face evaluation before and after 6 weeks of work. The indicators evaluated were: Abbreviated Minimental, 1 minute Sit to Stand Test (1 min STST), Timed Up and Go (TUG), Barthel index and the Simple "FRAIL" Questionnaire Screening Tool (FRAIL). Inferential and descriptive analyses were carried out and favorable improvements were found in the indicators of physical condition (TUG and 1min STST), Barthel Index and FRAIL. In conclusion, while most of the indicators had favorable results, it is required to further explore more sensitive assessment tools and targeted interventions that are tailored to people's needs.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Primary Health Care , Telerehabilitation , COVID-19/rehabilitation , Patient Discharge , Quality of Life , Program Evaluation , Retrospective Studies , Follow-Up Studies , VideoconferencingABSTRACT
Resumen: Objetivo: Determinar los efectos de un programa de telerehabilitación (TR) en el nivel de independencia funcional y el número de caídas en personas mayores, asistentes a un centro de cuidados diurno. Materiales y método: 14 personas mayores ( χ =74 años), sometidas a un programa de kinesiterapia/fisioterapia/ terapia física (TF) a través de tele rehabilitación por un período de 12 semanas. El grupo control recibió intervención educativa a través de un cuadernillo de actividad física que debieron desarrollar de forma autónoma, con supervisión telefónica semanal; mientras que el grupo experimental recibió 15 sesiones de kinesiterapia/fisioterapia/terapia física por video llamada mediante aplicación WhatsApp TM . Ambos grupos fueron evaluados pre y post intervención con escala índice de Barthel (IB) y el número de caídas, mediante el cuestionario de la valoración geriátrica integral (VGI). Resultados: El grupo experimental aumentó el puntaje del índice de Barthel (↑3.6), mientras que el grupo control disminuyó este puntaje (↓6.9). Ambos grupos disminuyen el número de caídas, sin encontrar diferencias entre grupos. Al comparar ambos grupos, las personas mayores sometidas a un programa de kinesiterapia/fisioterapia/ terapia física a través de tele rehabilitación presentaron mejoras significativamente mayores en el índice de Barthel que el grupo control (p<0.05). Conclusión: Las personas mayores que participaron en un programa kinesiterapia/ fisioterapia/ terapia física a través de tele rehabilitación presentaron un mayor nivel de independencia funcional que las personas con la intervención con cuadernillo de actividad física guiado por llamada telefónica, lo que sugiere considerar a los programas de terapia física como una alternativa terapéutica para mejorar el nivel de independencia en personas mayores.
Abstract: Objective: To determine the effects of a telerehabilitation (TR) program on the level of functional independence and the number of falls in older people attending a day care center. Materials and method: 14 older people ( χ = 74 years), submitted to a kinesitherapy / physiotherapy / physical therapy (PT) program through telerehabilitation for a period of 12 weeks. The control group received educational intervention through a physical activity booklet which they had to develop independently, with weekly telephone supervision, while the experimental group received 15 kinesitherapy / physiotherapy / physical therapy sessions via video calls through WhatsApp TM application. Both groups were evaluated pre and post intervention with the Barthel index scale (BI) and the number of falls using the comprehensive geriatric assessment (CGA). Results: The experimental group increased the Barthel index scale score (↑3,6) while the control group decreased this score (↓6,9). Both groups decreased the number of falls, without differences between groups. When comparing both groups, the elderly who underwent a kinesitherapy / physiotherapy / physical therapy program through telerehabilitation showed significantly greater improvements in Barthel index scale than the control group (p <0.05). Conclusion: Older people who participated in a kinesitherapy / physiotherapy / physical therapy program through telerehabilitation presented a higher level of functional independence compared to participants in the intervention with a phone call-guided physical activity booklet, which suggests a telerehabilitation programs as an alternative therapeutics to improve the level of independence in older people.