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1.
Acta Medica Philippina ; : 54-62, 2024.
Artigo em Inglês | WPRIM | ID: wpr-1006816

RESUMO

Background and Objective@#Pre-pandemic, various healthcare settings were not used to seeing patients virtually. The unprecedented need to adopt virtual care during the COVID-19 pandemic may have caught physical therapists (PTs) unready for it. This study aimed to determine the telerehabilitation knowledge, attitude, and practice of PTs in the Philippines during the COVID-19 pandemic and determine the association between demographic and study outcome variables.@*Methods@#This is an analytical cross-sectional study among members of the Philippine Physical Therapy Association, Inc. (PPTA) practicing in the Philippines. Purposive sampling (total enumeration) was employed. All PPTA members were invited to the study through e-mail and official social media group chats. A self-administered questionnaire was used to obtain data on telerehabilitation knowledge (through test questions on various theoretical aspects), attitude, and practice.@*Results@#The questionnaire items had a content validity index of >0.80. The study yielded a 40% response rate. Most respondents were practicing clinicians in urban-based, private rehabilitation centers. Approximately half had average telerehabilitation knowledge, while the majority had agreeable telerehabilitation attitudes across different constructs. Among the respondents, 15.9% used telerehabilitation pre-pandemic, while 64.8% used it during the pandemic. Hybrid (synchronous and asynchronous) telerehabilitation sessions usually lasted one hour per patient, mostly using Facebook Messenger. @*Conclusion@#Telerehabilitation was not widely practiced locally pre-pandemic, which may explain their average telerehabilitation knowledge. The positive telerehabilitation attitudes may represent a small group of PTs favoring telerehabilitation, while information from the larger population remains unknown. Early adopters of telerehabilitation may help introduce virtual care to colleagues and guide them in developing relevant knowledge and skills amid and beyond the enduring COVID-19 crisis.


Assuntos
COVID-19 , Países em Desenvolvimento , Modalidades de Fisioterapia , Telerreabilitação , Telemedicina
2.
Acta Medica Philippina ; : 1-8, 2024.
Artigo em Inglês | WPRIM | ID: wpr-1013406

RESUMO

Objectives@#While many healthcare workers (HCWs) contracted COVID-19 during the pandemic, more information is needed to fully understand the potential for adverse health effects in this population segment. The aim of the present study is to examine the association between healthcare worker status and neurologic and clinical outcomes in COVID-19 infected inpatients.@*Methods@#Using the nationwide database provided by the retrospective cohort Philippine CORONA study, we extracted relevant data and performed a secondary analysis primarily focusing on the presentation and outcomes of healthcare workers. Propensity score matching in a 3:1 ratio was performed to match HCWs and non-HCWs. We performed multiple logistic and Cox regression analyses to determine the relationship between HCWs and COVID-19 clinical outcomes.@*Results@#We included 3,362 patients infected with COVID-19; of which, 854 were HCWs. Among the HCWs, a total of 31 (3.63%) and 45 (5.27%) had the primary outcomes of in-hospital mortality and respiratory failure, respectively. For both overall and 3:1 propensity-matched cohorts, being an HCW significantly decreased the odds of the following outcomes: severe/critical COVID-19 at nadir; in-hospital mortality; respiratory failure; intensive care unit admission; and hospital stay >14 days.@*Conclusion@#We found that being an HCW is not associated with worse neurologic and clinical outcomes among patients hospitalized for COVID-19.


Assuntos
Pessoal de Saúde , COVID-19 , SARS-CoV-2 , Estudos de Coortes
3.
Acta Medica Philippina ; : 73-77, 2023.
Artigo em Inglês | WPRIM | ID: wpr-1003637

RESUMO

@#A 35-year-old female, right-handed, non-hypertensive, and non-diabetic Filipino presented with decreased verbal output and weakness of the right upper and lower extremities during the peak of the COVID-19 pandemic. Cerebral angiography showed bilateral steno-occlusive disease, which was consistent with Moyamoya disease. She underwent inpatient rehabilitation consisting of physical, occupational, and speech therapy. Rehabilitation posthospital discharge was continued using a hybrid rehabilitation approach with a mixed in-person home rehabilitation and remote telerehabilitation. The hybrid approach helped ensure continuity of rehabilitation care, minimize travel and exposure to the hospital or community amid the COVID-19 risks, and reduce costs, without entirely losing the benefits that could only be obtained from hands-on therapeutic evaluation and treatment. After six months of hybrid rehabilitation, the patient was able to return to work and regain functional independence.


Assuntos
Telerreabilitação , COVID-19
4.
Acta Medica Philippina ; : 68-74, 2022.
Artigo em Inglês | WPRIM | ID: wpr-988602

RESUMO

@#Neuropathic pain has been described following an electrical injury, whether as an immediate response or a late-onset sequela. There is much information on high-voltage injuries in literature due to its dramatic presentation, but limited studies on low-voltage injuries. However, low-voltage injuries can be as diverse and may have symptoms varying from minimal cutaneous involvement to full-thickness injury. Significant injuries may result from multiple factors, including prolonged duration of exposure and a higher amount of current transmitted. We illustrate an atypical presentation of a low-voltage injury in a 17-year-old female. The patient had a low voltage electrical injury with no cutaneous burn noted on the affected extremity. She initially presented with allodynia, which seemed disproportionate to the clinical findings expected in a low-voltage injury. The patient underwent an electrodiagnostic study, which showed cervical polyradiculopathy (C5, C6, C7 polyradiculopathy) and neuromusculoskeletal ultrasonology, which showed enlarged right C5 nerve root. Medical management, daily physical and occupational therapies, and psychological management, were instituted, which resulted in significant improvement of the patient’s pain level and functional status. We describe the importance of the multimodal approach (medical and rehabilitation) in managing this atypical case.


Assuntos
Hiperalgesia , Manejo da Dor
5.
Acta Medica Philippina ; : 74-80, 2022.
Artigo em Inglês | WPRIM | ID: wpr-988520

RESUMO

@#Parkinson’s disease (PD) is a chronic, neurodegenerative condition resulting in various motor impairments, including speech disorders. However, at the height of the coronavirus disease 2019 pandemic, a patient with PD could not access traditional in-person neurorehabilitation care. This case report highlights the feasibility of telerehabilitation to deliver speech therapy over a distance using available resources in a developing country. We describe a Filipino elderly woman, public speaker, and marriage counselor, seeking teleconsultation for her voice problems (slow and soft) attributed to PD. At that time, most center-based outpatient rehabilitation centers in Manila were closed due to the pandemic, and the patient preferred to stay at home for safety reasons. Hence, she was evaluated and managed remotely by an interdisciplinary team (neurologist, physiatrist, speech-language pathologist) through video calls. Since the ideal rehabilitation set up (in-person evaluation and therapy; use of Lee Silverman Voice Therapy) could not be done, the clinicians had to find practical alternatives, such as remotely administering subjective perceptual voice assessments, objective speech analysis using the Praat™ computer application, and speech teletherapy through synchronous (videocalls, phone calls) and asynchronous (e-mails, text messages, pre-recorded exercise videos) techniques. Notable speech improvements were observed by the clinicians, patient, and patient’s frequent communicative partners after at least four teletherapy sessions. However, the carry-over of the improvements was affected by the patient’s lack of compliance with the prescribed home exercise program. Telerehabilitation using synchronous and asynchronous techniques for speech disorders due to PD was found feasible, beneficial, safe, and practical amid social distancing and low resources in a developing country


Assuntos
Fonoterapia , Telerreabilitação , Doença de Parkinson , Distúrbios da Voz , COVID-19
6.
Acta Medica Philippina ; : 116-120, 2022.
Artigo em Inglês | WPRIM | ID: wpr-988248

RESUMO

@#Patients with burns are predisposed to heterotopic ossification and contracture formation. While radiographs and bone scans are used to detect heterotopic ossification, musculoskeletal ultrasound can be used to diagnose and localize the lesion in patients with contractures. A 14-year-old girl with multiple contractures of the limbs from thermal burn injury sustained three years ago underwent in-patient rehabilitation in a sub-acute burn rehabilitation unit. Despite close monitoring and daily therapy sessions, the patient had minimal improvement in the range of motion of bilateral hips. Musculoskeletal ultrasound demonstrated hyperechogenic focus on the posterolateral aspect of the bilateral hips. This report documents the advantage of diagnostic musculoskeletal ultrasound in localizing and guiding the treatment of heterotopic ossification in a burn patient with contractures.


Assuntos
Diagnóstico por Imagem , Ossificação Heterotópica , Queimaduras , Reabilitação , Pediatria
7.
Acta Medica Philippina ; : 105-110, 2022.
Artigo em Inglês | WPRIM | ID: wpr-988246

RESUMO

@#Pelvic sarcomas are rare malignancies that can result in extensive surgeries involving bone and soft tissue resection, which can greatly improve with rehabilitation. However, due to the restrictions brought about by the COVID-19 pandemic, the rehabilitation of patients with pelvic sarcomas was affected. Limited information is also presented in the literature regarding the rehabilitation of patients with lower extremity surgeries undergoing telerehabilitation and during a pandemic. This study presents the rehabilitation process of a 43-year-old woman diagnosed with pelvic round cell sarcoma of the right gluteal area during the COVID-19 pandemic. The patient underwent wide excision, buttockectomy and internal hemipelvectomy, and we measured outcomes using the Tinetti assessment tool (TAT) and Lower Extremity Functional Scale (LEFS). A decreased risk of falls and improved functional performance were recorded using the TAT and LEFS respectively. Telerehabilitation was noted to have a good satisfaction rate among the patient and health workers. Telerehabilitation may be an effective alternative to face-to-face therapy during the COVID-19 pandemic. More studies are needed to look into the conduct of telerehabilitation intervention among patients with bone and soft tissue surgeries.


Assuntos
Telerreabilitação
8.
Acta Medica Philippina ; : 100-104, 2022.
Artigo em Inglês | WPRIM | ID: wpr-988245

RESUMO

@#The suspension of facility-based rehabilitation services and restricted mobility at the onslaught of the coronavirus disease 2019 (COVID-19) pandemic forced healthcare workers to explore new methods of providing patient care. This case report presents a 40-year-old female who underwent osteotomy with iliac crest bone graft and intramedullary nailing with quadricepsplasty to correct the leg length discrepancy and knee extension contracture that developed secondary to multiple bone injuries sustained in a vehicular accident 17 months before admission. The in-hospital postoperative rehabilitation was prematurely terminated due to the COVID-19 lockdown. The client was discharged with pain and swelling of the right lower limb, knee flexion of 0–25°, and an ankle plantar flexion contracture. She had moderate to severe difficulty in walking, bathing, toileting, and lower garment dressing, needing assistance to complete these tasks. Telerehabilitation was done over three months using both synchronous and asynchronous methods. Gains from the remote program were independence in all the self-care activities with no difficulty in performing them. The patient was able to return to work. Gains in knee and ankle mobility were minimal. Telerehabilitation using available technologies can be used to continue patient care amidst barriers to face-to-face rehabilitation in a low-resource country


Assuntos
Telerreabilitação , Telemedicina , COVID-19 , Osteotomia
9.
Acta Medica Philippina ; : 89-93, 2022.
Artigo em Inglês | WPRIM | ID: wpr-988243

RESUMO

@#In April 2020, the Department of Rehabilitation Medicine (DRM) of the University of the Philippines - Philippine General Hospital (UP-PGH) transitioned to a telerehabilitation program called ITAWAG, an acronym for Introducing Telerehab As a Way to Access General rehabilitation medicine services. This was in response to the designation of UP-PGH as a COVID-19 referral center and the abrupt closure of all its in-patient and out-patient rehabilitation services. Eleven previous in-patients and out-patients with musculoskeletal and neurologic impairments continued their rehabilitation programs remotely, either through a phone call or video call. Their clinical outcomes and the implementation of the ITAWAG program were monitored to determine the effectiveness of an offsite continuing care program. Using the Clinical Global Impressions-Severity (CGI-S) scale, eight patients had a reduction in the severity of their illness, while the remaining three clients had no change. Feedback surveys showed that most clients and caregivers (68%) and health providers (77%) were satisfied with the program's implementation and its outcome. A frequent complaint was the poor phone reception and internet connection. As threats of a COVID-19 outbreak continue, telerehabilitation gives patients a safe, affordable, and convenient alternative for follow-up and continuity of care in medical rehabilitation. Integrating the ITAWAG program into the initial facility-based rehabilitation management can enhance its value in optimizing functional gains and resolving its shortcomings.


Assuntos
Telerreabilitação , COVID-19 , Continuidade da Assistência ao Paciente
10.
Acta Medica Philippina ; : 76-81, 2022.
Artigo em Inglês | WPRIM | ID: wpr-988241

RESUMO

Objectives@#The objective of this study was to determine the coping strategies and job satisfaction among rehabilitation medical and paramedical staff deployed to different areas at the University of the Philippines Manila Philippine General Hospital, a designated COVID-19 referral center. @*Method@#This was a cross-sectional study that utilized total population sampling of the medical and paramedical staff of the Department of Rehabilitation Medicine deployed to other areas in PGH and who carried out non-rehabilitation-related clinical work responsibilities during the COVID-19 pandemic. Electronic informed consent was obtained from each participant. Two sets of validated and reliable self-administered online questionnaires, namely, the Brief Coping Orientation to Problems Experienced (COPE) Inventory Tool and Satisfaction of Employee in Health Care (SEHC) Survey, were used to determine coping strategies and work satisfaction, respectively. Descriptive statistics (such as frequencies, percentages, ranges, means) were used to present the data. @*Results@#A total of 50 medical and paramedical staff participated in the study. The participants’ age ranged from 22 to 60 years (mean: 30.2 ± 8.7). The majority were single (84%), women (64%), and with a Bachelor of Science degree. Most of the participants were assigned in the orange zone, which included the COVID ward nurses’ station and donning/doffing areas; with 30% who rotated in the COVID wards. There were three types of coping strategies utilized by the department staff: (1) emotion-focused coping, (2) problem-focused coping, and (3) dysfunctional coping. Problem-focused coping was the most common general strategy (mean COPE score for all problem-focused strategies, 3.1 ± 0.9). Acceptance was the most common specific coping strategy, followed by active coping and a tie among positive reframing, planning, and self-distraction. The work satisfaction rate was at 76.9% ± 13.2. Three out of 4 participants would recommend their workplace to other healthcare workers. @*Conclusion@#The medical and paramedical staff of the Department of Rehabilitation Medicine in a COVID referral center had relatively high job satisfaction despite their health risks and changes in responsibilities among others. The majority utilized functional coping strategies to help them adapt to the work demands. The sources of motivation and values of the staff are areas for future research to help explain their positive outlook about their jobs and generally high recommendation about their workplace in the middle of the COVID-19 crisis.


Assuntos
Satisfação no Emprego , Pessoal de Saúde
11.
Acta Medica Philippina ; : 41-50, 2022.
Artigo em Inglês | WPRIM | ID: wpr-988237

RESUMO

Background@#The Department of Rehabilitation Medicine of the University of the Philippines-Philippine General Hospital (UP-PGH) established its telerehabilitation service program in 2017. The program previously catered to patients in a partner rural community by providing teleconsultation and teletherapy over a distance. With the unprecedented coronavirus disease 2019 (COVID-19) pandemic, the program has expanded its service to outpatients previously managed face-to-face by the department, regardless of location. @*Objectives@#This study aimed to evaluate the usability of the telerehabilitation service program at UP-PGH when it was expanded during the pandemic and to associate telerehabilitation usability ratings with the participant groups, demographic characteristics, and prior telemedicine knowledge and experience. @*Methods@#This cross-sectional study involved the doctors, physical therapists, occupational therapists, psychologists, patients, and patients’ carers, who participated in at least one telerehabilitation session and consented to respond to a digital survey thereafter. Total enumeration sampling of all telerehabilitation participants was employed. The study outcome was the usability of the expanded telerehabilitation program based on the System Usability Scale (SUS) benchmarked at 68. Descriptive and inferential statistics were done at a 95% confidence interval. The participants’ responses to open-ended questions regarding telerehabilitation experience and recommendations were also presented. @*Results@#The participants consisted of 19 doctors, 11 therapists, 37 patients, and 74 caregivers. The majority of the participants were female and lived in urban areas. The primary online telerehabilitation platforms used were Viber™ and Zoom™. The mean of overall SUS scores was below average for health providers [doctors (mean = 61.71), therapists (mean = 67.73)]; and above average for end-users [patients (mean 74.56), and carers (mean = 71.89)]. There was a significant difference in the overall SUS scores between doctors (mean: 61.7) and patients (mean: 74.6), p<0.05. In terms of videoconferencing platform, participants reported significantly higher system usability for those who used either Zoom™ (mean: 75.0) or Viber™ (mean: 69.3), as compared to Google Meet™ (mean: 53.1), p<0.05. There was no significant difference in the overall SUS scores across sexes, places of residence, primary telerehabilitation techniques used, prior telemedicine knowledge, and experience. The majority viewed telerehabilitation as a valuable method to provide service during the pandemic, but they were mostly concerned with technical problems, particularly an unstable Internet connection. @*Conclusion@#The expanded telerehabilitation service program of the PGH was perceived as useful by patients and caregivers but not by the health providers. While the program succeeded in providing continued outpatient rehabilitation services during the pandemic, the challenges experienced by its telehealth providers must be investigated and addressed.


Assuntos
Telemedicina , Telerreabilitação , Medicina Física e Reabilitação , Avaliação da Tecnologia Biomédica , Atenção à Saúde
12.
Acta Medica Philippina ; : 32-40, 2022.
Artigo em Inglês | WPRIM | ID: wpr-988236

RESUMO

Introduction@#The coronavirus disease 2019 (COVID-19) pandemic prompted a shift from standard in-person consultation to non-patient contact methods such as telemedicine. To our knowledge, there was no published a priori evaluation of the telemedicine readiness and acceptance among the medical staff of the Philippine General Hospital (PGH) before implementing the institution’s telemedicine program. The lack of this vital pre-implementation step is understandable given the unprecedented crisis. However, if telemedicine programs will continue in the post-quarantine period, it is crucial to determine the facilitators and barriers to the use of telemedicine. @*Objective@#This study determined the level of readiness and acceptance for telemedicine as an alternative method for patient consultation during the COVID-19 pandemic and post-enhanced community quarantine period among PGH medical staff (consultants, residents, fellows). @*Methods@#The cross-sectional study was conducted from October 2020 to July 2021. Medical staff from the 16 clinical departments of the PGH were selected by systematic random sampling. Inclusion criteria included appointment as medical staff in PGH or University of the Philippines College of Medicine (UPCM), voluntary informed consent, internet access, and technical capacity to access e-mail and SurveyMonkey™. The online survey consisted of two questionnaires. It collected data on the demographic profile and outcomes of interest (e.g., telemedicine readiness and acceptance). Technological readiness was determined through the 16-item modified version of Technological Readiness Index (TRI) version 2.0, while telemedicine acceptance was determined through the modified version of the 19-item Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire. Descriptive and analytical statistics were performed at a 95% confidence interval. @*Results@#The study had an 87% response rate with 205 respondents, 62% of whom were physicians in training (resident physicians and fellows). The respondents had a median age of 33 years and were mostly males. Only 19% had telemedicine experience before the pandemic. The majority (51%) learned telemedicine on their own. The most common devices used for telemedicine were mobile or smartphones (53%) and laptops (38%). The primary source of internet for telemedicine was mobile broadband (e.g., cellular data) (40%). The majority practiced telemedicine at their home or residence (51%), followed closely by the hospital or clinic (47%). The mean score of the respondents on TRI was 3.56 (very good technological readiness), and 4.00 (very good telemedicine acceptance) on UTAUT (behavioral intention to use the system). Performance expectancy (p = 0.02), effort expectancy (p = 0.03), and self-efficacy (p = 0.02) were significantly directly related to telemedicine adoption, while anxiety (p = 0.03) was significantly inversely related. @*Conclusion@#The PGH medical staff were found to have very good telemedicine readiness and acceptance. This suggests a willingness to use telemedicine during the pandemic. Further studies on the organization and technical support system of the telemedicine program in the PGH are strongly recommended. The quality and efficiency of the program will strongly influence the continued use of telemedicine by the medical staff even after the pandemic.


Assuntos
Administração de Serviços de Saúde , Telemedicina , Telecomunicações , Consulta Remota , COVID-19
13.
Acta Medica Philippina ; : 66-75, 2021.
Artigo em Inglês | WPRIM | ID: wpr-988498

RESUMO

Background@#Catalyzed by the coronavirus disease 2019 (COVID-19) pandemic that restricted non-essential travel, awareness of the value of telehealth increased among healthcare providers and consumers. Telerehabilitation, a subset of telehealth and telemedicine, refers explicitly to the remote provision of rehabilitation services. However, since the majority were new to the concept of telerehabilitation, which was commonly interchanged with other related terms (e.g., telehealth, telemedicine, teletherapy, telecare, telepractice, etc.), and relevant internationally recognized guidelines were not available pre-pandemic, many turned to online resources to learn more about it. However, such might create confusion with the terminologies. @*Objective@#This infodemiological study aimed to examine the trends of global online interest in telehealth, telemedicine, telerehabilitation, and related search terms. The authors hypothesized an abrupt rise in stakeholders' awareness regarding the virtual method of delivering or accessing healthcare, including rehabilitation services, during the pandemic. @*Method@#Using Google Trends™, we obtained and analyzed the trends of global online interest in telehealth, telemedicine, telerehabilitation, and other related search terms from 2004 to October 2020. @*Results@#The frequencies of searches for “telehealth,” “telemedicine,” and “telerehabilitation” peaked in March 2020, which coincided with the lockdown in many countries, including the Philippines. The term “telehealth” was more frequently searched in western countries, while “telemedicine” was relatively common in eastern countries. Among the terms synonymous with telerehabilitation, “teletherapy” was most commonly used worldwide, with “teletherapy speech” being the most searched related topic. The Philippines had the most significant number of times the term “telerehabilitation” was searched in the past decade. @*Conclusion@#During the COVID-19 pandemic, there is an overall global demand for the acquisition of knowledge related to telehealth, telemedicine, telerehabilitation, and related search terms. Of particular interest, tele rehabilitation, however, varied in terminologies across countries, with “teletherapy” mainly being used worldwide and “telerehabilitation” being primarily searched in the Philippines. Therefore, arriving at a consensus across professional societies and operationally defining different interrelated terms could help streamline our current or future guidelines and programs.


Assuntos
Telemedicina , Telerreabilitação , COVID-19 , Infodemiologia
14.
Acta Medica Philippina ; : 16-22, 2021.
Artigo em Inglês | WPRIM | ID: wpr-959973

RESUMO

@#<p style="text-align: justify;"><strong>Background.</strong> Stroke remains a leading cause of death and disability in the Philippines, rendering its survivors unable to cope well with activities of daily living, including sexual functioning. Sexual dysfunction is an under-recognized complication post-stroke, and mobility and communication barriers among those with aphasia can further contribute to sexual dysfunction, potentially affecting their quality of life.</p><p style="text-align: justify;"><strong>Objective.</strong> To determine the changes in sexual functioning among patients with aphasia and the communication methods they used to compensate for language and communication deficits.</p><p style="text-align: justify;"><strong>Method.</strong> This was a descriptive cross-sectional study involving patients (?30 years old, with 1 episode of stroke, with non-fluent aphasia) and their respective sexual partners. Data were gathered using a clinician-administered questionnaire based on previous studies. Outcomes included changes in libido, coital frequency, time of resumption of sexual activity, erectile/ orgasmic ability, sexual satisfaction, and alternative methods of communication.</p><p style="text-align: justify;"><strong>Results.</strong> Forty participants were included comprising of 20 patients with aphasia and their respective sexual partners. There was a decline in sexual activity among the couples, with reduced frequency of sexual intercourse. Both patients and partners reported difficulties in expressing the desire for sexual activities, hindering initiation. There was noted difficulty in ascertaining the sexual experience of patients with aphasia (i.e., whether pleasure or pain), hindering maintenance and enjoyment of the sexual act. In response to the difficulties mentioned above, sexual innuendoes as communication strategies were described by the couples.</p><p style="text-align: justify;"><strong>Conclusion.</strong> The study provides baseline local data on changes in sexual functioning among stroke patients with nonfluent aphasia and their sexual partners. Sexual rehabilitation is recommended in the holistic management of patients with aphasia to train couples develop compensatory techniques to adjust to the changes in their sexual lives.</p>


Assuntos
Acidente Vascular Cerebral , Afasia , Sexualidade , Comunicação
15.
Acta Medica Philippina ; : 1-5, 2020.
Artigo em Inglês | WPRIM | ID: wpr-980158

RESUMO

@#A 35-year-old female, right-handed, non-hypertensive, and non-diabetic Filipino presented with decreased verbal output and weakness of the right upper and lower extremities during the peak of the COVID-19 pandemic. Cerebral angiography showed bilateral steno-occlusive disease, which was consistent with Moyamoya disease. She underwent inpatient rehabilitation consisting of physical, occupational, and speech therapy. Rehabilitation posthospital discharge was continued using a hybrid rehabilitation approach with a mixed in-person home rehabilitation and remote telerehabilitation. The hybrid approach helped ensure continuity of rehabilitation care, minimize travel and exposure to the hospital or community amid the COVID-19 risks, and reduce costs, without entirely losing the benefits that could only be obtained from hands-on therapeutic evaluation and treatment. After six months of hybrid rehabilitation, the patient was able to return to work and regain functional independence.


Assuntos
Telerreabilitação , COVID-19
16.
Acta Medica Philippina ; : 1-3, 2020.
Artigo em Inglês | WPRIM | ID: wpr-979810

RESUMO

@#After two years of the Coronavirus Disease 2019 (COVID-19) pandemic, cases have generally begun to decline in the different regions of the world, and consequently a lot of people are gradually returning to face-to-face interactions, including health-related activities. Based on scarce local literatures published recently, telerehabilitation was envisioned to be a viable solution to bridge the perennial gaps in the delivery of rehabilitation services across the Philippine archipelago, such as the lack of manpower and resources, aggravated by the pandemic.


Assuntos
Atenção à Saúde , Telemedicina , Telerreabilitação , COVID-19 , Países em Desenvolvimento
17.
Acta Medica Philippina ; : 161-166, 2020.
Artigo em Inglês | WPRIM | ID: wpr-979681

RESUMO

Background@#Sexuality remains to be a sensitive issue in the Philippines, but it encompasses real problems that stroke patients and their partners continue to face. Sexual dysfunction, an under-recognized complication post-stroke, is caused by an interplay of physical, emotional, cognitive, and language impairments, in combination with psychosocial factors. @*Objectives@#This study aimed to determine changes in sexual functioning (libido, coital frequency, sexual arousal, and sexual satisfaction) among stroke out-patients at the Philippine General Hospital and their sexual partners.@*Methods@#This cross-sectional study involved patients (≥30 years old with 1 stroke episode), and their partners. Through individual interviews and questionnaires, data were gathered on general attitude toward sex, ability to address sexual issues with partner, fear of recurrence of stroke, unwillingness to participate in coitus, risk of depression, and level of happiness. @*Results@#Twenty-nine patients and 23 partners participated. There was a statistically significant decrease in coital frequency post-stroke among patients (p<0.001) and partners (p<0.05). Majority reported lower level of libido, sexual arousal, and sexual satisfaction post-stroke. Participants unable to discuss sexual issues with partner were more likely to report sexual dissatisfaction (p<0.05). Those with higher scores on Zung’s depression scale were likely to be sexually dissatisfied (p<0.05). Level of happiness was moderately correlated with sexual satisfaction (r=0.51).@*Conclusion@#Sexual life of couples affected by stroke is commonly overlooked. There was a decline in libido, coital frequency, arousal, and sexual satisfaction among stroke patients and partners at the Philippine General Hospital.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Sexualidade , Parceiros Sexuais
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