Authors
Yastrebtseva I.P., Kiseleva M.E.
Ivanovo State Medical Academy, Ivanovo
Abstract
Rationale: The use of remote technologies is a requirement of the present time due to the need for continuity and continuity of medical rehabilitation measures, the presence of remote areas in our country and rapidly developing rehabilitation technologies.
Purpose: To analyze the results of remote rehabilitation of patients with vertebral pathology with developing disabilities with flaccid paresis, pain and sensory disorders and also to study gender and age peculiarities, economic efficiency of tele-rehabilitation technologies application.
Methods: Relevant publications were searched using databases “CochraneLibrary”, “eLIBRARY.RU”, “PubMed”, “Googleacademy”, “MedLine”, EBSCO. Springer/Nature, Elsevier, Scopus, Web of Science, PEDro, CINAHL, Eric, MEDLINE, Health sources — Nursing/Academic edition), ProQuest and subject journals. Twenty-eight papers related to the use of remote rehabilitation technologies were included in the review.
Results: Regular use of modern technology remotely helped to reduce pain intensity, improve movement activity, improve the quality of daily life, and reduce the need for pain medications. Exercise sessions for up to 12 weeks through the app have comparable results with outpatient interventions, and 12 weeks or more with regular exercise (4 times a week or more) have superior results. Regular exercise sessions for at least 12 weeks help to reduce the intensity of pain, expand daily life opportunities, and improve the quality of life of patients. Remote rehabilitation is effective for acute, subacute and chronic pain in the lumbar region, paresis of the lower extremity, and also has a positive effect on patients’ recovery after surgical intervention. In order to increase the effectiveness of distance rehabilitation, an understandable explanation of the instructions should be given, choosing a demonstration format with the use of video. Explanations and instruction on how to properly perform the exercises help to increase patients’ motivation to perform the exercises. The app’s simple interface makes modern technology available for use. Elderly patients demonstrate a high response to the remote format, especially with a comprehensive approach to exercise. Women are more likely to seek medical assistance with pronounced painful manifestations. The effectiveness of the distance rehabilitation program for them surpasses that for men.
Conclusion: Remote work is effective for implementing the principle of continuity and succession in the rehabilitation of patients with vertebral pathology at the 3rd stage of care.
Keywords: telemedicine, outpatient, remote rehabilitation, vertebral pathology.
References
1. Distantsionno-kontroliruemaya reabilitatsiya (kompleksnaya meditsinskaya reabilitatsiya s primeneniem telemeditsinskoi tekhnologii) dlya patsientov so spasticheskim gemiparezom posle perenesennogo ostrogo narusheniya mozgovogo krovoobrashcheniya (ONMK) ilicherepno-mozgovoitravmy (ChMT) Klinicheskie rekomendatsii. 2019: 66. (In Russ.)
2. Snopkov PS, Lyadov KV, Shapovalenko TV, et al. Distantsionnaya reabilitatsiya: istoki, sostoyanie, perspektivy. Fizioterapiya, bal’neologiya i reabilitatsiya. 2016; 15(3): 141-145. (In Russ.) doi: 10.18821/16813456-2016-15-3-141-145.
3. Borisov IV, Bondar’ VA, KanarskiiMM, et al. Distantsionnay areabilitatsiya: rol’ i vozmozhnosti // Fizicheskaya i reabilitatsionnaya meditsina, meditsinskaya reabilitatsiya. — 2021. — T.3. — №4. — C.399-408. (In Russ.) doi: 10.36425/rehab80253.
4. Park KH, Song MR. Comparative analysis of pain, muscle strength, disability, and quality of life in middle-aged and older adults after web video lower back exercise. Comput Inform Nurs. 2021; 40(3): 170-177. doi: 10.1097/CIN.0000000000000801.
5. Costa F, Janela D, Molinos M, et al. Digital rehabilitation for acute low back pain: a prospective longitudinal cohort study. Journal of Pain Research. 2022; 15: 1873-1887. doi: 10.2147/JPR.S369926.
6. Sandal LF, Bach K, Overas CK, et al. Effectiveness of app-delivered, tailored self-management support for adults with lower back pain-related disability: a selfback randomized clinical trial. JAMA Intern Med. 2021; 181(10): 1288-1296. doi: 10.1001/jamainternmed.2021.4097.
7. Mbada CE, Olaoye MI, Dada OO, et al. Comparative efficacy of clinic-based and telerehabilitation application of Mckenzie therapy in chronic low-back pain. International Journal of Telerehabilitation. 2019; 11(1): 41-58. doi: 10.5195/ijt.2019.6260.
8. Cottrell MA, Galea OA, O’Leary SP, et al. Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clinical Rehabilitation. 2017; 31(5): 625-638. doi: 10.1177/0269215516645148.
9. Glauser G, Ali ZS, Gardiner D, et al. Assessing the utility of an IoS application in the perioperative care of spine surgery patients: theNeuroPath pilot study. Mobile Health. 2019; 5: 40. doi: 10.21037/mhealth.2019.09.01.
10. Hou J, Yang R, Yang Y, et al. The effectiveness and safety of utilizing mobile phone-based programs for rehabilitation after lumbar spinal surgery: multicenter, prospective randomized controlled trial. Journal of Medical Internet Research mHealth and uHealth. 2019; 7(2): e10201. doi: 10.2196/10201.
11. Glauser G, Ali ZS, Gardiner D, et al. Assessing the utility of an IoS application in the perioperative care of spine surgery patients: theNeuroPath Pilot study. Mobile Health. 2019; 5: 40. doi: 10.21037/mhealth.2019.09.01.
12. Dadarkhah A, Rezaimoghadam F, Najafi S, et al. Remote versus in-person exercise instruction for chronic nonspecific low back pain lasting 12 weeks or longer: a randomized clinical trial. Journal of the National Medical Association. 2021; 113(3): 278-284. doi: 10.1016/j.jnma.2020.11.016.
13. Raiszadeh K, Tapicer J, Taitano L, et al. In-clinic versus web-based multidisciplinary exercise-based rehabilitation for treatment of low back pain: prospective clinical trial in an integrated practice unit model. Journal of Medical Internet Research. 2021; 23(3): e22548. doi: 10.2196/22548.
14. Herbert MS, Afari N, Liu L, et al. Telehealth versus in-person acceptance and commitment therapy for chronic pain: a randomized noninferiority trial. The Journal of Pain. 2017, 18: 200-211. doi: 10.1016/j. jpain.2016.10.014.
15. Itoh N, Mishima H, Yoshida Y, et al. Evaluation of the effect of patient education and strengthening exercise therapy using a mobile messaging app on work productivity in Japanese patients with chronic low back pain: open-label, randomized, parallel-group trial. Journal of Medical Internet Research mHealth and uHealth. 2022; 10(5): e35867. doi: 10.2196/35867.
16. Toelle TR, Utpadel-Fischler DA, Haas KK, et al. App-based multidisciplinary back pain treatment versus combined physiotherapy plus online education: a randomized controlled trial. NPJ Digital Medicine. 2019; 2: 34. doi: 10.1038/s41746-019-0109-x.
17. Fiani B, Siddiqi I, Lee SC, et al. Telerehabilitation: development, application, and need for increased usage in the COVID-19 era for patients with spinal pathology. Cureus. 2020; 12(9): e10563. doi: 10.7759/cureus.10563.
18. Min Y, Xu P. Curative effects of remote home management combined with Feng’s spinal manipulation on the treatment of elderly patients with lumbar disc herniation. Journal of Healthcare Engineering. 2022; 2022: 1420392. doi: 10.1155/2022/1420392.
19. Nizeyimana E, Joseph C, Plastow N, et al. A scoping review of feasibility, cost, access to rehabilitation services and implementation of telerehabilitation: implications for low- and middle-income countries. Digital Health. 2022; 8: 20552076221131670. doi: 10.1177/20552076221131670.
20. Levy CE, Silverman E, Jia H, et al. Effects of physical therapy delivery via home video telerehabilitation on functional and health-related quality of life outcomes. Journal of Rehabilitation Research & Development. 2015; 52(3): 361-70. doi: 10.1682/JRRD.2014.10.0239.
21. Fatoye F, Gebrye T, Fatoye C, et al. The clinical and cost-effectiveness of telerehabilitation for people with nonspecific chronic low back pain: randomized controlled trial. Journal of Medical Internet Research mHealth and uHealth. 2020; 8(6): e15375. doi: 10.2196/15375.
22. Lewkowicz D, Wohlbrandt A, Bottinger E. Digital therapeutic care apps with decision-support interventions for people with low back painin Germany: cost-effectiveness analysis. Journal of Medical Internet Research mHealth and uHealth. 2022; 10(2): e35042. doi: 10.2196/35042.
23. Tenforde AS, Hefner JE, Kodish-Wachs JE, et al. Telehealth in physical medicine and rehabilitation: a narrative review. Physical and Rehabilitation Medicine. 2017; 9(5S): S51-S58. doi: 10.1016/j.pmrj.2017.02.013.
24. Agostini M, Moja L, Banzi R, et al. Telerehabilitation and recovery of motor function: a systematic review and meta-analysis. Journal of Telemedicine and Telecare. 2015; 21(4): 202-13. doi: 10.1177/1357633X15572201.
25. Del Pino R, Díez-Cirarda M, Ustarroz-Aguirre I, Gonzalez-Larragan S, Caprino M, Busnatu S, Gand K, Schlieter H, Gabilondo I, Gómez-Esteban JC. Costs and effects of telerehabilitation in neurological and cardiological diseases: A systematic review. Front Med (Lausanne). 2022; 9: 832229. doi: 10.3389/fmed.2022.832229.
26. Vershinin GS, Vinyarskaya IV, Terkeckaya RN, et al. Ocenka dopustimisti I kachectva telemedicinskih konsultacij pri okazanii medicinskoj pomoshi detyam (po rezultatam anketirovaniya vrachej). Vestnik Ivanovskoj Medicinskoj academii. 2021; 26(3): 20. (In Russ.) doi: 10.52246/ 1606-8157_2021_26_3_18.
27. Shafi K, Lovecchio F, Forston K, et al. The Efficacy of Telehealth for the Treatment of Spinal Disorders: Patient-Reported Experiences during the COVID-19 Pandemic. Humanities and Social Sciences. 2020; 16: 17-23. doi: 10.1007/s11420-020-09808-x.
