Možnosti využití distanční terapie a telerehabilitace v ergoterapii u pacientů po získaném poškození mozku – pilotní studie
Authors:
Hoidekrová- K. 1 3; Pětioký J. 1,4,5; Rogalewicz V. 3; Pavlů D. 2
Authors‘ workplace:
Rehabilitační ústav Kladruby, Kladruby u Vlašimi
1; Katedra fyzioterapie, Fakulta tělesné výchovy a sportu UK, Praha
2; Klinika rehabilitačního lékařství 1. LF UK a VFN Praze
3; 3. LF UK, Praha
4; 1. LF UK, Praha
5
Published in:
Rehabil. fyz. Lék., 28, 2021, No. 1, pp. 25-31.
Category:
Original Papers
doi:
https://doi.org/10.48095/ccrhfl202125
Overview
Background: The study focuses on patients who were discharged from inpatient rehabilitation care to their home environment, but due to the unavailability or impossibility of transport to outpatient rehabilitation, the patients did not have the possibility of follow-up occupational therapy for the upper limbs. The situation is even more strongly emphasised in the field of outpatient occupational therapy, which is minimally available in all regions of the Czech Republic. Aim: The aim of the study was to evaluate the application of distance therapy in patients with acquired brain injury with the therapy focusing on the upper limbs and to verify whether the fine motor skills of the paretic upper limb are maintained or significantly improved after distance occupational therapy. Methods: The study included seven subacute patients enrolled in distance therapy at home (five females, mean age 40 ± 15.66 years, four haemorrhagic stroke, three left-sided hemiparesis, seven right handedness) who completed therapy with Leap motion sensor and Rehamza software. The patients were evaluated at baseline (T1) and at the end of distance therapy (T2) by the Motor Assessment Scale (MAS) functional test, the 9 Hole Peg Test (9HPT) and Box and Block test (BBT) coordination and dexterity tests, the Motricity Index (MI) for the upper extremities for muscle strength, the modified Ashworth scale (mAS) for muscle tone, self-sufficiency was assessed by the Barthel Index (BI) and the change in the quality of life was monitored with the SF-36 questionnaire in the first month after discharge from hospitalisation. Results: The results of the motor tests show that there was a statistically significant improvement in fine motor skills, coordination and motor pace according to 9HPT (p = 0.05) and a statistically significant improvement in the upper limb function according to MAS (p = 0.05). A clinical improvement of 4.28 cubes in average was observed in BBT. In all seven patients, the muscle strength of the hand increased according to MI to the full score (33 b.) The adherence of seven patients to distance occupational therapy was 100%. Conclusion: The results of the study show that patients with a mild motor deficit on the upper limb after acquired brain damage can positively benefit from distance occupational therapy.
Keywords:
distance therapy – occupational therapy – Leap Motion Sensor – telerehabilitation – stroke – home environment – patient adherence
Sources
1. Trlep M, Mihelj M, Puh U et al. Rebabilitation robot with patient-cooparative kontrol for bimanual training of hemiparetic subjects. Advanced robotics 2011; 25: 1949–1968. doi: 10.1163/ 016918611X588853.
2. Schieber MH, Lang CE, Reilly KT et al. Selective activation of human finger muscles after stroke or amputation. Adv Exp Med Biol 2009; 629: 559–575. doi: 10.1007/ 978-0-387-77064-2_30.
3. Palmcrantz S, Borg J, Sommerfeld D et al. An interactive distance solution for stroke rehabilitation in the home setting – a feasibility study. Inform Health Soc Care 2017; 42(3): 303–320. doi: 10.1080/ 17538157.2016.1253015.
4. Hung KN G, Fong KN. Effects of telerehabilitation in occupational therapy practice: a systematic review. Hong Kong J Occup Ther 2019; 32(1): 3–21. doi: 10.1177/ 1569186119849119.
5. Beit YA, Jacobs JM, Shenkar S et al. Activity performance, participation, and quality of life among adults in the chronic stage after acquired brain injury – the feasibility of an occupation-based telerehabilitation intervention. Front Neurol 2019; 10: 1247. doi: 10.3389/ fneur.2019.01247.
6. Cason J. A pilot telerehabilitation program: delivering early intervention services to rural families. Int J Telerehabil 2009; 1(1): 29–38. doi: 10.5195/ ijt.2009.6007.
7. Hoffmann T, Russell T. Pre-admission orthopaedic occupational therapy home visits conducted using the internet. J Telemed Telecare 2008; 14: 83–87. doi: 10.1258/ jtt.2007.070808.
8. Jacobs K, Cason J, McCullough A. The process for the formulation of the international telehealth position statement for occupational therapy. Int J Telerehabil 2015; 7(1): 21–32. doi: 10.5195/ ijt.2015.6163.
9. Renda M, Lape JE. Feasibility and effectiveness of telehealth occupational therapy home modification interventions. Int J Telerehabil 2018; 10(1): 3–14. doi: 10.5195/ ijt.2018.6244.
10. Serwe KM, Hersch GI, Pancheri K. Feasibility of using telehealth to deliver the “Powerful tools for caregivers” program. Int J Telerehabil 2017; 9(1): 15–22. doi: 10.5195/ ijt.2017.6214.
11. American Occupational Therapy Association. Cason J et al. Telehealth in Occupational Therapy. Am J Occup Ther 2018; 72: 1–18.
12. World Federation of Occupational Therapists’ position statement on telehealth. Int J Telerehabil 2014; 6(1): 37–39. doi: 10.5195/ IJT.2014.6153.
13. Hoidekrova K, Petioky J, Svestkova O. Home-based functional evaluation of upper extremity stroke survivals after 6months discharge from high intensity neurorehabilitation program at Rehabilitation Centre Kladruby. 32. slovenský a český neurologický zjazd, Martin. Cesk Slov Neurol N 2018; 81/ 114 (suppl 2): 107.
14. Cramer SC, Dodakian L, Le V et al. Efficacy of home-based telerehabilitation vs in-clinic therapy for adults after stroke: a randomized clinical trial. JAMA Neurol 2019; 76(9): 1079–1087. doi: 10.1001/ jamaneurol.2019.1604.
15. Knepley KD, Mao JZ, Wieczorek P et al. Impact of telerehabilitation for stroke-related deficits. Telemed J Health 2021; 27(3): 239–246. doi: 10.1089/ tmj.2020.0019.
16. College of Occupational Therapist Of Ontarrio. Guidelines for telepractice in occupational therapy. 2017. [online]. Available from: https:/ / www.coto.org/ resources/ guidelines-for-telepractice-in-occupational-therapy.
17. Dvořák J. Logopedický slovník. 3. upr. a rozšíř. vyd. Žďár nad Sázavou: Logopedické centrum 2007.
Labels
Physiotherapist, university degree Rehabilitation Sports medicineArticle was published in
Rehabilitation and Physical Medicine
2021 Issue 1
Most read in this issue
- Syndróm mediálnej tibiálnej hrany
- Možnosti využití distanční terapie a telerehabilitace v ergoterapii u pacientů po získaném poškození mozku – pilotní studie
- Může pravidelná chůze u seniorů vést ke zlepšení jejich celkové posturální stability?
- Režimové opatrenia zlepšujú kvalitu života po infarkte myokardu