Skip to main content
Log in

Introducing remote physical rehabilitation for patients with chronic disorders by means of telemedicine

  • Original Paper
  • Published:
Health and Technology Aims and scope Submit manuscript

Abstract

This study involved an evaluation of a telemedicine service implemented as a partial replacement of a physical outpatient rehabilitation program. The telemedicine service was an exercise-based tele-rehabilitation service facilitating remote physical rehabilitation for patients suffering from chronic lower back pain or pulmonary disease. Effectiveness was evaluated with multiple outcomes on quality (complaints, disability and physical condition) and access (usability, satisfaction and motivational character of the service). Patients referred by their rehabilitation physician to a physical outpatient rehabilitation program between October 2009 and May 2010 were asked to participate in the control group. Patients referred to the program between June 2010 and December 2011 were asked to participate in the intervention group. The control group received the conventional rehabilitation program. The intervention group received the rehabilitation program in which telemedicine was used as partial replacement of face to face care. Instead of 3 visits per week to the clinic as was being carried out in conventional care, patients visited the outpatient rehabilitation clinic for 2 days and they were instructed to exercise at least 1 day in their own environment using the exercise-based tele-rehabilitation service. One hundred and eighteen patients were included in this study: 38 patients in the control group and 80 patients in the intervention group. Both groups equally benefit from the outpatient rehabilitation program. There were no significant differences between the groups. The usability (system usability scale sore of 71.2 (SD 15.0; n = 47), satisfaction (average rate 6.0 (SD 2.0; n = 55), and level of motivation of the exercise-based tele-rehabilitation service were sufficient, but slightly disappointing. The telemedicine supported the outpatient rehabilitation program as partial replacement of face to face care was as effective as the conventional outpatient rehabilitation program.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. http://www.euro.who.int/__data/assets/pdf_file/0008/175544/RC62wd10Rev1-Eng.pdf?ua=1 last checked 09-04-2014.

  2. Fortin M, Bravo G, Hudon C, Vanasse A, Lapointe L. Prevalence of multimorbidity among adults seen in family practice. Ann Fam Med. 2005;3(3):223–8. doi:3/3/223.

    Article  Google Scholar 

  3. Car J, Huckvale K, Hermens H. Telehealth for long term conditions. BMJ. 2012;344.

  4. Kennedy A, Rogers A, Bower P. Support for self care for patients with chronic disease. BMJ. 2007;335(7627):968–70.

    Article  Google Scholar 

  5. Zanaboni P, Lien LA, Hjalmarsen A, Wootton R. Long-term telerehabilitation of COPD patients in their homes: Interim results from a pilot study in Northern Norway. J Telemed Telecare. 2013;19(7):425–9.

    Article  Google Scholar 

  6. Holland AE, Hill CJ, Rochford P, Fiore J, Berlowitz DJ, McDonald CF. Telerehabilitation for people with chronic obstructive pulmonary disease: Feasibility of a simple, real time model of supervised exercise training. J Telemed Telecare. 2013;19(4):222–6.

    Google Scholar 

  7. Piotrowicz E, Baranowski R, Bilinska M, Stepnowska M, Piotrowska M, Wojcik A, et al. A new model of home-based telemonitored cardiac rehabilitation in patients with heart failure: effectiveness, quality of life, and adherence. Eur J Heart Fail. 2010;12(2):164–71.

    Article  Google Scholar 

  8. Scalvini S, Zanelli E, Comini L, Tomba MD, Troise G, Febo O, et al. Home-based versus in-hospital cardiac rehabilitation after cardiac surgery: a nonrandomized controlled study. Phys Ther. 2013;93(8):1073–83.

    Article  Google Scholar 

  9. Jansen-Kosterink S, Huis in ’t Veld MH, Cranen K, Hermens H, Vollenbroek-Hutten M. Why telemedicine does not find its way towards sustainable implementation? Int J Telemed App. 2014;submitted.

  10. Ekeland AG, Bowes A, Flottorp S. Methodologies for assessing telemedicine: a systematic review of reviews. Int J Med Inform. 2012;81(1):1–11.

    Article  Google Scholar 

  11. Kairy D, Lehoux P, Vincent C, Visintin M. A systematic review of clinical outcomes, clinical process, healthcare utilization and costs associated with telerehabilitation. Disabil Rehabil. 2009;31(6):427–47.

    Article  Google Scholar 

  12. DeChant HK, Tohme WG, Mun SK, Hayes WS, Schulman KA. Health systems evaluation of telemedicine: a staged approach. Telemed J. 1996;2(4):303–12.

    Article  Google Scholar 

  13. Derogatis LR. SCL-90-R, administration, scoring and procedures manual-II for the R(evised) version and other instruments of the psychopathology rating scale series. Townson: Clinical Psychometric Research; 1992.

    Google Scholar 

  14. Kosterink SM, Huis in ’t Veld RM, Cagnie B, Hasenbring M, Vollenbroek-Hutten MM. The clinical effectiveness of a myofeedback-based teletreatment service in patients with non-specific neck and shoulder pain: a randomized controlled trial. J Telemed Telecare. 2010;16(6):316–21. doi:10.1258/jtt.2010.006005.

    Article  Google Scholar 

  15. Sandsjo L, Larsman P, Huis in ’t Veld RM, Vollenbroek-Hutten MM. Clinical evaluation of a myofeedback-based teletreatment service applied in the workplace: a randomized controlled trial. J Telemed Telecare. 2010;16(6):329–35. doi:10.1258/jtt.2010.006007.

    Article  Google Scholar 

  16. Brooke J. SUS–a quick and dirty usability scale. In: Jordan PW, Thoma B, Weerdmeester BA, editors. Usability evaluation in industry. Lodon: Taylor & Francis; 1995. p. 189–94.

    Google Scholar 

  17. Mair F, Whitten P. Systematic review of studies of patient satisfaction with telemedicine. BMJ. 2000;320(7248):1517–20. doi:10.1136/bmj.320.7248.1517.

    Article  Google Scholar 

  18. Huis in ’t Veld MH, van Dijk H, Hermens HJ, Vollenbroek-Hutten MM. A systematic review of the methodology of telemedicine evaluation in patients with postural and movement disorders. J Telemed Telecare. 2006;12(6):289–97.

    Article  Google Scholar 

  19. Rubin BD. Multiple imputation for nonresponse in surveys, Wiley series in probability and statistics. New York: Wiley; 1987.

    Book  Google Scholar 

  20. Todd KH. Clinical versus statistical significance in the assessment of pain relief. Ann Emerg Med. 1996;27(4):439–41.

    Article  MathSciNet  Google Scholar 

  21. Ander DS, Aisiku IP, Ratcliff JJ, Todd KH, Gotsch K. Measuring the dyspnea of decompensated heart failure with a visual analog scale: how much improvement is meaningful? Congest Heart Fail. 2004;10(4):188–91.

    Article  Google Scholar 

  22. Bangor A, Kortum P, Miller J. Determining what individual SUS scores mean: adding an adjective rating scale. J Usability Stud. 2009;4(3):114–23.

    Google Scholar 

  23. Hadert A, Quinn F. The individual in research: experimental single-case studies in health psychology. Health Psychol Updat. 2008;17:20–7.

    Google Scholar 

  24. Ryan TP. Modern experimental design. New York: Wiley; 2006.

    Google Scholar 

  25. Hermens H, Huijgen B, Giacomozzi C, Ilsbroukx S, Macellari V, Prats E, et al. Clinical assessment of the HELLODOC tele-rehabilitation service. Ann Ist Super Sanita. 2008;44(2):154–63.

    Google Scholar 

  26. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111–7.

  27. Huis in ’t Veld RM, Kosterink SM, Barbe T, Lindegard A, Marecek T, Vollenbroek-Hutten MM. Relation between patient satisfaction, compliance and the clinical benefit of a teletreatment application for chronic pain. J Telemed Telecare. 2010;16(6):322–8.

    Article  Google Scholar 

  28. Tabak M, Vollenbroek-Hutten M, van der Valk P, van der Palen J, Hermens H. A telerehabilitation intervention for patients with COPD: a randomized controlled pilot trial. Submitted. 2012.

  29. Lange B, Flynn SM, Rizzo AA. Game-based telerehabilitation. Eur J Phys Rehabil Med. 2009;45(1):143–51.

    Google Scholar 

  30. Kato PM. Video games in health care: closing the gap. Rev Gen Psychol. 2010;14(2):113–21.

    Article  Google Scholar 

  31. van Weering MG, Vollenbroek-Hutten MM, Hermens HJ. The relationship between objectively and subjectively measured activity levels in people with chronic low back pain. Clin Rehabil. 2011;25(3):256–63.

    Article  Google Scholar 

  32. van Weering MG, Vollenbroek-Hutten MM, Tonis TM, Hermens HJ. Daily physical activities in chronic lower back pain patients assessed with accelerometry. Eur J Pain. 2009;13(6):649–54.

    Article  Google Scholar 

Download references

Acknowledgments

Special thanks go to the rehabilitation professionals of Roessingh Center of Rehabilitation. This work was funded by the European Union within the CLEAR project (ICT-PSP CLEAR 224985)

Disclosure

No competing financial interest exist

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stephanie Jansen-Kosterink.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jansen-Kosterink, S., Huis in ’t Veld, R., Wever, D. et al. Introducing remote physical rehabilitation for patients with chronic disorders by means of telemedicine. Health Technol. 5, 83–90 (2015). https://doi.org/10.1007/s12553-015-0111-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12553-015-0111-5

Keywords

Navigation