搜索结果：International journal of telerehabilitation

Cochrane Rehabilitation and the World Health Organization (WHO) Rehabilitation Programme have collaborated to produce four Cochrane overviews of systematic reviews synthesizing evidence from health policy and systems research (HPSR) in rehabilitation. Each overview focuses on one of the four HPSR pillars identified by the Cochrane Effective Practice and Organisation of Care (EPOC) taxonomy: delivery, financial, and governance arrangements; and implementation strategies. This overview addresses delivery arrangements, which Cochrane EPOC defines as how health services are organized and delivered, including who provides care, how care is coordinated and managed, and where services are provided. This overview aimed to synthesize current evidence on delivery arrangements in rehabilitation from an HPSR perspective. Our series of four overviews has the following overarching objectives. • To offer a broad synthesis of existing evidence on health policy and systems interventions' effects. • To direct end-users, including policymakers, towards systematic reviews that may address their health policy questions. • To identify current research gaps and set priorities for future primary HPSR. • To pinpoint needs and priorities for new evidence syntheses where no reliable, up-to-date systematic reviews currently exist. We searched Epistemonikos Health Systems Evidence databases and EPOC Group systematic reviews with no language limitations to identify reviews published between 2015 and 17 November 2024. We included Cochrane systematic reviews (CSRs) and non-CSRs of randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) evaluating the effectiveness of health policy and systems interventions for rehabilitation in health systems, specifically related to delivery arrangements as defined in the EPOC taxonomy. All four overview teams screened reviews and extracted data. We used AMSTAR 2 to critically appraise the reviews, and we analyzed the results descriptively. We included 25 systematic reviews. Three overlapped, and for 17 the AMSTAR 2 rating was low or critically low confidence. Five systematic reviews (2 CSRs and 3 non-CSRs) contributed to our synthesis. Most outcomes focused on patients, caregivers, or service use (e.g. access to rehabilitation). Equity-related outcomes were absent, and quality of care, adverse events, and our important outcomes were rarely reported. Below, we report the results of three of the five reviews judged to have moderate to high confidence for our outcomes of interest, in which authors conducted meta-analysis and assessed the certainty of the evidence. Who provides care One review analyzed advanced practice physiotherapy (APP) models, which may result in little to no difference in health-related outcomes measured by the Pain Disability Index and EuroQol 5-Dimension questionnaire after the intervention, compared with usual care in adults with spinal pain (standardized mean difference [SMD] 0.05, 95% confidence interval [CI] -0.32 to 0.42; 2 studies, 225 participants; low certainty). Information and communication technology We included two reviews in this category. One compared telerehabilitation with usual care in older adults, finding that telerehabilitation may have little or no effect on quality of life after seven to 20 weeks (SMD -0.09, 95% CI -0.23 to 0.40; 3 studies, 179 participants; low certainty). There was very low-certainty evidence on mobility after seven to 26 weeks (SMD 0.63, 95% CI -0.25 to 1.51; 5 studies, 302 participants), strength after 12 and 26 weeks (SMD 0.73, 95% CI -0.10 to 1.56; 4 studies, 226 participants), and balance after seven to 26 weeks (SMD 0.40, 95% CI -0.35 to 1.15; 3 studies, 199 participants). Another review on stroke survivors living in the community found that telerehabilitation compared with usual care probably has little or no effect on independence in activities of daily living (ADL) after 24 weeks (SMD 0.00, 95% CI -0.15 to 0.15; 2 studies, 661 participants; moderate certainty), self-reported quality of life after six to 24 weeks (SMD 0.03, 95% CI -0.14 to 0.20; 3 studies, 569 participants; moderate certainty), and depression after six to 24 weeks (SMD -0.04, 95% CI -0.19 to 0.11; 6 studies, 1145 participants; moderate certainty); and may have little or no effect on upper limb function after 12 weeks (SMD 0.33, 95% CI -0.21 to 0.87; 2 studies, 54 participants; low certainty) and mobility after six weeks (mean difference 0.01, 95% CI -0.12 to 0.14; 1 study; 144 participants; low certainty). This review also compared telerehabilitation with in-person rehabilitation and found that there may be little to no difference in independence in ADL, measured with the Modified Barthel Index at four to 12 weeks (MD 0.59, 95% CI -5.50 to 6.68; 2 studies, 75 participants; low certainty); balance, measured with the Berg Balance Scale at four to 12 weeks (MD 0.48, 95% CI -1.36 to 2.32; 3 studies, 106 participants; low certainty); and upper limb function, evaluated with the Fugl-Meyer Assessment (Upper Extremity) four weeks after intervention (MD 1.23, 95% CI -2.17 to 4.64; 3 studies, 170 participants; low certainty). Current evidence on delivery arrangements in rehabilitation is limited, mostly of low certainty, and derived from high-income countries. Reviews covered five EPOC categories, but reliable evidence for our outcomes of interest was available for only two categories. Most evidence was on telerehabilitation. Compared with usual care, APP models may have little to no effect on health outcomes in adults with spinal pain. In people with stroke, telerehabilitation compared with usual care probably has little or no effect on independence in daily living, quality of life, and depression, and may have little to no effect on upper limb function and mobility. Compared with in-person care, telerehabilitation may have little to no effect on ADL, balance, and upper limb function. Further high-quality research using well-defined frameworks is needed, especially in low- and middle-income countries, to identify effective strategies and evaluate organizational, implementation, and equity outcomes. Future Cochrane overviews in HPSR should consider a broader range of study designs, such as observational, qualitative, and mixed-design evidence, to better capture evidence on delivery arrangements in rehabilitation. PC, CK, and SN were supported and funded by the Italian Ministry of Health (Ricerca Corrente). The funder played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Protocol (2025): DOI 10.23736/S1973-9087.24.08833-6.

The research into and the adoption of telerehabilitation has greatly expanded over the last two decades. With this increasing level of interest in telerehabilitation there is a need for a comprehensive definition. The Telerehabilitation Special Interest Group of the World Federation of Neurorehabilitation is comprised of a diverse group of researchers from over 30 countries and so is well placed to reach a consensus on a definition of telerehabilitation and disseminate this widely. An e-Delphi approach was employed within the special interest group to reach a consensus on the definition. The agreed comprehensive definition of telerehabilitation includes a formal definition, an abbreviated version and a lay version, each with distinct purposes. A description of the scope of telerehabilitation is included, as well as an overview of the various modes of telerehabilitation. It is anticipated that this definition of telerehabilitation may assist researchers, clinicians, advocates and policy makers in a range of purposes.

First-line treatment for urinary incontinence (UI) is pelvic floor rehabilitation. Our objective was to assess the feasibility and effectiveness of pelvic floor telerehabilitation on women's urinary symptoms. This was a retrospective pilot study evaluating the impact of a pelvic floor telerehabilitation program on the symptoms of 48&#xa0;patients referred for UI between 2022 and 2024. The patients completed questionnaires at the beginning and end of the telerehabilitation program. The questionnaires included the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Urinary Symptom Profile (USP), Pelvic Floor Distress Inventory (PFDI-20), CONTILIFE, Wexner, and Kess. At the end of the program, the PGI-I (Patient Global Impression and Improvement) and a satisfaction questionnaire were also administered. The mean age of the women was 52.5&#xa0;years. They had received an average of 9.3&#xa0;telerehabilitation sessions. The ICIQ-SF and CONTILIFE scores significantly improved after the program (13.1 vs. 5.8, P<0.005; 75.3 vs. 46.4, P<0.005, respectively), as did the USP, PFDI-20, Wexner, and Kess questionnaire scores (P<0.05). After the program, 83.4% of the patients reported feeling better/much better according to the PGI-I. All reported they would undergo the protocol again and would recommend it. Pelvic floor telerehabilitation can significantly improve urinary and perineal symptoms as well as the quality of life of patients with UI. If these results are confirmed in larger prospectives studies, pelvic floor telerehabilitation programs could be integrated into an expanded care package, particularly in geographical areas lacking specialized professionals.

Urinary incontinence is highly prevalent among women 60 years and over, impacting their quality of life. The condition is often overlooked and untreated. Various treatments are available, but their benefits and harms in older women remain uncertain. To compare the benefits and harms of conservative, pharmacological, and surgical treatments for urinary incontinence in terms of 'cure', 'cure or improvement', and serious adverse events (SAEs) in women 60 years and over using network meta-analyses (NMA), and to rank interventions within a single treatment network. We searched the Cochrane Incontinence Specialized Register, comprising trials from CENTRAL, MEDLINE, MEDLINE In-Process, MEDLINE Epub Ahead of Print, MEDLINE Daily, and two major international clinical trial registries, on 23 March 2025. We handsearched journals, conference proceedings, and reference lists of relevant articles. We placed no limitations on the searches. We included randomized controlled trials (RCTs) that examined the benefits and harms of conservative, pharmacological, and/or surgical treatments in women 60 years and over with urinary incontinence. Our primary outcomes were 'cure' and 'cure or improvement' of urinary incontinence symptoms. Secondary outcomes included the number of women with SAEs. At least two review authors independently assessed trials for eligibility and risk of bias using Cochrane's risk of bias 2 (RoB 2) tool. A third author resolved any disagreements. We followed the guidance on undertaking NMA in Chapter 11 of the Cochrane Handbook for Systematic Reviews of Interventions. We included 43 RCTs involving 8506 participants, a mean of 198 per study (range 14 to 1438). Conservative treatments predominated (20/43, 46.5%) in the studies, followed by pharmacological (17/43, 39.5%), surgical (4/43, 9.3%), and mixed (2/43, 4.7%) treatments. The RCTs had variable risks of bias, often presenting 'some concerns' or 'high risk,' with poor reporting on randomization, blinding, and protocol details. Conservative and pharmacological treatments were often at a high risk of bias for all outcomes (cure, cure or improvement, and SAEs). For the 'cure' outcome, we excluded three studies to address network disconnections; hence, comparisons focused on conservative and pharmacological treatments. Results indicated that all treatments might be better than control, with physical therapies - mainly pelvic floor muscle training with or without complementary therapies or education - showing the best performance for 'cure': physical therapies combined with complementary therapies (odds ratio (OR) 17.79, 95% confidence interval (CI) 2.97 to 106.46; 1 study, 71 participants), physical therapies (OR 7.20, 95% CI 2.59 to 20.03; 4 studies, 310 participants), and physical therapies with education (OR 3.25, 95% CI 1.19 to 8.84; 4 studies, 364 participants), with the evidence for all three results being of very low certainty, followed by complementary therapies (OR 4.65, 95% CI 0.74 to 29.37; 1 study, 37 participants; very low-certainty evidence) and education (OR 2.68, 95% CI 0.61 to 11.73; 2 studies, 180 participants; low-certainty evidence). The mean ranks for best treatment, P scores, and surface under the cumulative ranking curve (SUCRA) values demonstrate the superiority of physical therapies, suggesting that the addition of complementary therapies may be the optimal treatment for 'cure' (SUCRA value ranged from 57% to 85% across the three interventions that included physical therapies). However, due to imprecision in effect estimates and sparse data, uncertainty regarding optimal treatment remains (low- to very low-certainty evidence). For 'cure or improvement of urinary incontinence', after adjusting for disconnected networks by excluding three studies, the analysis showed that physical therapies, with or without education, performed best compared with their controls, with very low-certainty evidence for all the following results (physical therapies: OR 3.98, 95% CI 2.02 to 7.82; 3 studies, 197 participants; physical therapies combined with education: OR 3.20, 95% CI 1.45 to 7.02; 3 studies, 236 participants; &#x3b2;3-adrenergic agonists: OR 2.44, 95% CI 1.28 to 4.62; 1 study, 360 participants) followed by education (OR 2.09, 95% CI 1.05 to 4.17; 2 studies, 213 participants) and antimuscarinic drugs (OR 1.90, 95% CI 1.19 to 3.03; 2 studies, 1469 participants). Both physical therapies, with or without an educational intervention, and &#x3b2;3-adrenergic agonists performed the best compared with their controls (physical therapies: SUCRA = 90%; physical therapies combined with education: SUCRA = 77%; &#x3b2;3-adrenergic agonists: SUCRA = 63%). However, the evidence was of very low certainty, suggesting the need for more trials. Notably, there were no SAEs in conservative treatments, and pharmacological treatments reported some. However, no treatment showed significantly less chance of SAEs, with very low-certainty evidence for all the following results (serotonin-noradrenaline uptake inhibitors: OR 0.40, 95% CI 0.10 to 1.59; 1 study, 264 participants; &#x3b2;3-adrenergic agonists: OR 0.61, 95% CI 0.04 to 10.19; 1 study, 404 participants; complementary therapies: OR 0.53, 95% CI 0.00 to 71.04; no direct evidence, 18 participants; antimuscarinic drugs: OR 0.81, 95% CI 0.46 to 1.42; 4 studies, 2731 participants; physical therapies combined with education: OR 0.99, 95% CI 0.10 to 9.80; 3 studies, 130 participants). Due to the limited number of trials and generally small sample sizes, the precision of estimates regarding treatment benefits and harms was low. We successfully conducted an NMA, but there was insufficient evidence to support a robust overall analysis. To establish a connected treatment network, we excluded surgical intervention studies. As a result, the analysis focused on conservative and pharmacological treatment comparisons. For the outcome of 'cure', evidence rated as very low to low certainty suggests that physical therapies combined with complementary therapies may be the most effective option, followed by physical therapies alone or combined with education. For 'cure or improvement', both physical therapies (with or without education) and &#x3b2;3-adrenergic agonists showed potential benefits. SAEs were absent for conservative interventions, whereas most of the pharmacological treatment studies reported some. However, there was insufficient evidence to determine whether any treatment reduced the likelihood of SAEs. Overall, the number and quality of studies were insufficient to draw firm conclusions about the most effective treatment for urinary incontinence in older women. To strengthen the evidence base, larger, high-quality trials with clearly defined interventions and consistently reported outcomes are needed.

To investigate the effects of hybrid telerehabilitation (Hybrid TR), telerehabilitation (TR-only), and clinic-based rehabilitation on gait speed (primary outcome: Timed 25-Foot Walk Test), as well as on fatigue, functional capacity, mobility, quality of life, and muscle activation in patients with multiple sclerosis (MS). A single-blind randomized controlled trial with assessments conducted at baseline, mid-treatment (wk 4), and post-treatment (wk 8). Rehabilitation settings included hybrid (combination of telerehabilitation, clinic-based interventions), only telerehabilitation, and clinic-based environments. A total of 44 participants (N=44) diagnosed with MS (Expanded Disability Status Scale scores ranging from 0 to 4) were randomly assigned into 3 groups: Hybrid TR (Group A), TR-only (Group B), and clinic-based rehabilitation (Group C). Participants underwent an 8-week intervention program. Selection was based on specific eligibility criteria, and random allocation methods were applied. Participants engaged in an 8-week program consisting of breathing exercises, aerobic training, and strengthening exercises delivered through Hybrid TR, TR-only, or clinic-based rehabilitation. Primary outcome was mobility assessed by the Timed 25-Foot Walk. Secondary outcomes included functional capacity assessed by 2-Minute Walk Test, and mobility assessed by timed Up and Go; fatigue assessed by the Modified Fatigue Impact Scale; quality of life assessed by the Multiple Sclerosis International Quality of Life questionnaire; and muscle activation measured by surface electromyography of the rectus femoris muscle. Significant within group improvements in mobility, fatigue, functional capacity, quality of life, and EMG parameters were observed by week 8 across all groups. However, statistically significant between-group differences were not observed, and effect sizes were small to moderate (&#x3b7;&#xb2;p=0.01-0.07). Hybrid TR appears to be a feasible and potentially beneficial approach for individuals with MS, with clinical outcomes that may be comparable with those of clinic-based rehabilitation in terms of mobility, fatigue, functional capacity, quality of life, and muscle activation.

Telerehabilitation has been proposed as an innovative, safe, and effective method of intervention to prevent or improve frailty. This rehabilitation modality facilitates access to opportunities and reduces gaps in healthcare. The advantages and challenges of implementing synchronous telerehabilitation programs in older people should be explored. This protocol describes the methodology to analyze the effects of a multicomponent physical exercise program in synchronous telerehabilitation modality compared to a multicomponent physical exercise program in face-to-face modality in terms of quality of life of frail older people. A systematic review will be performed in the following databases: Medline/PubMed, Scopus, Web of Science, CINAHL, Central, PeDRO, Lilacs, and Epistemonikos. To identify randomized clinical trials that meet the proposed eligibility criteria. The primary outcomes are quality of life and functionality, and the secondary outcomes are strength, balance, and cardiorespiratory capacity. In addition, the risk of bias will be assessed using the ROB-2 tool, and the certainty of the evidence will be assessed using the GRADE system. A meta-analysis will be performed if the procedures used to determine the results of the study are homogeneous; mean differences with a 95% confidence interval will be calculated. Otherwise, standardized mean differences will be used to determine the effect sizes. results The main findings of this review and meta-analysis will contribute to clarifying the effectiveness of physical therapy applied in a synchronous remote modality. It will also identify the variables on which it has a positive effect. CRD42024605527. La telerrehabilitaci&#xf3;n se ha propuesto como un m&#xe9;todo innovador, seguro y efectivo de intervenci&#xf3;n para prevenir o mejorar la fragilidad. Esta modalidad de rehabilitaci&#xf3;n facilita el acceso a oportunidades y reduce las brechas en la atenci&#xf3;n m&#xe9;dica. Las ventajas y desaf&#xed;os de la implementaci&#xf3;n de programas de telerrehabilitaci&#xf3;n sincr&#xf3;nica en personas mayores deben ser explorados. Este protocolo describe la metodolog&#xed;a para analizar los efectos de un programa de ejercicio f&#xed;sico multicomponente en modalidad telerrehabilitaci&#xf3;n sincr&#xf3;nica, en comparaci&#xf3;n con un programa de ejercicio f&#xed;sico multicomponente en modalidad presencial. Esto, en t&#xe9;rminos de calidad de vida de personas mayores fr&#xe1;giles. Se realizar&#xe1; una revisi&#xf3;n sistem&#xe1;tica en las siguientes bases de datos: MEDLINE/PubMed, Scopus, Web of Sciences, CINAHL, CENTRAL, PEDro, LILACS y Epistemonikos. Para identificar ensayos cl&#xed;nicos aleatorizados que cumplan los criterios de elegibilidad propuestos. Los desenlaces primarios son calidad de vida y funcionalidad. Los secundarios son fuerza, equilibrio y capacidad cardiorrespiratoria. Adem&#xe1;s, se evaluar&#xe1; el riesgo de sesgo con la herramienta ROB-2 y la certeza de la evidencia con el sistema GRADE. Se realizar&#xe1; un metaan&#xe1;lisis si los procedimientos utilizados para evaluar los resultados del estudio son homog&#xe9;neos, para ello se calcular&#xe1;n diferencias de medias con un intervalo de confianza del 95%. En caso contrario, se utilizar&#xe1;n diferencias de medias estandarizadas para determinar los tama&#xf1;os del efecto. esperados Los principales hallazgos de esta revisi&#xf3;n y metaan&#xe1;lisis contribuir&#xe1;n a tener m&#xe1;s claridad sobre la efectividad de la terapia f&#xed;sica aplicada en modalidad remota sincr&#xf3;nica. Tambi&#xe9;n identificar&#xe1; las variables en las cuales propicia efectos positivos. CRD42024605527.

Population aging leads to increased disability, implying a significant effect on health care systems and the lives of caregivers. As an example, stroke is a major cause of common diseases and is one of the leading causes of disability in older adults. Rehabilitation is the most effective intervention to counteract patient disability and simultaneously reduce the burden on caregivers. In particular, repetitive and task-specific training seems to be the most effective intervention for poststroke rehabilitation. Virtual reality (VR) is a very useful tool to provide this type of intervention, making it fun through gamification. This paper aims to present a protocol to evaluate the acceptability and usability of an upper limb rehabilitation solution based on VR. The RecoveryFun telerehabilitation system consists of a VR headset, wearable sensor, caregiver app, and clinical platform. A total of 15 older adult patients with neurological conditions (eg, stroke or brain injury) fulfilling the inclusion and exclusion criteria were recruited in 3 recruitment centers, 5 from each site. The system was given to patients, and they were free to use it when they preferred at their home, with or without caregiver help, following the clinical session set by the physiotherapist. At least 20 minutes of use per week was requested. The physical therapist was able to remotely monitor the progress of the therapy and increase the difficulty and repetitions of the exergames, also considering the patient's fatigue and stress levels. The system was kept by the patients for 4 weeks, and there were several meetings and supervision via phone calls by the therapist. The main dimensions investigated were system usability, using the System Usability Scale (SUS) and User Experience Questionnaire, and acceptability, using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) 2.0. Upper limb function and patient's quality of life, as well as caregiver's perceived stress, were also assessed as secondary outcomes. The study started in May 2024 and ended in June 2024. We recruited 16 patients with their caregivers and 6 health care professionals in Italy, Belgium, and Switzerland. Results are expected to be published by winter 2025. The aim of the study is to propose and evaluate a new telemedicine system that would allow greater adherence to therapy without moving from home, reducing the burden on the caregiver. The system could also be used in rehabilitation centers as a complement to traditional rehabilitation. Finally, with the calibration system enabling the therapist to create customized clinical sessions for the patient, the system could be versatile and fun for a wide range of patients. ClinicalTrials.gov NCT06640452; https://clinicaltrials.gov/study/NCT06640452. RR1-10.2196/68358.

This study aimed to evaluate the utilization of telerehabilitation services in Egypt and to investigate the concerns and barriers faced by Egyptian physiotherapists for implementation. This cross-sectional study recruited 306 Egyptian physiotherapists who were asked to complete an online survey including questions about the utilization of telerehabilitation services, awareness, perception, and attitude. A total of 299 physiotherapists completed the online survey. Within the sample, 38.5% utilized telerehabilitation at work. Telerehabilitation was used frequently to deliver patient advice (17.6%), follow-up (16%), and exercise prescription (15.2%). Pain (16.2%) was the most common outcome assessed utilizing telerehabilitation. Additionally, 85.3% of physiotherapists agreed that the inclusion of telerehabilitation during the rehabilitation program is effective. The main barriers to implementing telerehabilitation in Egypt were lack of awareness (59.9%) and technical issues (58.2%). This study sheds light on the trends and challenges in utilizing telerehabilitation and may help in shaping the future of telerehabilitation in Egypt.

For patients with low vision, rehabilitation enables the performance of daily activities and the acquisition of skills while enhancing quality of life, despite vision loss. Access to comprehensive low vision rehabilitation services, however, is often limited. The rise of telehealth during the COVID-19 pandemic has facilitated innovative delivery of healthcare, including telerehabilitation for low vision. This literature review was undertaken to evaluate the current evidence regarding telerehabilitation conducted by occupational therapists for patients with low vision. In this review, studies investigating the effects of new programs largely found significant improvements in outcomes. Results of a multicenter, randomized controlled trial found that reading ability significantly improved and results did not differ between therapies conducted through telerehabilitation or in-office. Additionally, studies surveying providers and patients regarding their sentiments about telehealth found that comfort level and overall satisfaction were similar between in-office visits and telerehabilitation.

Compare the effects of physiotherapist-supervised synchronous telerehabilitation (TR) with unsupervised asynchronous TR in adults diagnosed with post-COVID syndrome (PCS). In this single-blind randomized controlled trial conducted with 31 participants with PCS were randomized into a synchronous telerehabilitation (STR) group, which underwent two-hour sessions per week for eight weeks, and an asynchronous telerehabilitation (ATR) group, which performed unsupervised exercises. Lower limb functional strength (Five Times Sit-to-Stand Functional Test) as the primary outcome, and the dyspnea (Modified Medical Research Council), fatigue (Fatigue Assessment Scale), stress, anxiety, depression (Depression, Anxiety, and Stress Scale-21), and quality of life (World Health Organization Quality of Life-BREF Questionnaire) were assessed remotely at the baseline, after 8 weeks of intervention, and at a 20-week follow-up. Data were analyzed using a mixed-model analysis of variance. Participants were randomized into a synchronous telerehabilitation (TRS) group, which performed two-hour sessions per week for eight weeks, and an asynchronous telerehabilitation (TRA) group, which performed the same exercise protocol but without the supervision of a physiotherapist. Instructional videos were made available via social media (WhatsApp and YouTube). Participants were also instructed to perform the protocol twice a week for eight weeks. A statistically significant difference was only observed in lower limb functionality between both groups (p = 0.02). The STR group demonstrated significant improvements in lower limb functional strength (p = 0.03), dyspnea (p = 0.02), fatigue (p = 0.00), stress (p = 0.03), and quality of life (p = 0.00), without any adverse events. Conversely, the ATR group experienced significant improvements in fatigue (p = 0.00) and anxiety (p = 0.02). The present findings show that both modalities demonstrated positive effects over an 8-week TR program in adults with PCS. However, the synchronous approach achieved greater improvements in lower limb functionality, dyspnea, fatigue, stress, and quality of life. Our findings revealed that asynchronous model was associated with higher dropout rates and suggest synchronous TR may offer advantages regarding treatment adherence.

How effective is a telerehabilitation program in reducing reports of pelvic floor dysfunction in women after gynaecological cancer treatment? Randomised controlled trial with blinded assessors, concealed allocation and intention-to-treat analysis. Fifty-eight women reporting urinary incontinence (UI) after treatment for gynaecological cancer. Experimental group participants were allocated to undertake telerehabilitation sessions including pelvic floor muscle training once a week for 12 weeks. The control group received usual care. The primary outcome was the prevalence of UI on the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI-SF). The secondary outcomes were: the impact of UI on quality of life (ICIQ-UI-SF), sexual function (Female Sexual Function Index), dyspareunia (numerical assessment scale), self-esteem (Rosenberg), pain (numerical assessment scale), faecal incontinence, stool consistency, vaginal stenosis, quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire) and level of physical activity. After 12 weeks, the telerehab group also responded about treatment satisfaction, adherence and system usability. After 12 weeks, the experimental group had better outcomes than the control group in several areas: prevalence of UI (RD -0.45, 95% CI -0.62 to -0.23); total ICIQ-UI-SF score (MD -9.5, 95% CI -11.8 to -7.1); pelvic pain (MD -3.1, 95% CI -4.7 to -1.4); self-esteem (MD 2.9, 95% CI 0.7 to 5.1); and measures of vaginal stenosis and quality of life. A 12-week telerehabilitation program was effective in reducing reports of UI, severity of UI, pelvic pain and dyspareunia in women after the treatment of gynaecological cancer. Brazilian Clinical Trials Registry (ReBEC) RBR-8ht5nqq.

The objective of this study was to translate and cross&#x2011;culturally adapt the Telerehabilitation Usability Questionnaire (TUQ) into Arabic (TUQ-Arabic) and analyse the psychometric properties of the questionnaire. Translation and cross-cultural adaptation have been conducted following international guidelines. A cohort of 270 Arabic-speaking participants completed the TUQ-Arabic. This study included participants who had utilised telerehabilitation services. Internal consistency was assessed with Cronbach's alpha coefficient. The test-re-test reliability was performed on 69 participants using the intraclass correlation coefficient (ICC). The cohort of the study comprised of 118 female (43.7%) and 152 male (56.3%) participants. Our findings indicate robust internal consistency in TUQ-Arabic subscales, exhibiting excellent Cronbach's alpha values (>0.90, ranging from 0.902 to 0.940). The overall TUQ-Arabic score displayed excellent internal consistency (Cronbach's alpha = 0.98). The test-re-test reliability of the total TUQ-Arabic score was excellent, with an ICC of 0.975 (95% CI 0.960-0.984, p&#x2009;<&#x2009;0.001). Similarly, the test-re-test reliability of the TUQ-Arabic subscales ranged from good to excellent. The TUQ-Arabic is internally consistent and reliable, paralleling the original TUQ. Participants displayed favourable views on the telerehabilitation services, resulting in high satisfaction. The TUQ-Arabic is suitable for assessing the usability of remote telerehabilitation services in Saudi Arabia and populations globally.

Rehabilitation is a key in managing Parkinson disease (PD), but access barriers remain, and the benefits of telerehabilitation (TR) are still unclear. The objective of this systematic review and meta-analysis was to examine the effect of TR in adults with PD through the International Classification of Functioning, Disability, and Health. An electronic database search (PubMed, EMBASE, SCOPUS, PEDro, Cochrane) was performed for data published from inception to April 2025. Inclusion criteria were randomized controlled trials involving adults with PD, assessing remotely delivered physical activity or physical rehabilitation interventions, compared to control groups not exposed to TR, and reporting outcomes of interest. Exclusion criteria included studies involving additional neurological disorders. Data extraction was guided by the PRISMA guidelines. This review was registered with PROSPERO (CRD42023475545). A risk of bias assessment (RoB-2) and methodological quality assessment (PEDro) tools were used. Data were analyzed using random-effects models. The outcomes of interest were balance, gait, functional mobility, physical activity, quality of life (QOL), and social support. Eighteen studies were included in the final analysis, involving 731 individuals with PD. The most common types of TR included remote-based exergaming and using video conferencing platforms. The results indicated no statistically significant difference between TR and control groups on balance (standardized mean difference [SMD]&#x2009;=&#x2009;0.31, 95% CI&#x2009;=&#x2009;-0.02 to 0.65), gait speed (SMD&#x2009;=&#x2009;-0.07, 95% CI&#x2009;=&#x2009;-0.33 to 0.19), and functional mobility (SMD&#x2009;=&#x2009;0.05, 95% CI&#x2009;=&#x2009;-0.27 to 0.37) outcomes. However, the results were statistically in favor of TR for improving QOL (SMD&#x2009;=&#x2009;0.26, 95% CI&#x2009;=&#x2009;0.05 to 0.47). TR yielded similar or superior results compared to non-exposed control conditions across the 5 outcomes evaluated. Health care providers can decide which method of care delivery they prefer based on patients' preferences and resources.

Despite the recent surge in the use of telerehabilitation (TR) for neurological disorders, there is a lack of TR programs tailored to persons with Parkinson's disease (PwPD), particularly in low-resource settings. To address this gap, we aimed to develop a tele-assisted home exercise program for improving balance and functional mobility in PwPD (TELEPORT-PD). An e-Delphi process was conducted with an international, interprofessional team of experts involved in rehabilitation of PwPD. A comprehensive pool of exercises was compiled and evaluated across three rounds of e-Delphi process. Out of 473 exercises pooled from literature and experts, 99 exercises entered the e-Delphi process after deduplication and were categorized under six domains. After consensus, the final program included 42 exercises along with dosage, progression, and safety considerations. The TELEPORT-PD protocol developed through an international, e-Delphi consensus could be adapted for its use in low-resource settings worldwide.

Hand tendon injuries require a long rehabilitation process. Telerehabilitation may offer advantages in terms of accessibility, time, and cost. Accordingly, this study aimed to determine the efficacy of telerehabilitation in individuals who underwent hand tendon surgery. This randomized controlled study comprised two groups: a home program group and a telerehabilitation group. While the control group continued their routine treatment and home program, the intervention group's home program was monitored via telerehabilitation three times per week for six weeks. Outcomes were assessed using the Visual Analog Scale (VAS) for pain, a baseline hydraulic hand dynamometer for gross grip strength, a Lafayette hydraulic pinch meter for fine grip strength, the Nine-Hole Peg Test for dexterity, and the Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) questionnaire for functional status. The findings indicated that telerehabilitation had positive effects on activities of daily living and overall functionality.

Multiple sclerosis (MS) is a chronic, progressive, and neurodegenerative disease affecting more than 2.8 million people globally. Mobility impairments are among the most significant challenges faced by people with MS, leading to physical inactivity, deconditioning, and disability progression (for some, even irreversible disability). This negatively impacts mental health, social participation, and quality of life while placing a considerable economic burden on society. Exercise can improve mobility and mitigate disability progression, but facility-based options are often inaccessible, especially for those in remote areas. Telerehabilitation offers a promising alternative, but current systems are limited by complexity and hardware requirements. The PLATINUMS (Implementation of an Advanced Telerehabilitation Solution for People With Multiple Sclerosis) project proposes an AI-driven telerehabilitation system to deliver accessible, cost-effective, and home-based exercise therapy for people with MS. The PLATINUMS project begins with working package (WP) 1, focusing on obtaining ethical approval and recruiting staff. Following this, WP2 involves a 4-week system feasibility and usability study (n=40) to assess and refine the digital platform. WP3 comprises a validity study (n=60) to evaluate remote mobility tests via the system, such as the Short Physical Performance Battery (SPPB), functional reach, and sit-to-stand tests, to ensure their reliability for use in WP4, the feasibility multicenter randomized controlled trial (RCT). The 10-week multicenter feasibility RCT will be conducted in MS centers across Denmark, Ireland, Israel, and Italy, with 96 participants varying in disability levels. The primary objective is to evaluate the efficacy of the AI-powered telerehabilitation system on mobility outcomes compared to usual care. Finally, WP5 will assess the cost-effectiveness of the telerehabilitation system by analyzing implementation costs, adherence, and use of health care. The PLATINUMS project aims to revolutionize exercise therapy for people with MS by demonstrating the feasibility, validity, and preliminary efficacy of the AI-driven telerehabilitation system. This approach addresses barriers such as accessibility, privacy, and standardization while promoting patient and therapist acceptance. Funding for the PLATINUMS project was obtained in February 2024. WP2 data collection began in April 2025 across 4 European sites. WP3 is scheduled to launch in July 2025, with WP4 (the feasibility RCT) planned for January 2026. Initial WP2 results are expected by October 2025, with first publications anticipated in mid-2026. The PLATINUMS project is expected to generate critical insights into the feasibility, usability, and preliminary efficacy of an AI-based telerehabilitation system for people with MS. By leveraging widely available technology and real-time feedback, the system addresses key barriers to traditional rehabilitation. Findings from this protocol may inform future large-scale trials and support the broader implementation of digital health solutions in neurological rehabilitation. PRR1-10.2196/75983.

Rehabilitation is an essential service for healthy ageing. Scoping reviews have described how rehabilitation is delivered to older people, however, their evidence is overwhelmingly derived from research published in high-income countries (HICs). To a) assess whether descriptions of rehabilitation service delivery models derived from the literature reflect real-world practice, and b) gather knowledge about the use of different rehabilitation service delivery models in different settings and countries, including availability and implementation status. Observational study. International online survey conducted in eight languages. Healthcare workers involved in the provision of rehabilitation for people over 60. A 33-question questionnaire on the characteristics of rehabilitation service delivery models, their availability and implementation in different regions of the world was distributed globally using a three-layer stakeholder mapping approach. The CHERRIES checklist guided the reporting. The survey was completed by 1285 highly experienced health workers from 124 countries, representing all income levels and all WHO regions. The availability and implementation status of rehabilitation delivery models (inpatient, outpatient, telerehabilitation, home, community, and eldercare) was lower in low- and middle-income countries (LMICs) than in HICs, but none of the models was fully available or implemented nationwide in any region or income level. Physiotherapists, occupational therapists, speech-language therapists, nurses, and rehabilitation physicians are the most common healthcare workers providing rehabilitation in all models and regions. Rehabilitation is often fragmented and multidisciplinary teams are often only available in the inpatient model. Assistive technology is almost always provided in HICs, but only half the time in LMICs, while environmental adaptations are not fully reimbursed by any health system and are not prescribed in some regions. Our findings validate and complement previous reviews by incorporating insights from healthcare workers with real-world experience across income levels and regions. Older people in LMICs have less access to quality rehabilitation services than those in HICs. Globally, rehabilitation services are partially responsive and adequate for supporting healthy ageing. Rehabilitation stakeholders and policymakers can use this study to (re)design services to better support healthy ageing.

Persons with Parkinson's disease (PwPD) require ongoing rehabilitation to maintain independence, but traditional center-based and unsupervised home programs have limitations in accessibility and adherence. Home-based telerehabilitation (TR) offers a promising alternative by enabling remote delivery of exercise interventions. To evaluate the effect of home-based TR on balance, functional mobility, and quality of life in PwPD. A comprehensive electronic search was conducted across PubMed, CINAHL, Embase, OvidSP, ProQuest, Scopus, Web of Science, Cochrane CENTRAL, and PEDro databases. Interventional studies on exercise-centric home-based TR for PwPD with either balance, functional mobility, or quality of life as outcomes were included. A total of 37 studies were included in this systematic review, of which 13 were eligible for meta-analysis. The meta-analysis revealed small but significant improvements in balance (SMD = 0.25; 95% CI: 0.04 to 0.45; p = 0.02). and functional mobility (SMD = -0.28; 95% CI: -0.52 to -0.05; p = 0.02). However, no significant effect was observed for quality of life (SMD = -0.08; 95% CI: -0.25 to 0.09; p = 0.35). Home-based TR is effective for improving balance and functional mobility in PwPD, although, its effect on quality of life is unclear which warrants further research.

Total knee arthroplasty (TKA) is commonly performed to manage end-stage knee osteoarthritis, yet postsurgical recovery varies significantly among patients. Lifestyle modification and rehabilitation interventions play a critical role in optimizing outcomes. While telerehabilitation has shown promise in enhancing accessibility and compliance, its role in supporting lifestyle behavior change alongside supervised sensorimotor training remains underexplored. This study aimed to evaluate the effects of a home-based lifestyle modification program delivered through web-based telerehabilitation monitoring in addition to supervised sensorimotor training, in improving physical function, pain, balance, quality of life (QOL), and adherence in patients undergoing TKA. A single-blinded randomized controlled trial was conducted among 52 participants undergoing primary TKA, who were randomly assigned to either the intervention group (IG) (supervised sensorimotor training plus a telerehabilitation-supported lifestyle modification program) or the control group (CG) (supervised sensorimotor training alone and a traditional home exercise plan). The intervention lasted 22 weeks, and participants were assessed at baseline (presurgery), 14 weeks, and 22 weeks postsurgery. Outcome measures included joint position sense (JPS), musculoskeletal ultrasound of the rectus femoris muscle, Berg Balance Scale, knee function using the Knee Injury and Osteoarthritis Outcome Score, and QOL via EuroQol 5-dimension 5-level questionnaire. Significant improvements were observed in the IG across all outcomes compared with the CG. Notably, the IG showed greater improvements in musculoskeletal ultrasound thickness. JPS showed superior accuracy in the experimental group (baseline [3.2 degrees] to 22 wk postsurgery [0.05 degrees]) compared with the CG (baseline [3.1 degrees] to 22 wk postsurgery [1.8 degrees]), with significant improvements noted (P=.001, Cohen d=3.1 vs 0.7), Knee Injury and Osteoarthritis Outcome Score subscales (pain, symptoms, activities of daily living, sport, and QOL), and JPS (mean absolute error 0.05 vs 1.8 degrees). Berg Balance Scale demonstrated significant gains in balance for the experimental group (baseline [34] to 22 wk postsurgery [53]) relative to the CG (baseline [37] to 22 wk postsurgery [48]), with substantial differences observed (P=.001, Cohen d=1.8 vs 0.4). The EuroQol 5-dimension 5-level questionnaire health-related QOL scores were markedly higher for the experimental group (baseline [45.4] to 22 wk postsurgery [88.1]) compared with the CG (baseline [42.8] to 22 wk postsurgery [70.9]), indicating substantial gains in overall health status (P=.001, Cohen d=2.4 vs 1.3). The IG also reported higher compliance, with 81.8% (18/22) achieving over 90% adherence compared with 68.18% (15/22) in the CG. Home-based lifestyle modification program through telerehabilitation monitoring significantly improved functional and patient-reported outcomes in individuals following TKA. These findings support the integration of lifestyle modification programs through telerehabilitation monitoring into post-TKA recovery pathways to optimize rehabilitation outcomes.