A feasibility of home-based tele-rehabilitation on motor function and quality of life in spinal cord injury
Keywords:
tele-rehabilitation, spinal cord injury, exercise, feasibility, motor, strengtheningAbstract
Objectives: Individuals with spinal cord injury (SCI) require regular rehabilitation to improve motor function and quality of life. However, barrier factors i.e. transportation problems, financial constraints and caregivers’ availability to accompany them limit access to rehabilitation center. Tele-rehabilitation can overcome these barrier factors. This study aims to explore the feasibility of home-based tele-rehabilitation exercise in Thai SCI populations.
Materials and Methods: Ten individuals with SCI underwent a tailored tele-rehabilitation program (1 hour/session, 3 sessions/week, 4 weeks) supervised by the physical therapist. The exercise programs include stretching, strengthening, balance and transfer training. Exercise intensity and Perceived Exertion (RPE) scale were recorded for each session. Upper and lower extremity motor function (ASIA-motor score) and quality of life (WHQOL-Thai) were assessed at baseline and post-intervention.
Results: All participants demonstrated good adherence by completing 100% of the 12-session exercise program. The exercise program demonstrated high feasibility, with a high completion rate. However, no transfer training was provided to participants. The average RPE was 3.8, indicating light to moderate activity. ASIA-motor scores improved significantly (p = 0.003) after the intervention. However, no improvements were found in the total WHQOL-Thai score in any of its domains.
Conclusion: Home-based tele-rehabilitation exercises have a potential to maintain adherence to rehabilitation programs for SCI populations, improve motor performance, though it may not improve quality of life. However, certain types of training were not possible via tele-rehabilitation because of unsafe home environments, limited space and the need for assistance.
References
Global, regional, and national burden of spinal cord injury, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2023;22(11):1026-47.
Diop M, Epstein D. A Systematic Review of the Impact of Spinal Cord Injury on Costs and Health-Related Quality of Life. PharmacoEconomics - Open. 2024;8(6):793-808.
Fawcett JW, Curt A, Steeves JD, Coleman WP, Tuszynski MH, Lammertse D, et al. Guidelines for the conduct of clinical trials for spinal cord injury as developed by the
ICCP panel: spontaneous recovery after spinal cord injury and statistical power needed for therapeutic clinical trials. Spinal Cord. 2007;45(3):190-205.
Lu X, Battistuzzo CR, Zoghi M, Galea MP. Effects of training on upper limb function after cervical spinal cord injury: a systematic review. Clin Rehabil. 2015;29(1):3-13.
Dost G, Dulgeroglu D, Yildirim A, Ozgirgin N. The effects of upper extremity progressive resistance and endurance exercises in patients with spinal cord injury. J Back Musculoskelet Rehabil. 2014;27(4):419-26.
ACSM's guidelines for exercise testing and prescription. Eleventh edition ed. Philadelphia Baltimore New York London$PBuenod Aires Hong Kong Sydney Tokyo: Wolters Kluwer; 2022 2022. 513 p.
Lee S, Kim J, Kim J. Substantiating Clinical Effectiveness and Potential Barriers to the Widespread Implementation of Spinal Cord Injury Telerehabilitation: A Systematic Review and Qualitative Synthesis of Randomized Trials in the Recent Past Decade. Telemedicine Reports. 2021;2(1):64-77.
Shem K, Sechrist SJ, Loomis E, Isaac L. SCiPad: Effective Implementation of Telemedicine Using iPads with Individuals with Spinal Cord Injuries, a Case Series. Front Med (Lausanne). 2017;4:58.
Senthinathan A, Tadrous M, Hussain S, Craven BC, Jaglal SB, Moineddin R, et al. Examining the impact of COVID-19 on health care utilization among persons with chronic spinal cord injury/dysfunction: a population study. Spinal Cord. 2023.
Mirbaha S, Morgan A, Tang A, Smith-Turchyn J, Richardson J. Models of Telehealth Service Delivery in Adults With Spinal Cord Injuries: Scoping Review. JMIR Rehabil Assist Technol. 2023;10:e41186.
Peretti A, Amenta F, Tayebati SK, Nittari G, Mahdi SS. Telerehabilitation: Review of the State-of-the-Art and Areas of Application. JMIR Rehabilitation and Assistive Technologies. 2017;4(2):e7.
Lai B, Rimmer J, Barstow B, Jovanov E, Bickel CS. Teleexercise for Persons With Spinal Cord Injury: A Mixed-Methods Feasibility Case Series. JMIR Rehabilitation and Assistive Technologies. 2016;3(2):e8.
Mulroy SJ, Thompson L, Kemp B, Hatchett PP, Newsam CJ, Lupold DG, et al. Strengthening and optimal movements for painful shoulders (STOMPS) in chronic spinal cord injury: a randomized controlled trial. Phys Ther. 2011;91(3):305-24.
Roberts TT, Leonard GR, Cepela DJ. Classifications In Brief: American Spinal Injury Association (ASIA) Impairment Scale. Clinical Orthopaedics & Related Research. 2017;475(5):1499-504.
Cramer SC, Dodakian L, Le V, McKenzie A, See J, Augsburger R, et al. A Feasibility Study of Expanded Home-Based Telerehabilitation After Stroke. Frontiers in Neurology. 2021;11.
Furlan JC, Fehlings MG, Tator CH, Davis AM. Motor and Sensory Assessment of Patients in Clinical Trials for Pharmacological Therapy of Acute Spinal Cord Injury: Psychometric Properties of the ASIA Standards. Journal of Neurotrauma. 2008;25(11):1273-301.
Santos LV, Pereira ET, Reguera-García MM, Oliveira CEP, Moreira OC. Resistance Training and Muscle Strength in people with Spinal cord injury: A systematic review and meta-analysis. J Bodyw Mov Ther. 2022;29:154-60.
Ponzano M, Buren R, Adams NT, Jun J, Jetha A, Mack DE, et al. Effect of Exercise on Mental Health and Health-related Quality of Life in Adults With Spinal Cord Injury: A
Systematic Review and Meta-analysis.Archives of Physical Medicine and Rehabilitation. 2024;105(12):2350-61.
Abou L, Rice LA. The associations of functional independence and quality of life with sitting balance and wheelchair skills among wheelchair users with spinal cord injury. J Spinal Cord Med. 2024;47(3):361-8.
Foongchomcheay A, Eitivipart AC, Kespichayawattana J, Muangngoen M. Quality of life after spinal cord injury in Thai individuals: A mixed-methods study. Hong Kong Physiother J. 2019;39(1):35-55.
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