The effect of tele-rehabilitation on the participation of people with spinal cord injury: secondary analysis from a randomized controlled trial

authors:

avatar Fatemeh Motaharinezhad , * , avatar Fatemeh Hoseinpour ORCID , avatar Reza Al rabiee , avatar Mohammadamin Zaheri , avatar Nazanin Vatanparast

Koomesh: Vol.25, issue 1; 30-37
published online: March 02, 2023
article type: issue_documents_importer
received: August 01, 2022
accepted: February 02, 2023

how to cite: Motaharinezhad F, Hoseinpour F, Al rabiee R, Zaheri M, Vatanparast N. The effect of tele-rehabilitation on the participation of people with spinal cord injury: secondary analysis from a randomized controlled trial. koomesh. 2023;25(1):e152799. 

Abstract

Introduction: Due to participation being the main goal of rehabilitation in people with spinal cord injury, the distribution of services via telerehabilitation will be useful for most of these people who are no access to rehabilitation centers due to environmental barriers. Therefore, the aim of this research was to investigate the effect of telerehabilitation focused on transfer training and wheelchair mobility on the participation level of people with spinal cord injuries. Materials and Methods: In a single-blind randomized controlled clinical trial, people with spinal cord injuries were randomly assigned to intervention and control groups. The intervention group received group and online training in 4 sessions during 4 weeks, so two-hour sessions were held every week. The control group did not receive any intervention. The wheelchair outcome measure (WhOM) was completed by the participants before and after the intervention. The WhOM has two parts, the first part consists of a semi-structured interview and the participants specified their goals based on participation at home (question 1) and in the community or outside the home (question 2). Then the participants scored the importance of each goal and their level of satisfaction with this activity. In the second part, structured questions are asked about comfort, satisfaction with the sitting position and skin damage. Results: 44 people with paraplegic spinal cord injury participated in the telerehabilitation with an average age of 34.09 and a standard deviation of 8.19 and a control group with an average age of 35.50 and a standard deviation of 8.70. The average of all scores in the participants of the intervention group had a significant difference (P<0.001). Also except for the score related to the level of comfort with sitting position in the wheelchair (P=0.1) and participation scores at home {(P=0.23) (P=0.11)}, the results of the comparison between the two groups were significant (P<0.001). Conclusion: Based on the results, telerehabilitation was effective in the participation level of people with spinal cord injuries. Also, the results showed telerehabilitation had a significant impact on the patient's level of satisfaction with participation in their daily activities.

References

  • 1.

    Ahuja CS, Wilson JR, Nori S, Kotter MRN, Druschel C, Curt A, et al. Traumatic spinal cord injury. Nat Rev Dis Prim 2017; 3: 1701-1708.

  • 2.

    Fougeyrollas P, Noreau L. Long-term consequences of spinal cord injury on social participation: the occurrence of handicap situations. Disabil Rehabil 2000; 22: 170e180.

  • 3.

    Boschen KA, Miller WC, Noreau L, Wolfe DL, McColl MA, Martin Ginis KA, Konnyu KJ. Community reintegration following spinal cord injury. Spinal Cord Injury Rehabil Evid 2008; 2.

  • 4.

    New PW. Functional outcomes and disability after nontraumatic spinal cord injury rehabilitation: results from a retrospective study. Arch Phys Med Rehabil 2005; 86: 250e261.

  • 5.

    Mann WC, Hurren D, Charvat B, Tomita M. Problems with wheelchairs experienced by frail elders. Technol Disabil 1996; 5: 101e111.##https://doi.org/10.3233/TAD-1996-5112.

  • 6.

    Cooper RA, Ferretti E, Oyster M, Kelleher A, Cooper R. The relationship between wheelchair mobility patterns and community participation among individuals with spinal cord injury. Assist Technol 2011; 23: 177e183.##https://doi.org/10.1080/10400435.2011.588991.

  • 7.

    Mortenson WB, Miller WC, Miller-Polgar J. Measuring wheelchair intervention outcomes: Development of the wheelchair outcome measure. Disabil Rehabil 2007; 2: 275-285.

  • 8.

    Mortenson WB, Miller WC, Auger C. Issues for the selection of wheelchair-specific activity and participation outcome measures: a review. Arch Phys Med Rehabil 2008; 89: 1177e1186.

  • 9.

    Giesbrecht EM, Miller WC, Eng JJ, Mitchell IM, Woodgate RL, Goldsmith CH. Feasibility of the enhancing participation in the community by improving wheelchair skills (EPIC Wheels): program study protocol for a randomized controlled trial. Trials 2013; 14: 350.

  • 10.

    Da Costa CR, Ferreira FM, Bortolus MV, Carvalho MG. Dispositivos de tecnologia assistiva: fatores relacionados ao abandono. Cadernos Terapi Ocup UFSCar 2015; 23: 611-624.##https://doi.org/10.4322/0104-4931.ctoAR0544.

  • 11.

    Coulter EH, McLean AN, Hasler JP, Allan DB, McFadyen A, Paul L. The effectiveness and satisfaction of web-based physiotherapy in people with spinal cord injury: a pilot randomised controlled trial. Spinal Cord 2017; 55: 383-389.

  • 12.

    Sechrist S, Lavoie S, Khong CM, Dirlikov B, Shem K. Telemedicine using an iPad in the spinal cord injury population: a utility and patient satisfaction study. Spinal Cord Ser Cases 2018; 4: 71.

  • 13.

    Rabanifar N, Abdi K. Letter to Editor: Telerehabilitation: A Useful and appropriate approach for people with disability in Covid-19 pandemic. Med J Islamic Republ Iran 2021; 35: 125-126. (Persian).

  • 14.

    Cason J. Telehealth: A rapidly developing service delivery model for occupational therapy. Int J Telerehabil 2014; 6: 29-36.

  • 15.

    Cockrell JR, Folstein MF. Mini-Mental state examination (MMSE). Psychopharm Bull 1988; 24: 688-692.

  • 16.

    Kos D, Van Eupen I, Meirte J, Van Cauwenbergh D, Moorkens G, Meeus M, Nijs J. Activity pacing self management in chronic fatigue syndrome: A randomized controlled trial. Am J Occup Ther 2015; 69: 6905290020.

  • 17.

    CONSORT Website. http://www.consortstatement. org/ available 4-6-2016.

  • 18.

    Miller WC, Garden J, Mortenson WB. Measurement properties of the wheelchair outcome measure in individuals with spinal cord injury. Spinal Cord 2011; 49: 995-1000.

  • 19.

    Alimohammad S, Parvaneh S, Ghahari S, Saberi H, Yekaninejad MS, Miller WC. Translation and validation of the Farsi version of the Wheelchair Outcome Measure (WhOM-Farsi) in individuals with spinal cord injury. Disabil Health J 2016; 9: 265-271.

  • 20.

    Feng C, Wang H, Lu N, Tu XM. Log-transformation: applications and interpretation in biomedical research. Stat Med 2012; 32: 230-239.

  • 21.

    Changyong FE, Hongyue WA, Naiji LU, Tian CH, Hua HE, Ying LU. Log-transformation and its implications for data analysis. Shanghai Arch Psychiatry 2014; 26: 105-109.

  • 22.

    McColl MA, Aiken A, McColl A, Sakakibara B, Smith K. Primary care of people with spinal cord injury: scoping review. Can Fam Physician 2012; 58: 1207-1216.

  • 23.

    Kroll T, Jones GC, Kehn M, Neri MT. Barriers and strategies affecting the utilisation of primary preventive services for people with physical disabilities: a qualitative inquiry. Heal Soc Care Commun 2006; 14: 284-293.

  • 24.

    Taghizadeh Delkhoush C, Maroufi N, Ebrahimi Takamjani I, Farahmand F, Shakourirad A, Haghani H. Dynamic comparison of segmentary scapulohumeral rhythm between athletes with and without impingement syndrome. Iran J Radiol 2014; 11: e14821. (Persian).

  • 25.

    Hatch MN, Martinez RN, Etingen B, Cotner B, Hogan TP, Wickremasinghe IM, et al. Characterization of telehealth use in veterans with spinal cord injuries and disorders. PM R 2021; 13: 1094-1103.

  • 26.

    Walia S, Wolfe D, Keast D, Ho C, Ethans K, Worley S, et al. Facilitators and barriers for implementing an internet clinic for the treatment of pressure injuries. Telemed J E Health 2019; 25: 1237-1243.

  • 27.

    Stillman MD, Capron M, Alexander M, Di Giusto ML, Scivoletto G. COVID-19 and spinal cord injury and disease: results of an international survey. Spinal Cord Ser Case 2020; 6: 21.

  • 28.

    Barrows D, Goldstein B. Virtual care in the veterans affairs spinal cord injuries and disorders system of care during the COVID-19 national public health emergency. Phys Med Rehabil Clin N Am 2021; 32: 207-221.

  • 29.

    Worobey LA, Rigot SK, Hogaboom NS, Venus C, Boninger ML. Investigating the efficacy of web-based transfer training on independent wheelchair transfers through randomized controlled trials. Arch Phys Med Rehabil 2018; 99: 9-16.e10.

  • 30.

    Motaharinezhad F, Seyed S, Zeinali R. The impact of mental practice on sleep quality, fatigue, functional balance and gait in patient with Multiple sclerosis: A Case Report. Koomesh 2016; 17: 944-949. (Persian).