OBJECTIVE: To compare the 6-month outcomes of telerehabilitation intervention with those of standard care for spinal cord injury (SCI). DESIGN: Multicenter randomized controlled trial. SETTING: Home, nursing, or unspecialized hospital care provided after discharge from a spinal cord unit. PARTICIPANTS: Adult patients with nonprogressive, complete, or incomplete SCI discharged for the first time from the spinal cord unit to their homes (Belgium and Italy) or to their homes or another facility (England). INTERVENTIONS: All patients received the standard care they would have normally received after discharge from the spinal cord unit. In addition, patients in the telemedicine group received 8 telemedicine weekly sessions in the first 2 months, followed by biweekly telemedicine sessions for 4 months. MAIN OUTCOME MEASURES: Functional status at 6 months, clinical complications during the postdischarge period, and patient satisfaction. RESULTS: No significant differences in the occurrence of clinical complications were found between the study groups. A higher improvement of functional scores in the telemedicine group was found only at the Italian site: FIM total score 3.38+/-4.43 (controls) versus 7.69+/-6.88 (telemedicine group), FIM motor score 3.24+/-4.38 (controls) versus 7.55+/-7.00 (telemedicine group; P<.05). Items contributing to this difference were grooming, dressing upper body, dressing lower body, and bed/chair/wheelchair transfer. Higher satisfaction with care was reported by patients in the telemedicine group across all sites. CONCLUSIONS: Our study provides some of the first quantitative evidence, based on results from 1 site, that telerehabilitation may offer benefits to patients discharged from a spinal cord unit compared with standard care in terms of functional improvement. Further research is warranted to confirm or disprove this finding.
RCT Entities:
OBJECTIVE: To compare the 6-month outcomes of telerehabilitation intervention with those of standard care for spinal cord injury (SCI). DESIGN: Multicenter randomized controlled trial. SETTING: Home, nursing, or unspecialized hospital care provided after discharge from a spinal cord unit. PARTICIPANTS: Adult patients with nonprogressive, complete, or incomplete SCI discharged for the first time from the spinal cord unit to their homes (Belgium and Italy) or to their homes or another facility (England). INTERVENTIONS: All patients received the standard care they would have normally received after discharge from the spinal cord unit. In addition, patients in the telemedicine group received 8 telemedicine weekly sessions in the first 2 months, followed by biweekly telemedicine sessions for 4 months. MAIN OUTCOME MEASURES: Functional status at 6 months, clinical complications during the postdischarge period, and patient satisfaction. RESULTS: No significant differences in the occurrence of clinical complications were found between the study groups. A higher improvement of functional scores in the telemedicine group was found only at the Italian site: FIM total score 3.38+/-4.43 (controls) versus 7.69+/-6.88 (telemedicine group), FIM motor score 3.24+/-4.38 (controls) versus 7.55+/-7.00 (telemedicine group; P<.05). Items contributing to this difference were grooming, dressing upper body, dressing lower body, and bed/chair/wheelchair transfer. Higher satisfaction with care was reported by patients in the telemedicine group across all sites. CONCLUSIONS: Our study provides some of the first quantitative evidence, based on results from 1 site, that telerehabilitation may offer benefits to patients discharged from a spinal cord unit compared with standard care in terms of functional improvement. Further research is warranted to confirm or disprove this finding.
Authors: E Ray Dorsey; Alistair M Glidden; Melissa R Holloway; Gretchen L Birbeck; Lee H Schwamm Journal: Nat Rev Neurol Date: 2018-04-06 Impact factor: 42.937
Authors: Rachael N Martinez; Timothy P Hogan; Salva Balbale; Keshonna Lones; Barry Goldstein; Christine Woo; Bridget M Smith Journal: Telemed J E Health Date: 2017-01-09 Impact factor: 3.536
Authors: E Ray Dorsey; Meredith A Achey; Christopher A Beck; Denise B Beran; Kevin M Biglan; Cynthia M Boyd; Peter N Schmidt; Richard Simone; Allison W Willis; Nicholas B Galifianakis; Maya Katz; Caroline M Tanner; Kristen Dodenhoff; Nathan Ziman; Jason Aldred; Julie Carter; Joohi Jimenez-Shahed; Christine Hunter; Meredith Spindler; Zoltan Mari; John C Morgan; Dedi McLane; Patrick Hickey; Lisa Gauger; Irene Hegeman Richard; Michael T Bull; Nicte I Mejia; Grace Bwala; Martha Nance; Ludy Shih; Lauren Anderson; Carlos Singer; Cindy Zadikoff; Natalia Okon; Andrew Feigin; Jean Ayan; Christina Vaughan; Rajesh Pahwa; Jessica Cooper; Sydney Webb; Rohit Dhall; Anhar Hassan; Delana Weis; Steven DeMello; Sara S Riggare; Paul Wicks; Joseph Smith; H Tait Keenan; Ryan Korn; Heidi Schwarz; Saloni Sharma; E Anna Stevenson; William Zhu Journal: Telemed J E Health Date: 2016-02-17 Impact factor: 3.536
Authors: Ashraf S Gorgey; Robert M Lester; Rodney C Wade; Refka E Khalil; Rehan K Khan; Melodie L Anderson; Teodoro Castillo Journal: Spinal Cord Ser Cases Date: 2017-06-29
Authors: Eileen van de Pol; Karen Lucas; Timothy Geraghty; Kiley Pershouse; Sandra Harding; Sridhar Atresh; Annemarie Wagemakers; Anthony C Smith Journal: BMC Health Serv Res Date: 2016-01-25 Impact factor: 2.655
Authors: Meredith A Achey; Christopher A Beck; Denise B Beran; Cynthia M Boyd; Peter N Schmidt; Allison W Willis; Sara S Riggare; Richard B Simone; Kevin M Biglan; E Ray Dorsey Journal: Trials Date: 2016-01-05 Impact factor: 2.279