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K. Tawara1, S. Okuda1, S. Sato1, A. Sakamoto1, J. Hirata2, E. Ahmad3, N. Helal4
1Fukuyama City Hospital, Department of Rehabilitation, Fukuyama-shi, Hiroshima, Japan, 2Kawasaki University of Medical Welfare, Faculty of Rehabilitation, Kurashiki-shi,Okayama, Japan, 3International Committee of the Red Cross, Environmental Health Engineer, Kabul, Afghanistan, 4International Committee of the Red Cross, Physical Rehabilitation Project Manger, Kabul, Afghanistan
Background: With the development of information and communication technology, "telemedicine," the use of videophones and other means to examine patients in remote locations, has emerged.
The COVID-19 pandemic, which began in earnest in 2020, raged around the world, and telemedicine played an important role in overall healthcare.
In the physical therapy field as well, various effects appeared due to the response to COVID-19 patients and infection control measures. Under such circumstances, tele-physiotherapy attracted attention from the perspectives of continuity of care and infection control, and its use has expanded worldwide.
In Japan, tele-physiotherapy has been introduced as an alternative to face-to-face physiotherapy as the super-aging society is approaching.
However, looking at the world, even if physical therapy is really necessary, there are some areas where even tele-physiotherapy as an alternative to face-toface physical therapy is not implemented due to social circumstances.
The COVID-19 pandemic, which began in earnest in 2020, raged around the world, and telemedicine played an important role in overall healthcare.
In the physical therapy field as well, various effects appeared due to the response to COVID-19 patients and infection control measures. Under such circumstances, tele-physiotherapy attracted attention from the perspectives of continuity of care and infection control, and its use has expanded worldwide.
In Japan, tele-physiotherapy has been introduced as an alternative to face-to-face physiotherapy as the super-aging society is approaching.
However, looking at the world, even if physical therapy is really necessary, there are some areas where even tele-physiotherapy as an alternative to face-toface physical therapy is not implemented due to social circumstances.
Purpose: The purpose of this project is to share with physiotherapists around the world an example of a project that provides tele-physiotherapy to an area where medical resources are scarce due to conflict, and to take steps to generate future co-creation.
Methods: The patient is a 25-year-old male who presented with a spinal cord injury(Th5,ASIA Impairment Scale:B) from a gunshot.
He lives in Kabul, Afghanistan.
In October 2021, five months after the injury, we began communicating through a social networking service.
At the beginning we only sent each other exercise videos, but the following month we started tele-physiotherapy sessions once or twice a month, as we needed to communicate directly with each other for guidance on exercise posture, etc.
Tele-physiotherapy provided follow-up on progress and monitoring of exercise therapy, as well as advice on self-management and a wide range of physical activities.
He lives in Kabul, Afghanistan.
In October 2021, five months after the injury, we began communicating through a social networking service.
At the beginning we only sent each other exercise videos, but the following month we started tele-physiotherapy sessions once or twice a month, as we needed to communicate directly with each other for guidance on exercise posture, etc.
Tele-physiotherapy provided follow-up on progress and monitoring of exercise therapy, as well as advice on self-management and a wide range of physical activities.
Results: At the beginning of the intervention, he had no knowledge of pressure ulcer prevention and was not fully utilizing his own residual functions.
As of September 2022, with continued tele-physiotherapy, the self-care items on the Functional Independence Measure (FIM) had improved by 3 points, and the Life Space Assessment (LSA) appeared to have increased his opportunities to get out of bed for self-exercise.
In addition, The Center for Epidemiologic Studies Depression Scale (CES-D), Perceived Health Competence Scale (PHCS), General Self-Efficacy Scale (GSCS),The Rosenberg Self Esteem Scale (RSES) showed improvement in mental health.
And the EuroQol 5-dimensions 5-levels (EQ-5D-5L) and EQ-VAS showed positive effects, suggesting an improvement in quality of life.
As of September 2022, with continued tele-physiotherapy, the self-care items on the Functional Independence Measure (FIM) had improved by 3 points, and the Life Space Assessment (LSA) appeared to have increased his opportunities to get out of bed for self-exercise.
In addition, The Center for Epidemiologic Studies Depression Scale (CES-D), Perceived Health Competence Scale (PHCS), General Self-Efficacy Scale (GSCS),The Rosenberg Self Esteem Scale (RSES) showed improvement in mental health.
And the EuroQol 5-dimensions 5-levels (EQ-5D-5L) and EQ-VAS showed positive effects, suggesting an improvement in quality of life.
Conclusions: Tele-physiotherapy could be a new approach to humanitarian aid for those in need of rehabilitation, as long as an Internet environment is available.
On the other hand, it is feared that the new approach to humanitarian aid presented here alone will divide those who can be helped from those who cannot because of disparities in family circumstances or residential areas.
On the other hand, it is feared that the new approach to humanitarian aid presented here alone will divide those who can be helped from those who cannot because of disparities in family circumstances or residential areas.
Implications: We hope that more reports on tele-physiotherapy for areas where medical resources are scarce will be published, that methods will be brushed up, and that tele-physiotherapy will become more widely used as an option to contribute to the health and well-being of many more people.
Funding acknowledgements: The authors declare no conflicts of interest associated with this presentation of an abstract.
Keywords:
Tele-physiotherapy
Humanitarian aid
Spinal cord injury
Tele-physiotherapy
Humanitarian aid
Spinal cord injury
Topics:
Service delivery/emerging roles
Neurology: spinal cord injury
Health promotion & wellbeing/healthy ageing/physical activity
Service delivery/emerging roles
Neurology: spinal cord injury
Health promotion & wellbeing/healthy ageing/physical activity
Did this work require ethics approval? No
Reason: Because it is a description of an innovative approach that can contribute to the demand for physiotherapy in conflict zones where medical resources are scarce.
Presenting patients were given a consent form for the handling of their personal information, which was explained to them and signed by them.
Presenting patients were given a consent form for the handling of their personal information, which was explained to them and signed by them.
All authors, affiliations and abstracts have been published as submitted.
