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G. Rusconi1, R. Vaj1, V. Spunton2, R. Fenini2, M. Conti3
1Riabilitazione Rusconi, Como, Italy, 2Studio Medico Castagna-Conti, Milan, Italy, 3Humanitas Research Hospital, Milan, Italy
Background: The new contingencies of the COVID-19 pandemic suggest a new approach for the relationship physiotherapist-patient to guarantee both social distancing and the quality of the rehabilitation process. The remotely monitored home-based rehabilitation, still not a widespread reality, could help.
Purpose: To evaluate usability and effectiveness of a new interactive system to closely monitor the quantity and quality of the home-based rehabilitation using a dedicated web platform associated to a personal inertial sensor applied to patient’s extremities.
Methods: 24 patients (mean age 56±10 y/o) were enrolled by 4 physiotherapists based in Milano (Italy) and surroundings. 18 patients were affected by shoulder pathologies: RC Tears, post-op RC repair and GH Instability; 6 patients were affected by Knee Instability and ACL injuries.
Intervention: After a one-to-one introductory session, patients were asked to follow autonomously at home a 3-week exercise program specifically designed for each of them, using the ReHub platform on their tablet-PC associated to an inertial sensor fixed to the targeted joint with a strap.
The physiotherapists could always interact with the patient via chat or video call.
Parameters analysed: total number of exercises performed; patient’s adherence to the program set for him; exercise quality (including ROM, speed, number of repetitions) compared to the reference exercise set; patient satisfaction using the ReHub platform.
Intervention: After a one-to-one introductory session, patients were asked to follow autonomously at home a 3-week exercise program specifically designed for each of them, using the ReHub platform on their tablet-PC associated to an inertial sensor fixed to the targeted joint with a strap.
The physiotherapists could always interact with the patient via chat or video call.
Parameters analysed: total number of exercises performed; patient’s adherence to the program set for him; exercise quality (including ROM, speed, number of repetitions) compared to the reference exercise set; patient satisfaction using the ReHub platform.
Results:
- 1405 exercises were performed in 3 weeks by all patients using the ReHub platform
- Patient’s adherenceaverage score 74,1% (completed exercises over programmed exercises)
- Exercise quality: 69,9%, calculated - taking into account ROM, speed, number of repetitions - as percentage of each exercise performed compared to the physiotherapist’s reference movement.
- Patient’s satisfaction average score 76%: evaluated through System Usability Scale questionnaire upon the end of the exercise program (10 questions - 5 possible answers, from strongly disagree to strongly agree). Highest scored questions:
- Patients don’t think they needed to learn a lot of things to use it (88/100)
- Patients don’t think they would need the help of an expert to use it (86/100)
- Patients thought they would like to use ReHub frequently (78/100)
Conclusion(s): Data obtained show that ReHub is a well-accepted real-time, interactive system to monitor home-based rehabilitation, able to engage patients–as seen in the high adherence rates–much more than in standard home rehab reported in literature; the latter is an essential key point for a better, faster and cost-efficient recovery.
Professional physiotherapists play a crucial role in this rehabilitation process as highlighted by the fact that well guided patients using intensively ReHub are more adherent obtaining higher exercise quality scores as well as higher satisfaction rates. In addition, ReHub is perceived as easy-to-use even among lowly adherent patients.
Professional physiotherapists play a crucial role in this rehabilitation process as highlighted by the fact that well guided patients using intensively ReHub are more adherent obtaining higher exercise quality scores as well as higher satisfaction rates. In addition, ReHub is perceived as easy-to-use even among lowly adherent patients.
Implications: Due to the concurrent COVID-19 pandemic outbreak, this system could represent a powerful tool to guarantee the needed social distancing maintaining high quality level of rehabilitation.
Funding, acknowledgements: This study is supported by the European Union’s H2020-SME Instrument programme under grant agreement No 811755.
Keywords: Telerehabilitation, Monitored rehabilitation, Wearable
Topic: Innovative technology: information management, big data and artificial intelligence
Did this work require ethics approval? No
Institution: Riabilitazione Rusconi
Committee: Riabilitazione Rusconi
Reason: Investigated product is CE-marked Class I. Risk management and protocol evaluation determined no approval was needed. Patients signed consent forms.
All authors, affiliations and abstracts have been published as submitted.
