Health-Enabling Technologies for Telerehabilitation of the Shoulder: A Feasibility and User Acceptance Study.,Methods of Information in Medicine

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Health-Enabling Technologies for Telerehabilitation of the Shoulder: A Feasibility and User Acceptance Study.
Methods of Information in Medicine ( IF 1.3 ) Pub Date : 2020-08-10 , DOI: 10.1055/s-0040-1713685
Bianca Steiner ₁ , Lena Elgert ₂ , Birgit Saalfeld ₂ , Jonas Schwartze ₂ , Horst Peter Borrmann ₃ , Axel Kobelt-Pönicke ₄ , Andreas Figlewicz ₅ , Detlev Kasprowski ₅ , Michael Thiel ₅ , Ralf Kreikebohm ₆ , Reinhold Haux ₁ , Klaus-Hendrik Wolf ₂

Affiliation

Abstract

Background After discharge from a rehabilitation center the continuation of therapy is necessary to secure already achieved healing progress and sustain (re-)integration into working life. To this end, home-based exercise programs are frequently prescribed. However, many patients do not perform their exercises as frequently as prescribed or even with incorrect movements. The telerehabilitation system AGT-Reha was developed to support patients with shoulder diseases during their home-based aftercare rehabilitation.

Objectives The presented pilot study AGT-Reha-P2 evaluates the technical feasibility and user acceptance of the home-based telerehabilitation system AGT-Reha.

Methods A nonblinded, nonrandomized exploratory feasibility study was conducted over a 2-year period in patients' homes. Twelve patients completed a 3-month telerehabilitation exercise program with AGT-Reha. Primary outcome measures are the satisfying technical functionality and user acceptance assessed by technical parameters, structured interviews, and a four-dimensional questionnaire. Secondary endpoints are the medical rehabilitation success measured by the active range of motion and the shoulder function (pain and disability) assessed by employing the Neutral-0 Method and the standardized questionnaire “Shoulder Pain and Disability Index” (SPADI), respectively. To prepare an efficacy trial, various standardized questionnaires were included in the study to measure ability to work, capacity to work, and subjective prognosis of work capacity. The participants have been assessed at three measurement points: prebaseline (admission to rehabilitation center), baseline (discharge from rehabilitation center), and posttherapy.

Results Six participants used the first version of AGT-Reha, while six other patients used an improved version. Despite minor technical problems, all participants successfully trained on their own with AGT-Reha at home. On average, participants trained at least once per day during their training period. Five of the 12 participants showed clinically relevant improvements of shoulder function (improved SPADI score > 11). The work-related parameters suggested a positive impact. All participants would recommend the system, ten participants would likely reuse it, and seven participants would have wanted to continue their use after 3 months.

Conclusion The findings show that home-based training with AGT-Reha is feasible and well accepted. Outcomes of SPADI indicate the effectiveness of aftercare with AGT-Reha. A controlled clinical trial to test this hypothesis will be conducted with a larger number of participants.

Publication History

Received: 30 October 2019

Accepted: 14 May 2020

Publication Date:
10 August 2020 (online)

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Stuttgart · New York

中文翻译：

肩部远程康复的健康促进技术：可行性和用户接受度研究。

摘要

背景从康复中心出院后，必须继续治疗以确保已经取得的愈合进展并维持（重新）融入工作生活。为此，经常规定以家庭为基础的锻炼计划。然而，许多患者没有按照规定的频率进行锻炼，甚至没有以不正确的动作进行锻炼。远程康复系统 AGT-Reha 的开发是为了支持肩部疾病患者在家进行康复治疗。

目标所提出的试点研究 AGT-Reha-P2 评估了家庭远程康复系统 AGT-Reha 的技术可行性和用户接受度。

方法在患者家中进行了一项为期 2 年的非盲法、非随机探索性可行性研究。12 名患者使用 AGT-Reha 完成了为期 3 个月的远程康复锻炼计划。主要结果指标是通过技术参数、结构化访谈和四维问卷评估的令人满意的技术功能和用户接受度。次要终点是通过分别采用 Neutral-0 方法和标准化问卷“肩痛和残疾指数”（SPADI）评估的主动运动范围和肩部功能（疼痛和残疾）衡量的医疗康复成功率。为了准备功效试验，研究中包括了各种标准化问卷，以测量工作能力、工作能力和工作能力的主观预测。

结果六名参与者使用了 AGT-Reha 的第一个版本，而其他六名患者使用了改进版本。尽管存在轻微的技术问题，但所有参与者都成功地在家中使用 AGT-Reha 进行了培训。平均而言，参与者在训练期间每天至少训练一次。12 名参与者中有 5 名表现出临床相关的肩部功能改善（改善的 SPADI 评分 > 11）。与工作相关的参数表明产生了积极影响。所有参与者都会推荐该系统，10 名参与者可能会重复使用它，7 名参与者希望在 3 个月后继续使用。

结论研究结果表明，使用 AGT-Reha 进行的家庭培训是可行的并且被广泛接受。SPADI 的结果表明 AGT-Reha 术后护理的有效性。将在更多参与者中进行一项对照临床试验来检验这一假设。