Effectiveness and efficiency of telerehabilitation on functionality after spinal cord injury: A matched case-control study
Corresponding Author
Alejandro García-Rudolph PhD
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Correspondence
Alejandro García-Rudolph, Department of Research and Innovation, Institut Guttmann, Hospital de Neurorehabilitació, Barcelona, Spain.
Email: [email protected]
Search for more papers by this authorMark Andrew Wright MSc
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorCarlos Yepes MSc
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorNarda Murillo PhD
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorLucas Conesa MSc
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorIgnasi Soriano MSc
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorRaquel Bautista MSc
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorEloy Opisso PhD
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorJosep Maria Tormos PhD
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorJosep Medina PhD
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorCorresponding Author
Alejandro García-Rudolph PhD
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Correspondence
Alejandro García-Rudolph, Department of Research and Innovation, Institut Guttmann, Hospital de Neurorehabilitació, Barcelona, Spain.
Email: [email protected]
Search for more papers by this authorMark Andrew Wright MSc
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorCarlos Yepes MSc
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorNarda Murillo PhD
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorLucas Conesa MSc
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorIgnasi Soriano MSc
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorRaquel Bautista MSc
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorEloy Opisso PhD
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorJosep Maria Tormos PhD
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorJosep Medina PhD
Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
Universitat Autònoma de Barcelona, Bellaterra, Spain
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
Search for more papers by this authorAbstract
Background
Telerehabilitation in spinal cord injury (teleSCI) is a growing field that can improve access to care and health outcomes in patients with spinal cord injury (SCI). The clinical effectiveness of teleSCI is not known.
Objectives
To compare independence in activities of daily living and mobility capacity in patients following teleSCI and matched controls undergoing traditional rehabilitation.
Design
Matched case–control study.
Setting
TeleSCI occurring in home setting (cases) versus traditional rehabilitation on inpatient unit (controls).
Participants
Forty-two consecutive patients with SCI followed with teleSCI were compared to 42 historical rehabilitation inpatients (controls) matched for age, time since injury to rehabilitation admission, level of injury (paraplegia/tetraplegia), complete or incomplete injury, and etiology (traumatic/nontraumatic). The teleSCI group (n = 42) was also compared to the complete cohort of historical controls (n = 613).
Interventions
The teleSCI group followed home-based telerehabilitation (3.5 h/day, 5 days/week, 67 days average duration) and historical controls followed in-person rehabilitation.
Main Outcome Measure(s)
The Functional Independence Measure (FIM), the Spinal Cord Independence Measure (SCIM) and the Walking Index for Spinal Cord Injury (WISCI). We formally compared gains, efficiency and effectiveness. International Standards for Neurological Classification of Spinal Cord Injury and the American Spinal Injury Association Impairment Scale (AIS) were used.
Results
The teleSCI group (57.1% nontraumatic, 71.4% paraplegia, 73.8% incomplete, 52.4% AIS grade D) showed no significant differences compared with historical controls in AIS grades, neurological levels, duration, gains, efficiency and effectiveness in FIM, SCIM, or WISCI, although the teleSCI cohort had significantly higher admission FIM scores compared with the complete cohort of historical controls.
Conclusions
TeleSCI may provide similar improvements in mobility and functional outcomes as traditional rehabilitation in medically stable patients (predominantly with paraplegia and motor incomplete SCI) when provided with appropriate support and equipment.
Supporting Information
| Filename | Description |
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| pmrj13125-sup-0001-supinfo.pdfPDF document, 2 MB | Figure SM1. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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