Introducing remote physical rehabilitation for patients with chronic disorders by means of telemedicine

Abstract

This study involved an evaluation of a telemedicine service implemented as a partial replacement of a physical outpatient rehabilitation program. The telemedicine service was an exercise-based tele-rehabilitation service facilitating remote physical rehabilitation for patients suffering from chronic lower back pain or pulmonary disease. Effectiveness was evaluated with multiple outcomes on quality (complaints, disability and physical condition) and access (usability, satisfaction and motivational character of the service). Patients referred by their rehabilitation physician to a physical outpatient rehabilitation program between October 2009 and May 2010 were asked to participate in the control group. Patients referred to the program between June 2010 and December 2011 were asked to participate in the intervention group. The control group received the conventional rehabilitation program. The intervention group received the rehabilitation program in which telemedicine was used as partial replacement of face to face care. Instead of 3 visits per week to the clinic as was being carried out in conventional care, patients visited the outpatient rehabilitation clinic for 2 days and they were instructed to exercise at least 1 day in their own environment using the exercise-based tele-rehabilitation service. One hundred and eighteen patients were included in this study: 38 patients in the control group and 80 patients in the intervention group. Both groups equally benefit from the outpatient rehabilitation program. There were no significant differences between the groups. The usability (system usability scale sore of 71.2 (SD 15.0; n=47), satisfaction (average rate 6.0 (SD 2.0; n=55), and level of motivation of the exercisebased tele-rehabilitation service were sufficient, but slightly disappointing. The telemedicine supported the outpatient rehabilitation program as partial replacement of face to face care was as effective as the conventional outpatient rehabilitation program.