Professor Birthe Dinesen has written a chapter on the research project: “Future Patient – telerehabilitation of patients with heart failure” in the Japanese book on “Telenursing – Theory and Practice”.
The chapter describe the project and results from an RCT study: Increased quality of life, increased motivation and empowerment of patients.
Today the online newspaper “Avisen Danmark” has an article on results from the research study iTrain focusing on tele-rehabilitation of COPD patients in their own homes over a two-year period.
The study was carried out simultaneously in Denmark, Norway and Australia. The objective was to compare three types of rehabilitation for patients with COPD in the three countries.
In Denmark, the study was conducted as a collaboration between the Esbjerg Health Center, the Pulmonary Medicine Department of Southwest Jutland Hospital and Aalborg University.
The research project was headed by professor Paolo Zanaboni, Norwegian Center for e-Health research, Norway, professor Anne Holland, Monash University, Melbourne, Australia and professor Birthe Dinesen, Aalborg University. The study was financed by the Norwegian Research Council.
Long-term unsupervised exercise training at home is an effective treatment strategy which can reduce hospital readmissions for patients with COPD, similarly to the effect of a supervised telerehabilitation strategy. These interventions have the potential to improve uptake and access to pulmonary rehabilitation and support long-term exercise maintenance strategies. Unsupervised training at home could be offered to patients with COPD who do not access PR or maintenance programs. Telerehabilitation may be useful for patients who are unsuitable for unsupervised training and need a closer follow-up.
We have had our results published in the well estimated journal: ”American Journal of Respiratory and Critical Care Medicine”. You can read the paper here.
You can read more about the project here.
The project is a collaboration between Denmark, Norway and Australia. In Denmark the Pulmonary ward of Esbjerg Hospital and Esbjerg Healthcare Center has participated in the clinical part of the study. The Norwegian Research Council of Norway has financed the study.
Results from study with persons with dementia and the social robot LOVOT has been published in the international journal: JMIR Rehabilitation and Assistive Technologies.
The conclusion of the study is:
Read the full article: “Use of a Social Robot (LOVOT) for Persons With Dementia: Exploratory Study“.
Commercially available active video games (AVGs) have recently been used for rehabilitation in some specific patient populations but rarely in those with cardiovascular disease (CVD). Commercially available AVGs are designed to increase motivation for continuous play, which could be applicable to the long-term cardiac rehabilitation process.
To assess the effectiveness of AVG-induced physical exercise, safety management, and patient adherence by applying commercially available AVGs to cardiac rehabilitation.
Scoping review
Among 120 nonduplicate articles reviewed, 5 (4.2%) were eligible for inclusion, of which 3 (2.5%) were reported by the same research group. The AVG consoles used were Xbox Kinect and Nintendo Wii, and sports-related programs were adopted for the intervention. No adverse cardiac events occurred in the identified studies, and dropout rates tended to be low.
AVGs appear to be safe and feasible for promoting an active lifestyle in patients with CVD. However, the effectiveness of AVGs alone as a therapeutic exercise to improve physical function may be limited.
Morimoto Y, Takahashi T, Sawa R, Saitoh M, Morisawa T, Kagiyama N, Kasai T, Dinesen B, Hollingdal M, Refsgaard J, Daida H
Web Portals for Patients With Chronic Diseases: Scoping Review of the Functional Features and Theoretical Frameworks of Telerehabilitation Platforms
J Med Internet Res 2022;24(1):e27759
doi: 10.2196/27759PMID: 35084355
Background: The COVID-19 pandemic has required an increased need for rehabilitation activities applicable to patients with chronic diseases. Telerehabilitation has several advantages, including reducing clinic visits by patients vulnerable to infectious diseases. Digital platforms are often used to assist rehabilitation services for patients in remote settings. Although web portals for medical use have existed for years, the technology in telerehabilitation remains a novel method.
Objective: This scoping review investigated the functional features and theoretical approaches of web portals developed for telerehabilitation in patients with chronic diseases.
Methods: PubMed and Web of Science were reviewed to identify articles associated with telerehabilitation. Of the 477 nonduplicate articles reviewed, 35 involving 14 portals were retrieved for the scoping review. The functional features, targeted diseases, and theoretical approaches of these portals were studied.
Results: The 14 portals targeted patients with chronic obstructive pulmonary disease, cardiovascular, osteoarthritis, multiple sclerosis, cystic fibrosis diseases, and stroke and breast cancer survivors. Monitoring/data tracking and communication functions were the most common, followed by exercise instructions and diary/self-report features. Several theoretical approaches, behavior change techniques, and motivational techniques were found to be utilized.
Conclusions: The web portals could unify and display multiple types of data and effectively provide various types of information. Asynchronous correspondence was more favorable than synchronous, real-time interactions. Data acquisition often required assistance from other digital tools. Various functions with patient-centered principles, behavior change strategies, and motivational techniques were observed for better support shifting to a healthier lifestyle. These findings suggested that web portals for telerehabilitation not only provided entrance into rehabilitation programs but also reinforced participant-centered treatment, adherence to rehabilitation, and lifestyle changes over time.
Effects of Telerehabilitation Interventions on Heart Failure Management (2015-2020): Scoping Review by Schacksen et al 2021 in JMIR Rehabil Assist Technol 2021;8(4):e29714.
The aim of this scoping review was to assess the effects of telerehabilitation in the management of heart failure by systematically reviewing the available scientific literature within the period from January 1, 2015, to December 31, 2020.
It was found that there is a tendency toward improvement in patients’ quality of life and physical capacity when telerehabilitation was used in heart failure management. The outcome measures of depression, anxiety, and adherence to the intervention were found to be positive. Additional research is needed to determine more precise and robust effects of telerehabilitation.
We have just published a new paper from the Future Patient – telerehabilitation of Heart Failure Patients trial:
Predictors of Walking Activity in Patients With Systolic Heart Failure Equipped With a Step Counter: Randomized Controlled Trial by Josefine Dam Gade et al.
Results: A higher walking activity was associated with younger age, lower New York Heart Association (NYHA) classification, and higher ejection fraction (EF). There was a statistically significant correlation between the number of daily steps and NYHA classification at baseline (P=.01), between the increase in daily steps and EF at baseline (P<.001), and between the increase in daily steps and improvement in EF (P=.005). The patients’ demographic, clinical, and activity data could predict 81% of the variation in daily steps.
Conclusions: This study demonstrated an association between demographic, clinical, and activity data for patients with HF that could predict daily steps. A step counter can thus be a useful tool to help patients monitor their own physical activity.
Collaboration between master students in Clinical Science and Technology, AAU, Aalborg Municipality & Ory Lab, Japan:
The telepresence avatar robot OriHime as a communication tool for adults with acquired brain injury: an ethnographic case study
We conducted an exploratory ethnographic case study, applying the framework ‘community of practice.’ The intervention consisted of sessions where ABI patients at home interacted with a member from Aalborg Rehabilitation Club using OriHime. Data collection consisted of documentary materials, participant observations and semi-structured interviews.
Findings: The patients at home found nonverbal communication valuable, while the members at the rehabilitation center felt that OriHime lacked human features and preferred direct verbal communication. The technology facilitated a feeling of being a part of a community of practice between the participants, and it motivated the patients at home to participate in the rehabilitating activities at the center.
Reference: Vikkelsø, S., Hoang, T-H., Carrara, F., Hansen, K. D., & Dinesen, B. (2020). The telepresence avatar robot OriHime as a communication tool for adults with acquired brain injury: an ethnographic case study. Intelligent Service Robotics.
https://doi.org/10.1007/s11370-020-00335-6
A Focused Review of Technologies and Teleservices
A review of service delivery and technologies in telerehabilitation programs for patients with knee osteoarthritis has been performed since the year of 2000. The conclusion is that video-based telerehabilitation programs can be considered the best alternative solution to conventional treatment. Sensor-based solutions have also become more popular due to rapid developments in sensor technology. Communication and human-generated feedback remain as important as monitoring and intervention services.