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      An Affordable, User-friendly Telerehabilitation System Assembled Using Existing Technologies for Individuals Isolated With COVID-19: Development and Feasibility Study

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          Abstract

          Background

          Isolation due to a COVID-19 infection can limit activities and cause physical and mental decline, especially in older adults and people with disabilities. However, due to limited contact, adequate rehabilitation is difficult to provide for quarantined patients. Telerehabilitation technology could be a solution; however, issues specific to COVID-19 should be taken into consideration, such as strict quarantine and respiratory symptoms, as well as accessibility to deal with rapid increases in need due to the pandemic.

          Objective

          This study aims to develop and to investigate the feasibility of a telerehabilitation system for patients who are quarantined due to COVID-19 by combining existing commercial devices and computer applications.

          Methods

          A multidisciplinary team has identified the requirements for a telerehabilitation system for COVID-19 and developed the system to satisfy those requirements. In the subsequent feasibility study, patients diagnosed with COVID-19 (N=10; mean age 60 years, SD 18 years) were included. A single session of telerehabilitation consisted of stretching exercises, a 15-minute exercise program, and a video exercise program conducted under real-time guidance by a physical therapist through a video call. The system included a tablet computer, a pulse oximeter, videoconferencing software, and remote control software. The feasibility of the system was evaluated using the Telemedicine Satisfaction Questionnaire (TSQ; 14 items) and an additional questionnaire on the telerehabilitation system (5 items). Each item was rated from “1 = strongly disagree” to “5 = strongly agree.”

          Results

          The telerehabilitation system was developed by combining existing devices and applications, including a pulse oximeter and remote control mechanism, to achieve user-friendliness, affordability, and safety, which were determined as the system requirements. In the feasibility study, 9 out of 10 patients were able to use the telerehabilitation system without any on-site help. On the TSQ, the mean score for each item was 4.7 (SD 0.7), and in the additional items regarding telerehabilitation, the mean score for each item was 4.3 (SD 1.0).

          Conclusions

          These findings support the feasibility of this simple telerehabilitation system in quarantined patients with COVID-19, encouraging further investigation on the merit of the system’s use in clinical practice.

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          Most cited references24

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          The functional independence measure: a new tool for rehabilitation.

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            Impact of Social Isolation Due to COVID-19 on Health in Older People: Mental and Physical Effects and Recommendations

            Objectives To review the impact of social isolation during COVID-19 pandemic on mental and physical health of older people and the recommendations for patients, caregivers and health professionals. Design Narrative review. Setting Non-institutionalized community-living people. Participants 20.069 individuals from ten descriptive cross-sectional papers. Measurements Articles since 2019 to 2020 published on Pubmed, Scielo and Google Scholar databases with the following MeSh terms (‘COVID-19’, ‘coronavirus’, ‘aging’, ‘older people’, ‘elderly’, ‘social isolation’ and ‘quarantine’) in English, Spanish or Portuguese were included. The studies not including people over 60 were excluded. Guidelines, recommendations, and update documents from different international organizations related to mental and physical activity were also analysed. Results 41 documents have been included in this narrative review, involving a total of 20.069 individuals (58% women), from Asia, Europe and America. 31 articles included recommendations and 10 addressed the impact of social distancing on mental or physical health. The main outcomes reported were anxiety, depression, poor sleep quality and physical inactivity during the isolation period. Cognitive strategies and increasing physical activity levels using apps, online videos, telehealth, are the main international recommendations. Conclusion Mental and physical health in older people are negatively affected during the social distancing for COVID-19. Therefore, a multi component program with exercise and psychological strategies are highly recommended for this population during the confinement. Future investigations are necessary in this field.
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              Home-based telerehabilitation is not inferior to a centre-based program in patients with chronic heart failure: a randomised trial

              Is a 12-week, home-based telerehabilitation program conducted in small groups non-inferior to a traditional centre-based program in terms of the change in 6-minute walk distance? Is the telerehabilitation program also non-inferior to a centre-based program in terms of functional capacity, muscle strength, quality of life, urinary incontinence, patient satisfaction, attendance rates, and adverse events?
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                Author and article information

                Contributors
                Journal
                JMIR Rehabil Assist Technol
                JMIR Rehabil Assist Technol
                JRAT
                JMIR Rehabilitation and Assistive Technologies
                JMIR Publications (Toronto, Canada )
                2369-2529
                Jul-Dec 2020
                10 December 2020
                10 December 2020
                : 7
                : 2
                : e24960
                Affiliations
                [1 ] Department of Rehabilitation Medicine I School of Medicine Fujita Health University Toyoake Japan
                [2 ] Faculty of Rehabilitation School of Health Sciences Fujita Health University Toyoake Japan
                [3 ] Department of Rehabilitation Fujita Health University Hospital Toyoake Japan
                Author notes
                Corresponding Author: Yohei Otaka otaka119@ 123456mac.com
                Author information
                https://orcid.org/0000-0003-4348-8715
                https://orcid.org/0000-0001-8952-1651
                https://orcid.org/0000-0002-8068-1322
                https://orcid.org/0000-0003-1993-5896
                https://orcid.org/0000-0002-5583-0904
                https://orcid.org/0000-0001-5069-6198
                https://orcid.org/0000-0002-6797-2782
                Article
                v7i2e24960
                10.2196/24960
                7732353
                33279877
                b4008066-5897-4f8c-8d26-57eb190a4c46
                ©Masahiko Mukaino, Tsuyoshi Tatemoto, Nobuhiro Kumazawa, Shigeo Tanabe, Masaki Katoh, Eiichi Saitoh, Yohei Otaka. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 10.12.2020.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Rehabilitation and Assistive Technology, is properly cited. The complete bibliographic information, a link to the original publication on http://rehab.jmir.org/, as well as this copyright and license information must be included.

                History
                : 13 October 2020
                : 4 November 2020
                : 17 November 2020
                : 5 December 2020
                Categories
                Original Paper
                Original Paper

                telerehabilitation,covid-19,telemedicine,isolation,user-friendly,feasibility,rehabilitation,ehealth

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