Patients' satisfaction of healthcare services and perception with in-home telerehabilitation and physiotherapists' satisfaction toward technology for post-knee arthroplasty: an embedded study in a randomized trial. Agreement Between Telerehabilitation and Face-to-Face Clinical Outcome Assessments for Low Back Pain in Primary Care Internet-based outpatient telerehabilitation for patients following total knee arthroplasty: a randomized controlled trial. Telerehabilitation to improve outcomes for people with stroke: study protocol for a randomised controlled trial Validity of a brief outpatient functional assessment measure. Study protocol: home-based telehealth stroke care: a randomized trial for veterans INVITED COMMENTARY: Rating the Quality of Trials in Systematic Reviews of Physical Therapy Interventions On the reliability and validity of manual muscle testing: a literature review Long-term integrated telerehabilitation of COPD Patients: a multicentre randomised controlled trial (iTrain) Low-bandwidth telerehabilitation for patients who have undergone total knee replacement: Preliminary results Effectiveness, usability, and cost-benefit of a virtual reality-based telerehabilitation program for balance recovery after stroke: a randomized controlled trial. Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke. Home-based telerehabilitation shows improved upper limb function in adults with chronic stroke: a pilot study. Virtual Reality Telerehabilitation for Postural Instability in Parkinson's Disease: A Multicenter, Single-Blind, Randomized, Controlled Trial Evaluation of a comprehensive rehabilitation program for post-treatment patients with cancer. Quality of life in heart failure patients undergoing home-based telerehabilitation versus outpatient rehabilitation – a randomized controlled study Telehealth system (e-CUIDATE) to improve quality of life in breast cancer survivors: rationale and study protocol for a randomized clinical trial
OBJECTIVE We measured the satisfaction of both patients and healthcare professionals with the technologies and services provided during in-home telerehabilitation as an alternative to conventional rehabilitation after discharge from total knee arthroplasty surgery . METHODS This study was embedded in a larger controlled trial where 48 community-living older adults who received total knee arthroplasty were recruited prior to discharge from acute care following surgery and r and omly assigned to treatment arms ( Tele and Comparison ) . The participants ' satisfaction with the services was assessed at the end of the intervention for both groups using the Healthcare Satisfaction Question naire . For the Tele group , the patients ' perception of in-home telehealth was assessed before treatment and after completion of teletreatments . The satisfaction of the healthcare professionals with the technology during the telerehabilitation services was noted at the end of each treatment session using a technical quality subjective appreciation question naire . RESULTS Both groups of patients ( Tele and Comparison ) were satisfied with the services received and no significant difference was observed between them . Moreover , the physiotherapists ' satisfaction with regard to goal achievement , patient-therapist relationship , overall session satisfaction , and quality and performance of the technological platform was high . CONCLUSIONS As patient satisfaction is important in maintaining motivation and treatment compliance and the satisfaction of healthcare professionals must be high in order for new treatments to become mainstream in clinics , the results show that in-home telerehabilitation seems to be a promising alternative to traditional face-to-face treatments Study Design . A descriptive study of repeated measures using a crossover design . Objective . To determine the level of agreement between assessment s obtained via telerehabilitation and those obtained by traditional face-to-face method in a population of individuals with chronic low back pain ( LBP ) in a primary care setting . Summary of Background Data . Musculoskeletal assessment using telerehabilitation has shown adequate inter- and intrarater agreement and concordance with face-to-face clinical assessment in different diseases . There have been no published studies on the reliability of a telerehabilitation system to assess LBP . Methods . Fifteen individuals ( 6 males ; mean age , 37 yr ) with chronic LBP attended a session for a clinical interview , followed by face-to-face and real-time online telerehabilitation evaluations . There was a 30-minute interval between the 2 assessment s , the order of which was r and omly selected for each patient . The telerehabilitation system used an Internet application conducted via Internet connection ( 17 kB/s ) between 2 personal computers . Real-time video connection facilitated communication between the therapist and the subject . Outcome measures included lumbar spine mobility , Sorensen test , anterior straight leg raise test , Oswestry Disability Index , visual analogue scale for pain , 12-Item Short Form Health Survey question naire , and Tampa Kinesiophobia Scale . Results . The & agr ; reliability between face-to-face and telerehabilitation evaluations was more than 0.80 for 7 of the 9 outcome measures . Lowest reliability was for lateral flexion range of motion ( & agr;= 0.75 ) . Very good inter- and intrarater intraclass correlation coefficients ( & rgr ; ) were obtained ( 0.92–0.96 ) . Conclusion . The findings of our pilot study suggest that this telerehabilitation system may be useful to assess individuals with chronic LBP , providing initial support for its implementation in primary care . Level of Evidence : BACKGROUND total knee arthroplasty is an effective means for relieving the symptoms associated with degenerative arthritis of the knee . Rehabilitation is a necessary adjunct to surgery and is important in regaining optimum function . Access to high- quality rehabilitation services is not always possible , especially for those who live in rural or remote areas . The aim of this study was to evaluate the equivalence of an Internet-based telerehabilitation program compared with conventional outpatient physical therapy for patients who have had a total knee arthroplasty . METHODS this investigation was a single-blinded , prospect i ve , r and omized , controlled noninferiority trial . Sixty-five participants were r and omized to receive a six-week program of outpatient physical therapy either in the conventional manner or by means of an Internet-based telerehabilitation program . The primary outcome measure was the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) measured at baseline and six weeks by a blinded independent assessor . Secondary outcomes included the Patient-Specific Functional Scale , the timed up- and -go test , pain intensity , knee flexion and extension , quadriceps muscle strength , limb girth measurements , and an assessment of gait . Noninferiority was assessed through the comparison of group differences with a noninferiority margin and with linear mixed model statistics . RESULTS baseline characteristics between groups were similar , and all participants had significant improvement on all outcome measures with the intervention ( p < 0.01 for all ) . After the six-week intervention , participants in the telerehabilitation group achieved outcomes comparable to those of the conventional rehabilitation group with regard to flexion and extension range of motion , muscle strength , limb girth , pain , timed up- and -go test , quality of life , and clinical gait and WOMAC scores . Better outcomes for the Patient-Specific Functional Scale and the stiffness subscale of the WOMAC were found in the telerehabilitation group ( p < 0.05 ) . The telerehabilitation intervention was well received by participants , who reported a high level of satisfaction with this novel technology . CONCLUSIONS the outcomes achieved via telerehabilitation at six weeks following total knee arthroplasty were comparable with those after conventional rehabilitation . LEVEL OF EVIDENCE therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence Background In New Zeal and , around 45,000 people live with stroke and many studies have reported that benefits gained during initial rehabilitation are not sustained . Evidence indicates that participation in physical interventions can prevent the functional decline that frequently occurs after discharge from acute care facilities . However , on-going stroke services provision following discharge from acute care is often related to non-medical factors such as availability of re sources and geographical location . Currently most people receive no treatment beyond three months post stroke . The study aims to determine if the Augmented Community Telerehabilitation Intervention ( ACTIV ) results in better physical function for people with stroke than usual care , as measured by the Stroke Impact Scale , physical subcomponent . Methods / design This study will use a multi-site , two-arm , assessor blinded , parallel r and omised controlled trial design . People will be eligible if they have had their first ever stroke , are over 20 and have some physical impairment in either arm or leg , or both . Following discharge from formal physiotherapy services ( inpatient , outpatient or community ) , participants will be r and omised into ACTIV or usual care . ACTIV uses readily available technology , telephone and mobile phones , combined with face-to-face visits from a physiotherapist over a six-month period , to help people with stroke resume activities they enjoyed before the stroke . The impact of stroke on physical function and quality of life will be assessed , measures of cost will be collected and a discrete choice survey will be used to measure preferences for rehabilitation options . These outcomes will be collected at baseline , six months and 12 months . In-depth interviews will be used to explore the experiences of people participating in the intervention arm of the study . Discussion The lack of on-going rehabilitation for people with stroke diminishes the chance of their best possible outcome and may contribute to a functional decline following discharge from formal rehabilitation . Best practice guidelines recommend a prolonged period of rehabilitation , however this is expensive and therefore not undertaken in most publicly funded centres . An effective , cost-effective , and preference-sensitive therapy using basic technology to assist programme delivery may improve patient autonomy as they leave formal rehabilitation and return home . Trial registration Aspects of validity are investigated with a brief functional assessment measure among out patients undergoing rehabilitation for musculoskeletal problems . The Medical Rehabilitation Follow Along measure ( MRFA ) currently has screening , musculoskeletal , neurologic , and multiple sclerosis forms . In this study , the 31-item musculoskeletal form of the MRFA is compared with and contrasted to a measure of general health status , the Medical Outcomes Trust SF-36 . Content , construct , and criterion validity are addressed using scale scores before ( n = 94 ) and after ( n = 48 ) outpatient rehabilitation .  Scale scores are compared with therapists ' ratings of improvement . The results provide support for the validity of inferences made from scale scores of the MRFA for persons with musculoskeletal problems . Applications of the MRFA , including screening , monitoring , and outcome assessment are discussed for clinical management , measuring treatment effectiveness , and program evaluation Background Stroke is one of the most disabling and costly impairments of adulthood in the United States . Stroke patients clearly benefit from intensive inpatient care , but due to the high cost , there is considerable interest in implementing interventions to reduce hospital lengths of stay . Early discharge rehabilitation programs require coordinated , well-organized home-based rehabilitation , yet lack of sufficient information about the home setting impedes successful rehabilitation . This trial examines a multifaceted telerehabilitation ( TR ) intervention that uses telehealth technology to simultaneously evaluate the home environment , assess the patient 's mobility skills , initiate rehabilitative treatment , prescribe exercises tailored for stroke patients and provide periodic goal oriented re assessment , feedback and encouragement . Methods We describe an ongoing Phase II , 2-arm , 3-site r and omized controlled trial ( RCT ) that determines primarily the effect of TR on physical function and secondarily the effect on disability , falls-related self-efficacy , and patient satisfaction .  Fifty participants with a diagnosis of ischemic or hemorrhagic stroke will be r and omly assigned to one of two groups : ( a ) TR ; or ( b ) Usual Care . The TR intervention uses a combination of three videotaped visits and five telephone calls , an in-home messaging device , and additional telephonic contact as needed over a 3-month study period , to provide a progressive rehabilitative intervention with a treatment goal of safe functional mobility of the individual within an accessible home environment . Dependent variables will be measured at baseline , 3- , and 6-months and analyzed with a linear mixed-effects model across all time points . Discussion For patients recovering from stroke , the use of TR to provide home assessment s and follow-up training in prescribed equipment has the potential to effectively supplement existing home health services , assist transition to home and increase efficiency . This may be particularly relevant when patients live in remote locations , as is the case for many veterans . Trial Registration Clinical Trials.gov Identifier : & NA ; Physical therapists seeking to use evidence to guide their practice may have limited time to read research reports . One way to reduce the time required to identify and read about the research that is relevant to a particular clinical question is to read a systematic review that summarizes multiple studies . This paper explains the process that is used to conduct systematic review s , which includes the establishment of a protocol , comprehensive search ing , appraisal of the quality of the included studies , data extraction and meta analysis , and consideration of the clinical and research implication s of the findings . We also consider how the reader of a systematic review can determine whether the review is likely to provide an unbiased ( believable ) estimate of the treatment effect . A systematic review of r and omized trials of a  cardiopulmonary physical therapy intervention is used as an example . The issue of appraisal of quality is then discussed further , with a demonstration of how one vali date d tool for quality appraisal ‐‐the PEDro scale‐‐can be used to evaluate a r and omized trial in cardiopulmonary physical therapy INTRODUCTION A body of basic science and clinical research has been generated on the manual muscle test ( MMT ) since its first peer- review ed publication in 1915 . The aim of this report is to provide an historical overview , literature review , description , synthesis and critique of the reliability and validity of MMT in the evaluation of the musculoskeletal and nervous systems . METHODS Online re sources were search ed including Pubmed and CINAHL ( each from inception to June 2006 ) . The search terms manual muscle testing or manual muscle test were used . Relevant peer- review ed studies , commentaries , and review s were selected . The two review ers assessed data quality independently , with selection st and ards based on predefined method ologic criteria . Studies of MMT were categorized by research content type : inter- and intraexaminer reliability studies , and construct , content , concurrent and predictive validity studies . Each study was review ed in terms of its quality and contribution to knowledge regarding MMT , and its findings presented . RESULTS More than 100 studies related to MMT and the applied kinesiology chiropractic technique ( AK ) that employs  MMT  in its methodology were review ed , including studies on the clinical efficacy of MMT  in the diagnosis of patients with symptomatology . With regard to analysis there is evidence for good reliability and validity in the use of MMT for patients with neuromusculoskeletal dysfunction . The observational cohort studies demonstrated good external and internal validity , and the 12 r and omized controlled trials ( RCTs ) that were review ed show that MMT findings were not dependent upon examiner bias . CONCLUSION The MMT employed by chiropractors , physical therapists , and neurologists was shown to be a clinical ly useful tool , but its ultimate scientific validation and application requires testing that employs sophisticated research models in the areas of neurophysiology , biomechanics , RCTs , and statistical analysis Background Pulmonary rehabilitation ( PR ) is an effective intervention for the management of people with chronic obstructive pulmonary disease ( COPD ) . However , available re sources are often limited , and many patients bear with poor availability of programmes . Sustaining PR benefits and regular exercise over the long term is difficult without any exercise maintenance strategy . In contrast to traditional centre-based PR programmes , telerehabilitation may promote more effective integration of exercise routines into daily life over the longer term and broaden its applicability and availability . A few studies showed promising results for telerehabilitation , but mostly with short-term interventions . The aim of this study is to compare long-term telerehabilitation with unsupervised exercise training at home and with st and ard care . Methods / Design An international multicentre r and omised controlled trial conducted across sites in three countries will recruit 120 patients with COPD . Participants will be r and omly assigned to telerehabilitation , treadmill and control , and followed up for 2 years . The telerehabilitation intervention consists of individualised exercise training at home on a treadmill , telemonitoring by a physiotherapist via videoconferencing using a tablet computer , and self-management via a customised website . Patients in the  treadmill  arm are provided with a treadmill only to perform unsupervised exercise training at home . Patients in the control arm are offered st and ard care . The primary outcome is the combined number of hospitalisations and emergency department presentations . Secondary outcomes include changes in health status , quality of life , anxiety and depression , self-efficacy , subjective impression of change , physical performance , level of physical activity , and personal experiences in telerehabilitation . Discussion This trial will provide evidence on whether long-term telerehabilitation represents a cost-effective strategy for the follow-up of patients with COPD . The delivery of telerehabilitation services will also broaden the availability of PR and maintenance strategies , especially to those living in remote areas and with no access to centre-based exercise programmes . Trial registration Clinical Trials.gov : NCT02258646 summary We have developed a low-b and width , Internet-based telerehabilitation system to provide outpatient rehabilitation to patients who have undergone total knee arthroplasty . The preliminary efficacy of this treatment programme in terms of both physical and functional objective outcome measures was assessed on 21 patients . Subjects receiving a six-week rehabilitation programme were r and omized to the telerehabilitation system or the usual face-to-face method .  The physical and functional improvements in the telerehabilitation group were similar to those in the control group . There was a non-significant trend for greater improvements in the telerehabilitation group for most outcome measurements . The telerehabilitation programme was well received by patients . The results of this study provide evidence for the efficacy of low-b and width telerehabilitation consultations OBJECTIVES First , to evaluate the clinical effectiveness of a virtual reality (VR)-based telerehabilitation program in the balance recovery of individuals with hemiparesis after stroke in comparison with an in-clinic program ; second , to compare the subjective experiences ; and third , to contrast the costs of both programs . DESIGN Single-blind , r and omized , controlled trial . SETTING Neurorehabilitation unit . PARTICIPANTS Chronic out patients with stroke ( N=30 ) with residual hemiparesis . INTERVENTIONS Twenty 45-minute training sessions with the telerehabilitation system , conducted 3 times a week , in the clinic or in the home . MAIN OUTCOME MEASURES First , Berg Balance Scale for balance assessment . The Performance-Oriented Mobility Assessment balance and gait subscales , and the Brunel Balance Assessment were secondary outcome measures . Clinical assessment s were conducted at baseline , 8 weeks ( posttreatment ) , and 12 weeks ( follow-up ) . Second , the System Usability Scale and the Intrinsic Motivation Inventory for subjective experiences . Third , cost ( in dollars ) . RESULTS Significant improvement in both groups ( in-clinic group [ control ] and a home-based telerehabilitation group ) from the initial to the final assessment in the Berg Balance Scale ( ηp(2)=.68 ; P=.001 ) , in the balance ( ηp(2)=.24 ; P=.006 ) and gait ( ηp(2)=.57 , P=.001 ) subscales of the Tinetti Performance-Oriented Mobility Assessment , and in the Brunel Balance Assessment ( control : χ(2)=15.0 ; P=.002 ; experimental : χ(2)=21.9 ; P=.001 ) . No significant differences were found between the groups in any balance scale or in the feedback question naires . With regard to subjective experiences , both groups considered the VR system similarly usable and motivating . The in-clinic intervention result ed in more expenses than did the telerehabilitation intervention ( $ 654.72 per person ) . CONCLUSIONS First , VR-based telerehabilitation interventions can promote the reacquisition of locomotor skills associated with balance in the same way as do in-clinic interventions , both complemented with a conventional therapy program ; second , the usability of and motivation to use the 2 interventions can be similar ; and third , telerehabilitation interventions can involve savings that vary depending on each scenario BACKGROUND AND PURPOSE The purpose of this study was to establish the interrater reliability of assessment s made with the Fugl-Meyer evaluation of physical performance in a rehabilitation setting . SUBJECTS Twelve patients ( 7 male , 5 female ) , aged 49 to 86 years ( mean = 66 ) , who had sustained a cerebrovascular accident participated in the study . All patients were admitted consecutively to a rehabilitation center and were between 6 days and 6 months poststroke . METHODS Three physical therapists , each with more than 10 years of experience , assessed the patients in a r and omized and balanced order using this assessment . The therapists st and ardized the assessment approach prior to the study but did not discuss the procedure once the study began . RESULTS The overall reliability was high ( overall intraclass correlation coefficient = .96 ) , and the intraclass correlation coefficients for the subsections of the assessment varied from .61 for pain to .97 for the upper extremity . CONCLUSION AND DISCUSSION The relative merits of using the Fugl-Meyer assessment as a research tool versus a clinical assessment for stroke are discussed OBJECTIVE This pilot study investigates the use of telerehabilitation to improve upper limb performance in chronic stages of stroke recovery . DESIGN Intervention study with pre/post/one month follow-up tests . METHODS Seven adults with chronic stroke participated in the study . Tests consisted of lab-based clinical and kinematic assessment s. Participants completed the Upper Limb Training and Assessment ( ULTrA ) program at home . Training was 5 days/week , 60 min/day for 6 weeks with intermittent supervision of participants . RESULTS Participants showed improvements in the training program tasks as well as clinical and kinematic assessment s. Results also suggest there may be auxiliary benefits in cognitive function . CONCLUSIONS A home-based telerehabilitation program is a viable approach to provide rehabilitation in chronic stages of stroke Introduction Telerehabilitation enables patients to access remote rehabilitation services for patient-physiotherapist videoconferencing in their own homes . Home-based virtual reality ( VR ) balance training has been shown to reduce postural instability in patients with Parkinson 's disease ( PD ) . The primary aim was to compare improvements in postural stability after remotely supervised in-home VR balance training and in-clinic sensory integration balance training ( SIBT ) . Methods In this multicenter study , 76 PD patients ( modified Hoehn and Yahr stages 2.5–3 ) were r and omly assigned to receive either in-home VR telerehabilitation ( n = 38 ) or in-clinic SIBT ( n = 38 ) in 21 sessions of 50 minutes each , 3 days/week for 7 consecutive weeks . VR telerehabilitation consisted of grade d exergames using the Nintendo Wii Fit system ; SIBT included exercises to improve postural stability . Patients were evaluated before treatment , after treatment , and at 1-month follow-up . Results Analysis revealed significant between-group differences in improvement on the Berg Balance Scale for the VR telerehabilitation group ( p = 0.04 ) and significant Time × Group interactions in the Dynamic Gait Index ( p = 0.04 ) for the in-clinic group . Both groups showed differences in all outcome measures over time , except for fall frequency . Cost comparison yielded between-group differences in treatment and equipment costs . Conclusions VR is a feasible alternative to in-clinic SIBT for reducing postural instability in PD patients having a caregiver PURPOSE / OBJECTIVES To evaluate the effects of a rehabilitation program on quality of life , fatigue , fear of movement ( kinesiophobia ) , distress , anxiety , depression , and physical condition . DESIGN Pretest/post-test . SETTING An outpatient rehabilitation setting in the Oncology Centre at the University Hospital Brussels in Belgium . SAMPLE 36 patients who had completed cancer treatment with a curative potential . METHODS Participants completed a question naire and underwent a physical test at baseline and at the end of the program . The measurement instruments used included the European Organisation for Research and Treatment of Cancer Quality -of-Life Question naire-Core 30 , Functional Assessment of Cancer Therapy-Fatigue , Hospital Anxiety and Depression Scale , R AND -36 , Tampa Scale for Kinesiophobia , Distress Barometer , and Tecumseh Step Test . MAIN RESEARCH VARIABLES Quality of life , fatigue , kinesiophobia , distress , anxiety , depression , and physical condition . FINDINGS Significant improvement was observed in quality of life ( p < 0.001 ) , physical condition ( p = 0.007 ) , fatigue ( p = 0.01 ) , and depression ( p = 0.012 ) . In contrast , kinesiophobia ( p = 0.229 ) , distress ( p = 0.344 ) , and anxiety ( p = 0.101 ) did not change significantly . CONCLUSIONS A general and significant improvement in all aspects affecting quality of life and rehabilitation was observed , but less so for aspects that might be influenced by prognostic concerns . The relative contribution of the program versus spontaneous recovery and long-term impact need to be determined further in a prospect i ve r and omized study . IMPLICATION S FOR NURSING Multidisciplinary rehabilitation should become part of the total care plan for patients with cancer Background : The most common manifestation of heart failure is physical capacity impairment result ing in dyspnoea and fatigue . The disease deteriorates the quality of life ( QoL ) . Its consequences restrict not only functioning in the physical aspect of QoL but also patients ’ emotional condition . Objective : The study is aim ed to assess QoL changes in HF patients after home-based telemonitored cardiac rehabilitation ( HTCR Group ) versus outpatient-based st and ard cardiac rehabilitation ( SCR Group ) . Methods : The study comprised 131 heart failure patients ( aged 56.4±10.9 years ; II/III NYHA ) rehabilitated for eight weeks in two r and om groups : HTCR Group ( n=75 ) ,  participating in home-based rehabilitation supervised telemedically based on walking training ; SCR Group ( n=56 ) ,  participating in traditional outpatient-based rehabilitation ( cycloergometer training ) . QoL parameters were assessed with a Polish version of the Medical Outcomes Study Short Form 36 Health Survey Question naire ( SF-36 ) . Results : After rehabilitation , both groups achieved a significant QoL improvement , both physically and mentally . HTCR Group patients improved in QoL physical categories in one subscale ( physical function ) , and in two subscales in the mental categories ( mental health , vitality ) . In SCR Group , three physical subscales improved ( physical function , role limitation caused by physical problems , bodily pain ) . In the mental categories , also three subscales improved ( social function , mental health , vitality ) . Conclusions : The study demonstrated that in heart failure patients HTCR provided a similar improvement in total QoL index as SCR . Yet it differed in QoL subscales . Patients who underwent home-based telerehabilitation observed an improvement mainly in the mental categories . Patients in SCR Group improved their general physical well-being Background Breast cancer survivors suffer physical impairment after oncology treatment . This impairment reduces quality of life ( QoL ) and increase the prevalence of h and icaps associated to unhealthy lifestyle ( for example , decreased aerobic capacity and strength , weight gain , and fatigue ) . Recent work has shown that exercise adapted to individual characteristics of patients is related to improved overall and disease-free survival . Nowadays , technological support using telerehabilitation systems is a promising strategy with great advantage of a quick and efficient contact with the health professional . It is not known the role of telerehabilitation through therapeutic exercise as a support tool to implement an active lifestyle which has been shown as an effective re source to improve fitness and reduce musculoskeletal disorders of these women . Methods / Design This study will use a two-arm , assessor blinded , parallel r and omized controlled trial design . People will be eligible if : their diagnosis is of stages I , II , or IIIA breast cancer ; they are without chronic disease or orthopedic issues that would interfere with ability to participate in a physical activity program ; they had access to the Internet and basic knowledge of computer use or living with a relative who has this knowledge ; they had completed adjuvant therapy except for hormone therapy and not have a history of cancer recurrence ; and they have an interest in improving lifestyle . Participants will be r and omized into e-CUI DATE or usual care groups . E-CUI DATE give participants access to a range of contents : planning exercise arranged in series with breathing exercises , mobility , strength , and stretching . All of these exercises will be assigned to women in the telerehabilitation group according to perceived needs . The control group will be asked to maintain their usual routine . Study endpoints will be assessed after 8 weeks ( immediate effects ) and after 6 months . The primary outcome will be QoL measured by The European Organization for Research and Treatment of Cancer Quality of Life Question naire Core 30 version 3.0 and breast module called The European Organization for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life question naire . The secondary outcomes : pain ( algometry , Visual Analogue Scale , Brief Pain Inventory short form ) ; body composition ; physical measurement ( abdominal test , h and grip strength , back muscle strength , and multiple sit-to-st and test ) ; cardiorespiratory fitness ( International Fitness Scale , 6-minute walk test , International Physical Activity Question naire-Short Form ) ; fatigue ( Piper Fatigue Scale and Borg Fatigue Scale ) ; anxiety and depression ( Hospital Anxiety and Depression Scale ) ; cognitive function ( Trail Making Test and Auditory Consonant Trigram ) ; accelerometry ; lymphedema ; and anthropometric perimeters . Discussion This study investigates the feasibility and effectiveness of a telerehabilitation system during adjuvant treatment of patients with breast cancer . If this treatment option is effective , telehealth systems could offer a choice of supportive care to cancer patients during the survivorship phase . Trial registration Clinical Trials.gov Identifier :
The physiotherapy assessment s such as pain , swelling , range of motion , muscle strength , balance , gait and functional assessment demonstrated good concurrent validity .
Conclusion TR-based physiotherapy assessment was technically feasible with overall good concurrent validity and excellent reliability , except for lumbar spine posture , orthopaedic special tests , neurodynamic testa and scar assessment
Purpose The purpose of this review is to systematic ally explore and summarise the validity and reliability of telerehabilitation (TR)-based physiotherapy assessment for musculoskeletal disorders .