1 Faculty of Health Sciences, University of Málaga, Málaga, Spain.
2 Department of Physiotherapy, Faculty of Nursery and Physiotherapy, University of Cádiz, Cádiz, Spain.
J Telemed Telecare. 2018 Jul;24(6):428-433. doi: 10.1177/1357633X17706583. Epub 2017 Apr 27.
Background Telerehabilitation promises to improve quality, increase patient access and reduce costs in health care. Physiotherapy with exercises is generally recommended to restore function after surgery in patients with chronic subacromial syndrome. Relatively few studies have investigated the feasibility of telerehabilitation interventions in musculoskeletal and orthopaedic disorders. The aim of this study was to evaluate the feasibility and effectiveness of a customizable telerehabilitation intervention and compare with traditional care. Methods This research includes 18 consecutive patients with subacromial impingement who underwent arthroscopic subacromial decompression in a controlled clinical prospective study. Patients were randomized to either a 12-week telerehabilitation programme or the usual face-to-face physical therapy for immediate postoperative rehabilitation. We have developed a telerehabilitation system to provide services to patients who have undergone shoulder arthroscopy. An independent blinded observer performed postoperative follow-up after 4, 8, and 12 weeks. Results The preliminary efficacy of this telerehabilitation programme in terms of both physical and functional objective outcome measures was assessed on eight patients. Using the Constant-Murley score to evaluate functional outcome, patients in the telerehabilitation group were shown to have improved from a mean 43.50 ± 3.21 points to a mean 68.50 ± 0.86 points after 12 weeks. The physical and functional improvements in the telerehabilitation group were similar to those in the control group ( p = 0.213). There was a non-significant trend for greater improvements in the telerehabilitation group for most outcome measurements. Conclusion The results of this study provide evidence for the efficacy of telerehabilitation after shoulder arthroscopy in shoulder impingement syndrome. A telerehabilitation programme with range of motion, strengthening of the rotator cuff and scapula stabilizers exercises seems to be similar and not inferior to traditional face-to-face physiotherapy after subacromial arthroscopic decompression. Through this study, we are developing our preliminary dataset to evaluate the efficacy of telerehabilitation programmes following surgical procedures in musculoskeletal injuries and for comparison with more traditional interventions.
远程康复有望提高医疗质量、增加患者就诊机会并降低成本。慢性肩峰下撞击综合征患者术后通常推荐进行运动疗法以恢复功能。相对较少的研究调查了远程康复干预在肌肉骨骼和骨科疾病中的可行性。本研究旨在评估可定制远程康复干预的可行性和有效性，并与传统护理进行比较。
本研究纳入了 18 例接受关节镜下肩峰下减压术的慢性肩峰下撞击综合征患者，这是一项对照前瞻性研究。患者随机分配到 12 周远程康复方案或术后即刻进行传统面对面物理治疗。我们开发了一种远程康复系统，为接受肩关节镜手术的患者提供服务。一位独立的盲法观察者在术后 4、8 和 12 周进行随访。
8 例患者初步评估了该远程康复方案在身体和功能客观结局测量方面的疗效。使用 Constant-Murley 评分评估功能结局，远程康复组患者从平均 43.50±3.21 分改善至 12 周时的平均 68.50±0.86 分。远程康复组的身体和功能改善与对照组相似（p=0.213）。在大多数结局测量中，远程康复组的改善趋势更大，但无统计学意义。
本研究结果为肩峰下撞击综合征患者肩关节镜术后远程康复的疗效提供了证据。一项包含关节活动度、肩袖和肩胛稳定器强化运动的远程康复方案，似乎与肩峰下关节镜减压术后的传统面对面物理治疗相似，且并不劣于后者。通过这项研究，我们正在建立初步数据集，以评估手术后远程康复方案在肌肉骨骼损伤中的疗效，并与更传统的干预措施进行比较。
