Tyagi Nishu, Amar Goel Shakti, Alexander Marcalee
1Department of Rehabilitation and Telehealth, Indian Spinal Injuries Centre, Delhi, India.
2Department of Spine and Research, Indian Spinal Injuries Centre, Delhi, India.
Spinal Cord Ser Cases. 2019 Aug 7;5:70. doi: 10.1038/s41394-019-0212-x. eCollection 2019.
Despite adequate inpatient rehabilitation, a number of spinal cord injury (SCI) individuals suffer from difficulties at home and in their local environments. This is mainly prevalent in low-middle-income countries (LMIC) due to a lack of qualified personal caregivers. This issue could be addressed with the help of telehealth technology, which may be used in LMICs without economic concerns.
A 44-year-old male with C3 AIS C SCI and a 35-year-old female with T12 AIS A SCI were discharged after successful rehabilitation from a tertiary care spinal center. The patients demonstrated gradual loss in their independence, which was evident by monitoring their home activities biweekly for 4 weeks via a combination of telephone calls, live video chat, and WhatsApp. Subsequently after 4 weeks of consistent guidance, pre-post scores after teletherapy were analyzed for the self-care and mobility subcomponents of the self-reported SCIM III.
After consistent supervised guidance via telehealth, self-care scores improved in the C3 AIS C case from 3 to 15 and in the T12 AIS A case from 4 to 15, while mobility scores respectively improved from 14 to 27 and 4 to 16. Identification of individual competencies, performance, and capacity in activities of daily living and participation, self-assessment, caregiver training, and home integration contributed toward successful community integration. This case series documents the benefits of using telehealth and home goal planning in the aftercare of SCI individuals, in order to improve quality of life in their local environment.
尽管进行了充分的住院康复治疗,但仍有一些脊髓损伤(SCI)患者在家庭和当地环境中面临困难。由于缺乏合格的个人护理人员,这种情况在低收入和中等收入国家(LMIC)尤为普遍。借助远程医疗技术可以解决这个问题,该技术可在低收入和中等收入国家使用而无需考虑经济因素。
一名44岁的男性,患有C3 AIS C级脊髓损伤,以及一名35岁的女性,患有T12 AIS A级脊髓损伤,在一家三级护理脊髓中心成功康复后出院。通过电话、实时视频聊天和WhatsApp相结合的方式,每两周对患者的家庭活动进行4周监测,结果显示患者的独立性逐渐丧失。在持续指导4周后,对远程治疗前后自我报告的脊髓损伤独立性测量量表III(SCIM III)的自我护理和移动性子成分得分进行了分析。
通过远程医疗进行持续的监督指导后,C3 AIS C级病例的自我护理得分从3分提高到15分,T12 AIS A级病例从4分提高到15分,而移动性得分分别从14分提高到27分和从4分提高到16分。识别个体在日常生活活动和参与、自我评估、护理人员培训以及家庭融入方面的能力、表现和能力,有助于实现成功的社区融入。本病例系列记录了在脊髓损伤患者的后续护理中使用远程医疗和家庭目标规划的益处,以改善他们在当地环境中的生活质量。