Bell Mitchell, Schein Richard M, Straatmann Joseph, Dicianno Brad E, Schmeler Mark R
Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Int J Telerehabil. 2020 Dec 8;12(2):27-34. doi: 10.5195/ijt.2020.6335.
The purpose of this study was to compare telehealth and in-person service delivery models for wheeled mobility devices in terms of functional outcomes. We hypothesized that clinically significant improvements in functional mobility measured by the Functional Mobility Assessment (FMA) will occur in individuals receiving both telehealth and in-person clinic evaluations. A total of 27 Veterans receiving telehealth visits were compared to 27 individuals seen in clinic, selected from a database, matching for age, gender, and primary diagnosis. All mean individual item and total FMA scores in both groups increased from Time 1 to Time 2. Within the telehealth group, all changes in individual item and total FMA scores were statistically significant, with changes in 8 of 10 items meeting threshold for clinical significance (change >1.85 points). Within the clinic group, changes in 7 of 10 individual items and total FMA scores were statistically significant, and these same 7 items met threshold for clinical significance. Change scores for individual item and total FMA scores did not differ significantly between the two groups. A larger and clinically significant change in transfer score was seen in the telehealth group, suggesting telehealth visits may confer an advantage in being able to assess and address transfer issues in the home.
本研究的目的是比较远程医疗和面对面服务模式在轮式移动设备功能结果方面的差异。我们假设,通过功能移动性评估(FMA)测量的功能移动性在接受远程医疗和面对面诊所评估的个体中会出现具有临床意义的改善。从数据库中选取27名接受远程医疗问诊的退伍军人与27名在诊所就诊的个体进行比较,匹配年龄、性别和主要诊断。两组中所有个体项目的平均得分和FMA总分从时间1到时间2均有所增加。在远程医疗组中,个体项目和FMA总分的所有变化均具有统计学意义,10个项目中有8个项目的变化达到临床意义阈值(变化>1.85分)。在诊所组中,10个个体项目中有7个项目和FMA总分的变化具有统计学意义,且这7个相同项目达到临床意义阈值。两组之间个体项目和FMA总分的变化分数没有显著差异。在远程医疗组中观察到转移分数有更大且具有临床意义的变化,这表明远程医疗问诊在评估和解决家中的转移问题方面可能具有优势。