Rehabilitation Sciences Graduate Program, Department of Physical Therapy, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627 - Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
Trials. 2021 Jul 13;22(1):445. doi: 10.1186/s13063-021-05387-2.
Delays in starting physical therapy after hospital discharge worsen deconditioning in older adults. Intervening quickly can minimize the negative effects of deconditioning. Telerehabilitation is a strategy that increases access to rehabilitation, improves clinical outcomes, and reduces costs. This paper presents the protocol for a pragmatic clinical trial that aims to determine the effectiveness and cost-effectiveness of a multi-component intervention offered by telerehabilitation for discharged older adults awaiting physical therapy for any specific medical condition.
This is a pragmatic randomized controlled clinical trial with two groups: telerehabilitation and control. Participants (n=230) will be recruited among individuals discharged from hospitals who are in the public healthcare system physical therapy waiting lists. The telerehabilitation group will receive a smartphone app with a personalized program (based on individual's functional ability) of resistance, balance, and daily activity training exercises. The intervention will be implemented at the individuals' homes. This group will be monitored weekly by phone and monthly through a face-to-face meeting until they start physical therapy. The control group will adhere to the public healthcare system's usual flow and will be monitored weekly by telephone until they start physical therapy. The primary outcome will be a physical function (Timed Up and Go and 30-s Chair Stand Test). The measurements will take place in baseline, start, and discharge of outpatient physical therapy. The economic evaluations will be performed from the perspective of society and the Brazilian public healthcare system.
The study will produce evidence on the effectiveness and cost-effectiveness of multi-component telerehabilitation intervention for discharged older adult patients awaiting physical therapy, providing input that can aid the implementation of similar proposals in other patient groups.
Brazilian Registry of Clinical Trials (ReBEC), RBR-9243v7 . Registered on 24 August 2020.
老年人出院后开始物理治疗的延迟会使身体状况恶化。快速干预可以将身体状况恶化的负面影响降到最低。远程康复是一种增加康复机会、改善临床结果和降低成本的策略。本文介绍了一项实用临床试验的方案，旨在确定多组件远程康复干预措施对等待任何特定医疗条件的物理治疗的出院老年患者的有效性和成本效益。
这是一项实用的随机对照临床试验，分为两组：远程康复组和对照组。参与者（n=230）将从公立医院系统物理治疗等候名单中出院的人群中招募。远程康复组将使用带有个性化程序（基于个人功能能力）的阻力、平衡和日常活动训练练习的智能手机应用程序。干预将在个人家中实施。该组将每周通过电话和每月通过面对面会议进行监测，直到他们开始物理治疗。对照组将遵守公共医疗保健系统的常规流程，并在开始物理治疗前每周通过电话进行监测。主要结局将是身体功能（计时起立和 30 秒坐立测试）。测量将在门诊物理治疗开始、开始和出院时进行。经济评估将从社会和巴西公共医疗保健系统的角度进行。
该研究将为等待物理治疗的出院老年患者的多组件远程康复干预的有效性和成本效益提供证据，为在其他患者群体中实施类似方案提供参考。
巴西临床试验注册（ReBEC），RBR-9243v7。于 2020 年 8 月 24 日注册。
