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远程物理治疗的可行性、可接受性和效果的范围综述。

A scoping review of the feasibility, acceptability, and effects of physiotherapy delivered remotely.

机构信息

School of Health Sciences and Manchester Academic Health Science Centre (MAHSC), Jean McFarlane Building, University Place, University of Manchester, Manchester, UK.

Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.

出版信息

Disabil Rehabil. 2023 Nov;45(23):3961-3977. doi: 10.1080/09638288.2022.2138574. Epub 2022 Nov 2.

Abstract

PURPOSE

To review the feasibility, acceptability, and effects of physiotherapy when delivered remotely.

MATERIALS AND METHODS

CINAHL, MEDLINE, EBM Reviews, and Cochrane Library databases (January 2015-February 2022) were searched and screened for papers (of any design) investigating remote physiotherapy. Data were extracted by two independent raters. Methodological quality of the identified papers was not assessed. Thematic content analysis drew out the key issues.

RESULTS

Forty-one papers (including nine systemic reviews and six with meta-analyses) were selected involving musculoskeletal, stroke and neurological, pulmonary, and cardiac conditions. The most commonly delivered intervention was remote exercise provision, usually following assessment which was completed in-person. All studies, which assessed it, found that remote physiotherapy was comparably effective to in-person delivery at lower cost. Patient satisfaction was high, they found remote physiotherapy to be more accessible and convenient. It boosted confidence and motivation by reminding patients when and how to exercise but adherence was mixed. No adverse events were reported. Barriers related to access to the technology; technical problems and concerns about therapists' workload.

CONCLUSIONS

Remote physiotherapy is safe, feasible, and acceptable to patients. Its effects are comparable with traditional care at lower cost.IMPLICATIONS FOR REHABILITATIONRemote physiotherapy is safe, feasible, and acceptable to patients with comparable effects to in-person care.Remote delivery increases access to physiotherapy especially for those who cannot travel to a treatment facility whether due to distance or disability.Remote physiotherapy may increase adherence to exercise by reminding patients when and how to exercise.Remote physiotherapy does not suit everyone, thus a hybrid system with both in-person and remote delivery may be most effective.

摘要

目的

综述远程物理治疗的可行性、可接受性和效果。

材料与方法

检索 CINAHL、MEDLINE、EBM Reviews 和 Cochrane Library 数据库(2015 年 1 月至 2022 年 2 月),筛选出调查远程物理治疗的论文(任何设计)。由两名独立评估员提取数据。未评估所确定论文的方法学质量。主题内容分析得出了关键问题。

结果

共纳入 41 篇论文(包括 9 篇系统评价和 6 篇包含荟萃分析的论文),涉及肌肉骨骼、中风和神经、肺部和心脏疾病。最常提供的干预措施是远程运动方案,通常在现场评估后进行。所有评估远程物理治疗的研究都发现,远程物理治疗的效果与面对面治疗相当,但成本更低。患者满意度高,他们发现远程物理治疗更便于患者获得且更方便。它通过提醒患者何时以及如何锻炼来增强患者的信心和积极性,但坚持情况不一。没有报告不良事件。与获得技术相关的障碍;技术问题和对治疗师工作量的担忧。

结论

远程物理治疗对患者是安全、可行且可接受的。其效果与传统治疗相当,但成本更低。

对康复的影响

远程物理治疗对患者是安全、可行且可接受的,其效果与面对面治疗相当。

远程提供增加了获得物理治疗的机会,特别是对于那些由于距离或残疾而无法前往治疗场所的人。

远程物理治疗通过提醒患者何时以及如何锻炼,可能会提高患者对运动的依从性。

远程物理治疗并不适合所有人,因此,面对面和远程混合提供的混合系统可能最有效。

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