中风患者远程康复期间确保安全的措施:一项范围综述

Measures to ensure safety during telerehabilitation of people with stroke: A scoping review.

作者信息

Gutierrez-Arias Ruvistay, González-Mondaca Camila, Marinkovic-Riffo Vinka, Ortiz-Puebla Marietta, Paillán-Reyes Fernanda, Seron Pamela

机构信息

Departamento de Apoyo en Rehabilitación Cardiopulmonar Integral, Instituto Nacional del Tórax, Santiago, Chile.

Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences,Universidad Andres Bello, Santiago, Chile.

出版信息

J Telemed Telecare. 2025 Feb;31(2):198-206. doi: 10.1177/1357633X231181426. Epub 2023 Jun 15.

Abstract

BACKGROUND

Measures used to prevent adverse events during the implementation of exercise sessions delivered via telerehabilitation can be varied, ranging from simple telephone monitoring to synchronous therapist-led sessions. However, this information is scattered in the literature, as evidence synthesis studies have only addressed the safety, satisfaction, and effectiveness aspects of exercise delivered via telerehabilitation.

AIMS

This scoping review aims to describe that measures are used to ensure safety during exercise sessions delivered to people with stroke through telerehabilitation, as reported by authors of primary studies. Secondarily, it describes the designs most frequently used to notify the effects of telerehabilitation and evidence level, the characteristics of the participants and type of stroke, and the characteristics of telerehabilitation.

SUMMARY OF REVIEW

A scoping review was conducted according to the Joana Briggs Institute (JBI) recommendations. A systematic search of MEDLINE (Ovid), Embase (Ovid), CENTRAL, and CINHAL was conducted from inception to August 2022, and a review of systematic review references on the topic. We included primary studies that enrolled adults with stroke who underwent exercise delivered via telerehabilitation. Two independent reviewers performed study selection and data extraction, and disagreements were resolved by consensus or a third reviewer. A qualitative analysis of the information was performed. One hundred seven primary studies (3991 participants) published between 2002 and 2022 were included. Most studies were case series (43%) and rated with an Oxford level of evidence of "4" (55.3%). Regarding randomized clinical trials, half included 53 or more participants (IQR 26.75 to 81). Most studies applied the exercises via asynchronous telerehabilitation (55.1%), of which only ten reported measures to avoid adverse events. Some of the measures included assessing the location where exercises are to be performed, only using a seated position, and using live warning systems that prevent or stop exercises when they are risky.

CONCLUSIONS

Reporting of measures implemented to prevent adverse events during exercise delivery via asynchronous telerehabilitation is scarce. Future primary studies should always consider reporting adverse events related to exercise delivery via telerehabilitation and strategies implemented to decrease the incidence of these unwanted safety events.

REGISTRATION NUMBER

INPLASY202290104.

摘要

背景

在通过远程康复进行运动训练期间,用于预防不良事件的措施多种多样,从简单的电话监测到由治疗师同步指导的训练课程。然而,这些信息在文献中较为分散,因为证据综合研究仅涉及通过远程康复进行运动训练的安全性、满意度和有效性方面。

目的

本范围综述旨在描述初级研究的作者所报告的、用于确保通过远程康复为中风患者提供运动训练期间安全的措施。其次,描述最常用于报告远程康复效果、证据水平、参与者特征和中风类型以及远程康复特征的设计。

综述总结

根据乔安娜·布里格斯研究所(JBI)的建议进行了范围综述。从创刊至2022年8月,对MEDLINE(Ovid)、Embase(Ovid)、CENTRAL和CINHAL进行了系统检索,并对该主题的系统综述参考文献进行了回顾。我们纳入了招募成年中风患者并通过远程康复进行运动训练的初级研究。两名独立评审员进行研究筛选和数据提取,分歧通过协商一致或由第三名评审员解决。对信息进行了定性分析。纳入了2002年至2022年间发表的107项初级研究(3991名参与者)。大多数研究为病例系列(43%),牛津证据水平评定为“4”(55.3%)。关于随机临床试验,一半研究纳入了53名或更多参与者(四分位间距26.75至81)。大多数研究通过异步远程康复应用训练(55.1%),其中只有10项报告了避免不良事件的措施。一些措施包括评估进行训练的地点、仅采用坐姿以及使用实时预警系统,在有风险时预防或停止训练。

结论

关于在通过异步远程康复进行运动训练期间为预防不良事件而实施的措施的报告很少。未来的初级研究应始终考虑报告与通过远程康复进行运动训练相关的不良事件以及为降低这些不良安全事件发生率而实施的策略。

注册号

INPLASY202290104

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索