Moretti Lorenzo, Bizzoca Davide, Farì Giacomo, Caricato Alessandro, Angiulli Francesco, Cassano Giuseppe Danilo, Solarino Giuseppe, Moretti Biagio
Orthopaedic and Trauma Unit, AOUC Policlinico di Bari, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124 Bari, Italy.
Physical Medicine and Rehabilitation Unit, University of Bari "Aldo Moro", 70124 Bari, Italy.
J Pers Med. 2023 Jul 20;13(7):1159. doi: 10.3390/jpm13071159.
The COVID-19 pandemic drastically changed many aspects of the traditional functioning of health systems all around the world. In Italy, as reported by the CIO, compared to the previous year, there was a significant reduction in 2020 in overall outpatient activities by up to 75%. These data support the need for telemedicine, which represents a current challenge and can no longer be postponed in the future. This study aims to elaborate on a possible model for remote shoulder examination based on traditional tests to improve the quality of telemedicine in orthopedic and rehabilitation. Between May 2020 and November 2020, ten orthopedic surgeons individually examined six patients with a known shoulder disorder, both in hospital and via webcam according to the previously shared protocol (B-STEP). According to the 10 observers, completing 100% of the ASES score and at least 87.5% of the Constant score is possible. Shoulder ROM and many specific tests are also reproducible via webcam, but with less sensitivity, according to the subjective opinion of observers. The B-STEP is a useful protocol for the standardization of the objective examination of the shoulder via webcam. Further studies are necessary to determine if the B-STEP protocol is useful for diagnosing pathology in unknown patients and evaluating its sensitivity and specificity for each pathology.
新冠疫情极大地改变了全球卫生系统传统运作的许多方面。据意大利国家卫生信息技术中心（CIO）报告，在意大利，与上一年相比，2020年门诊活动总量显著减少，降幅高达75%。这些数据凸显了远程医疗的必要性，远程医疗是当前面临的一项挑战，未来不能再推迟。本研究旨在基于传统检查方法精心设计一种远程肩部检查的可能模式，以提高骨科和康复领域远程医疗的质量。在2020年5月至2020年11月期间，10名骨科医生分别按照之前共享的方案（B-STEP），在医院和通过网络摄像头对6名已知肩部疾病的患者进行了检查。据10名观察者称，完成100%的美国肩肘外科医师学会（ASES）评分和至少87.5%的康斯坦特（Constant）评分是可行的。根据观察者的主观意见，肩部活动范围（ROM）和许多特定检查通过网络摄像头也具有可重复性，但敏感性较低。B-STEP是通过网络摄像头对肩部进行客观检查标准化的有用方案。有必要进一步开展研究，以确定B-STEP方案对诊断未知患者的病理状况是否有用，以及评估其对每种病理状况的敏感性和特异性。
