Swarnakar Raktim, Yadav Shivlal, Wadhwa Sanjay, Venkataraman Srikumar
Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
Cureus. 2023 Jul 7;15(7):e41513. doi: 10.7759/cureus.41513. eCollection 2023 Jul.
Introduction The COVID-19 pandemic has posed numerous challenges in accessing adequate healthcare services, particularly for individuals with spinal cord injury (SCI). On the other hand, telerehabilitation has emerged as a promising solution to address healthcare needs. Since there was no study during the pandemic, we started this study with the aim of assessing the efficacy of telerehabilitation for individuals with SCI during the COVID-19 pandemic. Methods This is a prospective double-blind, randomized, controlled trial conducted in a tertiary rehabilitation care center hospital. Thirty participants with traumatic spinal cord injuries (age 18 years or more, either gender) were equally randomized to the telerehabilitation or control group (1:1). Biweekly telerehabilitation sessions (each session: 30 minutes) were provided. Participants in the control group were advised to continue standard usual care as advised previously during outpatient or inpatient rehabilitation. The Spinal Cord Independence Measure (SCIM III) (primary outcome measure) and Coronavirus Anxiety Scale (CAS) (secondary outcome measure) were evaluated at baseline, four weeks, and eight weeks. Results The mean age of the intervention group was 28.2±6.9 years, and the mean age of the control group was 26.3±7.7 years. The self-care (P = 0.03) and mobility domains (P=0.01) of the SCIM III in the intervention group compared to the control group, as determined through a between-group analysis, showed statistically significant differences. CAS also showed improvement in the intervention group compared to the control group. Within-group analysis showed a mean difference of 6.3 points in the intervention group compared to the control group (1.3 points). Conclusion Telerehabilitation intervention is safe, feasible, and effective in improving self-care and mobility domains in persons with spinal cord injuries during the pandemic. It is also effective in reducing the anxiety related to the coronavirus in this population. Further research with a larger sample size and a longer duration is needed to evaluate long-term effectiveness during such crises.
新冠疫情在获取充足医疗服务方面带来了诸多挑战，尤其是对于脊髓损伤（SCI）患者而言。另一方面，远程康复已成为满足医疗需求的一种有前景的解决方案。由于疫情期间尚无相关研究，我们开展了本研究，旨在评估新冠疫情期间远程康复对脊髓损伤患者的疗效。
这是一项在三级康复护理中心医院进行的前瞻性双盲、随机对照试验。30名创伤性脊髓损伤患者（年龄18岁及以上，不限性别）被等比例随机分为远程康复组或对照组（1:1）。每两周进行一次远程康复治疗（每次治疗：30分钟）。建议对照组患者按照此前门诊或住院康复时的建议继续接受标准常规护理。在基线、四周和八周时评估脊髓独立性测量量表（SCIM III）（主要结局指标）和冠状病毒焦虑量表（CAS）（次要结局指标）。
干预组的平均年龄为28.2±6.9岁，对照组的平均年龄为26.3±7.7岁。通过组间分析确定，与对照组相比，干预组SCIM III的自我护理领域（P = 0.03）和移动领域（P = 0.01）显示出统计学上的显著差异。与对照组相比，干预组的CAS也有所改善。组内分析显示，干预组与对照组相比平均差异为6.3分（对照组为1.3分）。
在疫情期间，远程康复干预对于改善脊髓损伤患者的自我护理和移动领域是安全、可行且有效的。它在减轻该人群与冠状病毒相关的焦虑方面也有效。需要进行更大样本量和更长时间的进一步研究，以评估此类危机期间的长期有效性。
