JMIR Publications

ABSTRACT

Background:

To perform a randomized controlled trial to study the long-term effect of telerehabilitation in the outpatient follow-up setting in two spinal cord injury (SCI) outpatient clinics in Norway.

Objective:

To analyze and compare healing, health related quality of life (HRQoL), and consumer satisfaction using home based telerehabilitation versus regular outpatient care in persons with SCI and pressure injury (PI) in a randomized controlled setting.

Methods:

We needed 50 participants, 25 in each group to achieve calculated power. Fifty-six participants, 28 in each group, were randomized to a telerehabilitation group, or a regular care group. Validated questionnaires were used to measure the effect of healing and HRQoL, as well as a Likert scale to measure follow-up satisfaction in the two groups.

Results:

Fifty-three participants completed the study, 27 in the telerehabilitation group and 26 in the regular care group. Mean values showed a tendency towards better HRQoL in the telerehabilitation group (p-values ranging from 0.09 to 0.88). A total of 37 (67 %) of all PIs healed, 18 (64 %) in the telerehabilitation group, 19 (70 %) in the regular care group. Mean reduction in ulcer volume was 79 % in the telerehabilitation group, 85 %, in the regular care group (p= 0.32). A Kaplan Mayer plot with a logrank test regarding time to healing did not show any significant difference between the two groups (p= 0.56). No significant differences were found regarding follow-up satisfaction (p= 0.78) in the two groups.

Conclusions:

Telerehabilitation to participants in their own home, in cooperation with the local health care providers was a useful way to manage PIs in terms of healing, HRQoL and follow-up satisfaction as compared to the regular care group. Telerehabilitation will reduce risk of temporary worsening related to transportation to hospital. Telerehabilitation enhances individualized management and cooperation by facilitating discussion and action planning with local care providers. Clinical Trial: 1. www.ClinicalTrials.gov; NCT02800915. 2. Regional Committees for Medical and Health Research (REC) 2014/ 684/ REK-Nord. https://rekportalen.no. 3. CRISTIN.no. https://app.cristin.no/projects/show.jsf?id=545284. 4. Sunnaas Rehabilitation Hospital; https://www.sunnaas.no/kliniske-studier/bruk-av-telemedisin-som-virkemiddel-til-samhandling-i- polikliniskoppfolging-av-pasienter-med-ryggmargsskade-og-trykksar.