4.2 Article

Telerehabilitation for physical disabilities and movement impairment: A service evaluation in South West England

Journal

JOURNAL OF EVALUATION IN CLINICAL PRACTICE
Volume 28, Issue 6, Pages 1084-1095

Publisher

WILEY
DOI: 10.1111/jep.13689

Keywords

movement impairment; physical disabilities; remote consultations; telerehabilitation

Funding

  1. UK Research and Innovation [COV0079]

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Telerehabilitation was used during the COVID-19 pandemic to provide continued care, with positive experiences and optimism for its future use. However, challenges such as technological issues and safety concerns need to be addressed, while best practice involves person-centered care and clear communication.
Rationale, Aims and Objectives Telerehabilitation was used to ensure continued provision of care during the COVID-19 pandemic, but there was a lack of guidance on how to use it safely and effectively for people with physical disabilities and movement impairment. In this service evaluation, we aimed to collate information on practitioner and patient experiences, challenges and facilitators, and examples of best practice to inform the development of an online toolkit and training package. Methods Guided discussions were carried out with 44 practitioners, 7 patients and 2 carers from five health and social care organisations in South West England, and analysed thematically. Results Practitioners and patients had positive experiences of telerehabilitation and were optimistic about its future use. Recognized benefits for people with physical disabilities included greater flexibility, reduced travel and fatigue, having appointments in a familiar environment and ease of involving family members. Challenges encountered were: technological (usability issues, access to technology and digital skills); difficulties seeing or hearing patients; the lack of 'hands-on' care; and safety concerns. Facilitators were supported by colleagues or digital champions, and family members or carers who could assist patients during their appointments. Key themes in best practice were: person-centred and tailored care; clear and open communication and observation and preparation and planning. Practitioners shared tips for remote physical assessments; for example, making use of patient-reported outcomes, and asking patients to wear bright and contrasting coloured clothing to make it easier to see movement. Conclusion Telerehabilitation holds promise in health and social care, but it is necessary to share good practice to ensure it is safe, effective and accessible. We collated information and recommendations that informed the content of the Telerehab Toolkit (), a practical resource for practitioners, patients and carers, with a focus on remote assessment and management of physical disabilities and movement impairment.

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