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      A Commentary on Telerehabilitation Services in Pakistan: Current Trends and Future Possibilities

      research-article
      Author(s): , MS HEALTH INFORMATICS 1 , , PHD 2 , , MS COMMUNICATION SCIENCES 3 , , MS PHYSIOTHERAPY 4 , , MSC ECONOMICS 5 , , BSC HONS ORTHOTICS PROSTHETICS 6
      Publication date (Electronic):
      Journal: International Journal of Telerehabilitation
      Publisher: University Library System, University of Pittsburgh
      Keywords: eHealth, mHealth, Pakistan, Telemedicine, Telehealth, Telerehabilitation

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          Abstract

          A 2014 World Health Organization (WHO) study reported that almost 27 million people with disability live in Pakistan with fewer than one allied rehabilitation professional per 10,000 people. The current study sought to determine the attitudes toward telerehabilitation via a survey administered to 329 Pakistani rehabilitation professionals. Study results indicate that rehabilitation professionals in Pakistan are knowledgeable about telerehabilitation and Information and Communication Technology (ICT), and are receptive to employing telerehabilitation programs and applications. Therefore, we can infer that the future of telerehabilitation can be bright in Pakistan but requires the attention of policy makers and non-government organizations to launch an appropriate program nationwide. The authors suggest that a range of telerehabilitation services (e.g., consultation, assessment, and therapy) could alleviate the shortage of rehabilitation personnel in Pakistan.

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          Role of telerehabilitation in patients following total knee arthroplasty: Evidence from a systematic literature review and meta-analysis

          H Shukla, SR Nair, D. Thakker (2016)
          Introduction Increased physical activity and functional ability are the goals of total knee replacement surgery. Therefore, adequate rehabilitation is required for the recovery of patients after discharge from hospital following total knee arthroplasty (TKA). This systematic literature review aimed to evaluate the effectiveness of home telerehabilitation in patients who underwent TKA. Methods Studies published in the English language between 2000 and 2014 were retrieved from Embase, PubMed, and Cochrane databases using relevant search strategies. Two researchers independently reviewed the studies as per the Cochrane methodology for systematic literature review. We considered telerehabilitation sessions as those that were conducted by experienced physiotherapists, using videoconferencing to patients' homes via an internet connection. The outcomes assessed included: knee movement (knee extension and flexion); quadriceps muscle strength; functional assessment (the timed up-and-go test); and assessment of pain, stiffness, and functional capacity using the Western Ontario and McMaster Universities Osteoarthritis Index and visual analogue scale for pain. Results In total, 160 potentially relevant studies were screened. Following the screening of studies as abstracts and full-text publications, six primary publications (four randomized controlled trials, one non-randomized controlled trial, and one single-arm trial) were included in the review. Patients experienced high levels of satisfaction with the use of telerehabilitation alone. There was no significant difference in change in active knee extension and flexion in the home telerehabilitation group as compared to the control group (mean difference (MD) -0.52, 95% CI -1.39 to 0.35, p = 0.24 and MD 1.14, 95% CI -0.61 to 2.89, p = 0.20, respectively). The patients in the home telerehabilitation group showed improvement in physical activity and functional status similar to patients in the conventional therapy group. Discussion The evidence from this systematic literature review demonstrated that telerehabilitation is a practical alternative to conventional face-to-face rehabilitation therapy in patients who underwent TKA.
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            Health-related rehabilitation services: assessing the global supply of and need for human resources

            Neeru Gupta, Carla Castillo-Laborde, Michel Landry (2011)
            Background Human resources for rehabilitation are often a neglected component of health services strengthening and health workforce development. This may be partly related to weaknesses in the available research and evidence to inform advocacy and programmatic strategies. The objective of this study was to quantitatively describe the global situation in terms of supply of and need for human resources for health-related rehabilitation services, as a basis for strategy development of the workforce in physical and rehabilitation medicine. Methods Data for assessing supply of and need for rehabilitative personnel were extracted and analyzed from statistical databases maintained by the World Health Organization and other national and international health information sources. Standardized classifications were used to enhance cross-national comparability of findings. Results Large differences were found across countries and regions between assessed need for services requiring health workers associated to physical and rehabilitation medicine against estimated supply of health personnel skilled in rehabilitation services. Despite greater need, low- and middle-income countries tended to report less availability of skilled health personnel, although the strength of the supply-need relationship varied across geographical and economic country groupings. Conclusion The evidence base on human resources for health-related rehabilitation services remains fragmented, the result of limited availability and use of quality, comparable data and information within and across countries. This assessment offered the first global baseline, intended to catalyze further research that can be translated into evidence to support human resources for rehabilitation policy and practice.
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              Web-based telerehabilitation for the upper extremity after stroke.

              D.J. Reinkensmeyer, C.T. Pang, J.A. Nessler … (2002)
              Stroke is a leading cause of disability in the United States and yet little technology is currently available for individuals with stroke to practice and monitor rehabilitation therapy on their own. This paper provides a detailed design description of a telerehabilitation system for arm and hand therapy following stroke. The system consists of a Web-based library of status tests, therapy games, and progress charts, and can be used with a variety of input devices, including a low-cost force-feedback joystick capable of assisting or resisting in movement. Data from home-based usage by a chronic stroke subject are presented that demonstrate the feasibility of using the system to direct a therapy program, mechanically assist in movement, and track improvements in movement ability.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Int J Telerehabil
                Journal ID (iso-abbrev): Int J Telerehabil
                Journal ID (publisher-id): IJT
                Title: International Journal of Telerehabilitation
                Publisher: University Library System, University of Pittsburgh
                ISSN (Electronic): 1945-2020
                Publication date Collection: Spring 2017
                Publication date (Electronic): 29 June 2017
                Volume: 9
                Issue: 1
                Pages: 71-76
                Affiliations
                [1 ]HEALTH INFORMATICS UNIT, COMSATS INSTITUTE OF INFORMATION TECHNOLOGY, ISLAMABAD, PAKISTAN
                [2 ]DEPARTMENT OF MEDICAL INFORMATICS, TAIPEI MEDICAL UNIVERSITY, TAIPEI, TAIWAN
                [3 ]DEPARTMENT OF COMPUTER SCIENCES, UNIVERSITY OF ENGINEERING AND TECHNOLOGY, LAHORE, PAKISTAN
                [4 ]DEPARTMENT OF PHYSIOTHERAPY, RIPHAH UNIVERSITY, ISLAMABAD, PAKISTAN
                [5 ]DEPARTMENT OF ECONOMICS, PUNJAB UNIVERSITY, LAHORE, PAKISTAN
                [6 ]DEPARTMENT OF ORTHOTICS & PROSTHETICS, RAWALPINDI MEDICAL COLLEGE, RAWALPINDI, PAKISTAN
                Article
                Publisher ID: ijt-09-71
                DOI: 10.5195/ijt.2017.6224
                PMC ID: 5546563
                PubMed ID: 28814996
                SO-VID: 3d2529e4-018c-4c8f-a029-e5288e63cda4
                Copyright statement: Copyright @ 2017
                License:

                This work is licensed under a Creative Commons Attribution 4.0 International License

                History
                Categories
                Subject: Country Report

                Keywords: ehealth,mhealth,pakistan,telemedicine,telehealth,telerehabilitation
                Data availability:
                Keywords: ehealth, mhealth, pakistan, telemedicine, telehealth, telerehabilitation

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