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

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

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 (https://www.plymouth.ac.uk/research/telerehab), a practical resource for practitioners, patients and carers, with a focus on remote assessment and management of physical disabilities and movement impairment.

movement impairment, physical disabilities, remote consultations, telerehabilitation
1356-1294
1084-1095
Buckingham, Sarah A.
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Sein, Kim
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Anil, Krithika
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Demain, Sara
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Gunn, Hilary
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Jones, Ray B.
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Kent, Bridie
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Logan, Angela
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Marsden, Jonathan
9cad2aad-a4a5-4f90-81b7-852b9f8d822c
Playford, E D.
51707e0d-5490-4d2f-99cc-cd6297464d61
Freeman, Jenny
5416ebd6-edff-4f7b-8b6a-bbc653f46078
Buckingham, Sarah A.
9e984559-25e9-4a9d-8dee-3a135135b75f
Sein, Kim
f91de668-919a-48e0-8693-2e1a307cbb73
Anil, Krithika
2b2690a5-37f4-4b3e-9b4c-df721d12a2f3
Demain, Sara
09b1124d-750a-4eb1-90c7-91f5f222fc31
Gunn, Hilary
2f6d03a5-20b5-431f-8f64-596e511ad4f5
Jones, Ray B.
b96fe4b3-7405-4b67-8154-68647a59491f
Kent, Bridie
9a16161a-c0a4-4a2d-a1da-47ab54241c34
Logan, Angela
d97cd7e2-8a12-4f30-9528-553c09b244c3
Marsden, Jonathan
9cad2aad-a4a5-4f90-81b7-852b9f8d822c
Playford, E D.
51707e0d-5490-4d2f-99cc-cd6297464d61
Freeman, Jenny
5416ebd6-edff-4f7b-8b6a-bbc653f46078

Buckingham, Sarah A., Sein, Kim, Anil, Krithika, Demain, Sara, Gunn, Hilary, Jones, Ray B., Kent, Bridie, Logan, Angela, Marsden, Jonathan, Playford, E D. and Freeman, Jenny (2022) Telerehabilitation for physical disabilities and movement impairment: A service evaluation in South West England. Journal of Evaluation in Clinical Practice, 28 (6), 1084-1095. (doi:10.1111/jep.13689).

Record type: Article

Abstract

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 (https://www.plymouth.ac.uk/research/telerehab), 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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Telerehabilitation for physical disabilities and movement impairment - Accepted Manuscript
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Accepted/In Press date: 6 April 2022
e-pub ahead of print date: 19 April 2022
Additional Information: Funding Information: The authors thank the participants and lead practitioners at the following organisations: University Hospitals Plymouth NHS Trust; Royal Devon University Healthcare NHS Foundation Trust (formerly Royal Devon and Exeter NHS Foundation Trust and Northern Devon Healthcare NHS Trust); Cornwall Partnership NHS Foundation Trust; and Livewell Southwest. This study was funded by UK Research and Innovation – Medical Research Council (UKRI–MRC; Award number: COV0079). The views expressed are those of the author(s) and not necessarily those of the UKRI‐MRC. Publisher Copyright: © 2022 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd. Copyright: Copyright 2022 Elsevier B.V., All rights reserved.
Keywords: movement impairment, physical disabilities, remote consultations, telerehabilitation

Identifiers

Local EPrints ID: 457124
URI: http://eprints.soton.ac.uk/id/eprint/457124
ISSN: 1356-1294
PURE UUID: 6efaf64c-d081-4736-b9b4-ab728e4db486
ORCID for Krithika Anil: ORCID iD orcid.org/0000-0002-8027-1665

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Date deposited: 24 May 2022 16:51
Last modified: 21 Nov 2022 17:59

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Contributors

Author: Sarah A. Buckingham
Author: Kim Sein
Author: Krithika Anil ORCID iD
Author: Sara Demain
Author: Hilary Gunn
Author: Ray B. Jones
Author: Bridie Kent
Author: Angela Logan
Author: Jonathan Marsden
Author: E D. Playford
Author: Jenny Freeman

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