Abstract
Dallolio L, Menarini M, China S, Ventura M, Stainthorpe A, Soopramanien A, Rucci P,
Fantini MP, on behalf of the THRIVE Project. Functional and clinical outcomes of telemedicine
in patients with spinal cord injury.
Objective
To compare the 6-month outcomes of telerehabilitation intervention with those of standard
care for spinal cord injury (SCI).
Design
Multicenter randomized controlled trial.
Setting
Home, nursing, or unspecialized hospital care provided after discharge from a spinal
cord unit.
Participants
Adult patients with nonprogressive, complete, or incomplete SCI discharged for the
first time from the spinal cord unit to their homes (Belgium and Italy) or to their
homes or another facility (England).
Interventions
All patients received the standard care they would have normally received after discharge
from the spinal cord unit. In addition, patients in the telemedicine group received
8 telemedicine weekly sessions in the first 2 months, followed by biweekly telemedicine
sessions for 4 months.
Main Outcome Measures
Functional status at 6 months, clinical complications during the postdischarge period,
and patient satisfaction.
Results
No significant differences in the occurrence of clinical complications were found
between the study groups. A higher improvement of functional scores in the telemedicine
group was found only at the Italian site: FIM total score 3.38±4.43 (controls) versus
7.69±6.88 (telemedicine group), FIM motor score 3.24±4.38 (controls) versus 7.55±7.00
(telemedicine group; P<.05). Items contributing to this difference were grooming, dressing upper body, dressing
lower body, and bed/chair/wheelchair transfer. Higher satisfaction with care was reported
by patients in the telemedicine group across all sites.
Conclusions
Our study provides some of the first quantitative evidence, based on results from
1 site, that telerehabilitation may offer benefits to patients discharged from a spinal
cord unit compared with standard care in terms of functional improvement. Further
research is warranted to confirm or disprove this finding.
Key Words
List of Abbreviations:
ANOVA (analysis of variance), CI (confidence interval), IRT (item response theory), LOS (length of stay), SCI (spinal cord injury), SCIM (Spinal Cord Independence Measure), SCIM II (Spinal Cord Independence Measure II), THRIVE (Telerehabilitation Through Interactive Video Endorsement)To read this article in full you will need to make a payment
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Article info
Footnotes
Supported by the European Community under the European Commission's Framework V Programme.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
The THRIVE project includes the following investigators: Telemedicina Rizzoli, Bologna: Roberto Ongaro, David Menasci. Dipartimento di Medicina e Sanità Pubblica, Università di Bologna: Maria Pia Fantini, Laura Dallolio, Paola Rucci, Andy Stainthorpe. Spinal Cord Unit—Montecatone Rehabilitation Institute, Imola (Bologna): Mauro Menarini, Sandra China, Mario Loffredo, Francesco Gambino, Anna Maria Cresciulli, Daniela Monducci, Giovanna Ferrara, Elisabetta Cardelli. Health Information Management, Bruxelles: Marco D'Angelantonio, Reinhard Prior, John Oates. Centre de Traumatologie et de Réadaptation, Bruxelles: Manfredi Ventura. Salisbury Health Care National Health Service Trust, Salisbury: Helen Pain, Anba Soopramanien.
Identification
Copyright
© 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
