scholarly journals Combining a Hudl App With Telehealth to Increase Home Exercise Program Adherence in People With Chronic Diseases Experiencing Financial Distress: Randomized Controlled Trial

10.2196/22659 ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. e22659
Author(s):  
Ann Van de Winckel ◽  
Tanjila Nawshin ◽  
Casey Byron
Keyword(s):  
Randomized Controlled Trial ◽  
Chronic Diseases ◽  
Financial Distress ◽  
Controlled Trial ◽  
Exercise Adherence ◽  
Home Exercise ◽  
Control Group ◽  
Randomized Controlled ◽  
Experimental Group

Background Patients with chronic diseases often need to adhere to long-term individualized home exercise programs (HEPs). Limited adherence to long-term exercise given during physical therapy (PT) visits reduces the capacity of exercise to manage or improve symptoms related to chronic disease. In addition, a lower socioeconomic status negatively impacts exercise adherence. To mitigate this, apps that motivate people to exercise could be a viable option. Using an app through telehealth may help adults with chronic diseases to achieve long-term HEP adherence. However, because apps for rehabilitation are an emerging field, the feasibility of the app needs to be evaluated. Objective To address HEP adherence in participants with chronic diseases who are experiencing financial distress, we aim to evaluate the feasibility of and satisfaction with the Hudl Technique app and telehealth and satisfaction with PT care and to monitor HEP adherence and compliance (ie, percentage of participant-recorded videos sent) in participants using the app with telehealth compared with those using standard HEPs on paper. Methods We recruited patients scheduled for outpatient PT. We performed a randomized controlled trial in which the experimental group received weekly HEP demonstrations through app videos on a tablet with feedback on their self-recorded HEP video performance from the telehealth physical therapist. The control group received HEPs on paper without feedback, as is customary in PT practice. Demographic, clinical, and health coverage information was collected for screening and baseline measurements. Adherence and compliance were evaluated. Both groups completed surveys at 8 and 24 weeks on their satisfaction with PT care, and the experimental group also completed a survey on their satisfaction with the app with telehealth use. Descriptive and nonparametric statistics were used for within-group and between-group comparisons and analyzed with JMP, version 13. Results Overall, 45 adults with chronic diseases who were experiencing financial distress were randomized into experimental (23/45, 51%) and control (22/45, 49%) groups, with 74% (17/23) and 86% (19/22) participants completing the 24-week HEP, respectively. The experimental group had an HEP adherence frequency of 4 (SD 2) to 5 (SD 2) times per week at 8 and 24 weeks (P=.14), whereas HEP adherence decreased in the control group from 4 (SD 2) to 3 (SD 2) times per week (P=.07), with a significant difference (P=.01) between groups at 24 weeks. Of the total participants, 68% (15/22) sent videos. They sent 68% (16/24) of the requested number of videos on average. The average score for PT care satisfaction was maintained at 87% in the experimental group (P=.99), whereas it decreased from 89% at 8 weeks to 74% at 24 weeks (P=.008) in the control group. App-related adverse events were not observed. Conclusions The Hudl app/telehealth platform is feasible for delivering HEPs and maintaining HEP adherence in participants with chronic diseases who are experiencing financial distress. Trial Registration ClinicalTrials.gov NCT02659280; https://clinicaltrials.gov/ct2/show/NCT02659280

scholarly journals Exploratory Study for Using the mobile Hudl App with Telehealth: A Randomized Controlled Trial Shows Positive Impact on Home Exercise Program Adherence in People with Chronic Diseases and in Financial Distress (Preprint)

2020 ◽  
Author(s):  
Ann Van de Winckel ◽  
Tanjila Nawshin ◽  
Casey Byron
Keyword(s):  
Chronic Diseases ◽  
Financial Distress ◽  
Controlled Trial ◽  
Exercise Program ◽  
Home Exercise ◽  
Control Group ◽  
Home Exercise Program ◽  
Randomized Controlled ◽  
Experimental Group

BACKGROUND Patients with chronic diseases often must adhere to a long-term individualized home exercise program (HEP) to manage their symptoms, and improve or maintain their cardiovascular health, flexibility and/or strength. Those exercises are provided and updated during physical therapy (PT) visits. Limited adherence (ie, perform the required number of HEP/week) to long-term exercise reduces the capacity of exercise to improve or stabilize impairments related to chronic disease. Lower socio-economic status is an additional factor that negatively impacts exercise adherence. To mitigate this, online apps available to motivate people to exercise could be a viable option. Using an app through telehealth may benefit adults with chronic diseases achieve long-term home exercise program (HEP) adherence. However, because using apps for rehabilitation is an emerging field, the app’s feasibility needs to be evaluated. OBJECTIVE To address HEP adherence in participants with chronic diseases and in financial distress, defined by people being on Medicaid or similar programs, we evaluated HEP adherence, compliance (ie, percentage of participant-recorded videos sent), as well as satisfaction with the PT care and with the Hudl Technique® app and telehealth in terms of feasibility, compared to standard HEP on paper. METHODS We recruited patients scheduled for outpatient PT. We performed a randomized controlled trial where the experimental group received weekly HEP demonstrations through app videos on a tablet and received feedback on their self-recorded HEP video performance from the telehealth-physical therapist. The control group received HEP on paper without feedback as is custom in PT practice. The treating therapist and data analyst were blinded to the allocation. Demographic, clinical, and health coverage information was collected for screening and baseline measurements. Adherence and compliance were evaluated. Both groups completed surveys at 8 and 24 weeks on satisfaction with PT care and, for the experimental group, also satisfaction with the app/telehealth use. RESULTS Forty-five adults with chronic diseases and financial distress were randomized into an experimental (n=23) and a control group (n=22), with respectively 17 and 19 participants completing the 24-week HEP. The experimental group maintained a HEP adherence frequency of 4±2 times/week at 8 and 24 weeks (P=.29), whereas in the control group HEP adherence decreased from 4±2 to 3±2 times/week (P=.07), with a significant difference (P=.04) between groups at 24 weeks. Sixty-eight percent of participants sent videos. They sent on average 68% of the requested number of videos. The average score for satisfaction with PT care was maintained at 87% in the experimental group (P=1.00) whereas it dropped from 89% at 8 weeks to 74% at 24 weeks (P=.008) in the control group. There were no app-related adverse events. CONCLUSIONS The Hudl app/telehealth is feasible for delivering HEP and helps participants with chronic diseases and financial distress maintain HEP adherence. CLINICALTRIAL The full trial protocol is available at ClinicalTrials.gov (NCT02659280).

Long-term Effectiveness and Adoption of a Cellphone Augmented Reality System for Stroke Rehabilitation: Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Jie Jia ◽  
Chong Li ◽  
Xinyu Song ◽  
Shugeng Chen ◽  
Chuankai Wang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Motor Function ◽  
Controlled Trial ◽  
Control Group ◽  
Stroke Patients ◽  
Randomized Controlled ◽  
Augmented Reality System ◽  
Home Based ◽  
Experimental Group

BACKGROUND A serious game-based Cellphone Augmented Reality System (CARS) was developed for rehabilitation of stroke patients, which is portable, convenient, and suitable for self-training. OBJECTIVE The present research aimed to study the effectiveness of CARS in improving upper limb motor function and cognition function of stroke patients via conducting a long-term randomized controlled trial and analyze the patient’s acceptance of the proposed system. METHODS A randomized, double-blind, controlled trial was performed with 30 post-stroke, sub-acute phase patients. All patients in both the experimental group (n=15) and the control group (n=15) performed a 1-hour session of therapy each day, 5 days per week, for 2 weeks. Patients in the experimental group received 30 minutes of rehabilitation training with CARS and 30 minutes of conventional occupational therapy (OT) each session, while patients in the control group received conventional OT for the full 1 hour each session. The Fugl-Meyer Assessment-Upper Extremity subscale (FMA-UE), Action Research Arm Test (ARAT), Manual Muscle Test (MMT), Brunnstrom Stage (BS), and Barthel Index (BI) were used to assess motor function, and the Mini-Mental State Examination (MMSE), Add VS Sub (AVS), and Stroop Game (SG) were used to assess cognitive function before and after the 2-week treatment period. In addition, the User Satisfaction Evaluation Questionnaire (USEQ) was used to reflect the patients’ acceptance of the system in the experimental group after the final intervention. RESULTS All the assessment scores of the experimental group and control group were significantly improved after intervention (p＜0.05). The experimental group’s score of FMA-UE and ARAT increased by 11.47 and 5.86 respectively after intervention, which were both significantly higher than the increase of the control group (p＜0.01). Similarly, the score of AVS and SG in the experimental group increased by 7.53 and 6.83 respectively after the intervention, which was also higher than the control group (p＜0.01). The evaluation of the adoption of this system has three sub-dimensions. In terms of accessibility, the patients reported a mean score of 4.27±0.704 for the enjoyment of their experience with the system, 4.33±0.816 for success to use the system, 4.67±0.617 for the ability to control the system. In terms of comfort, the patients reported 4.40±0.737 for clear information provided by the system, 4.40±0.632 for comfort. In terms of acceptability, the patients reported 4.27±0.884 for usefulness in their rehabilitation, 4.67±0.617 for agreeing with CARS as a suitable tool for home-based rehabilitation. CONCLUSIONS CARS and conventional OT together-based rehabilitation were more effective in improving both upper limb motor function and cognition function as compared with conventional OT. Due to the low cost, and ease of use, CARS is also potentially suitable for home-based rehabilitation. CLINICALTRIAL The Chinese Clinical Trial Registry (ChiCTR1800017568).

Cluster Symptoms Reduction via Telephone-Based Intervention in Thai Breast Cancer Patients Undergoing 4-Cycle Adjuvant Chemotherapy: A Randomized-Controlled Trial

2021 ◽  
Vol 104 (6) ◽  
pp. 887-894
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trial ◽  
Adjuvant Chemotherapy ◽  
Energy Conservation ◽  
Cancer Patients ◽  
Controlled Trial ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Randomized Controlled ◽  
Experimental Group

Background: Cluster symptoms are a common occurrence in breast cancer patients undergoing chemotherapy. The telephone is a well-recognized, convenient device for reaching out to patients for monitoring and managing their symptoms in an efficient, prompt, and appropriate manner. Objective: To investigate the efficacy of telephone-based intervention to achieve energy conservation among breast cancer patients with the aim of alleviating fatigue, pain, sleep disturbance, and depression. Materials and Methods: The present study was a two-armed, randomized control trial conducted in the university hospital between March and September 2019. Seventy-four breast cancer patients, receiving four courses of adjuvant chemotherapy, were randomly recruited and assigned into the experimental group and the control group. One face-to-face intervention interview for energy conservation was conducted, followed by 20-minutes telephone brief counselling and assessment sessions, scheduled on day 1, 2, 7, and 14. Results: The scores for symptoms of median fatigue and pain in the experimental group were shown to be significantly reduced at the end of the study as compared to those scores within the control group (p<0.05). Similarly, scores for median sleep time and depression were greater at the end of cycle 1 and highest in cycle 2 (p<0.05, 0.001, respectively). Physical activity levels were also higher in the experimental group than in the control group in every cycle, with a statistical significance (p<0.001). Conclusion: The present study intervention demonstrated an effectiveness for the reduction of cluster symptoms. Further studies would be needed in a larger population scale in the customary, randomized controlled trial manner. Keywords: Cancer; Energy conservation; Fatigue; Pain; Sleep; Telephone

Testing the Effectiveness of a Strengths-Based Intervention Targeting All 24 Strengths: Results From a Randomized Controlled Trial

2020 ◽  
pp. 003329412093744
Author(s):  
Lobna Chérif ◽  
Valerie M. Wood ◽  
Christian Watier
Keyword(s):  
Randomized Controlled Trial ◽  
Character Strengths ◽  
Controlled Trial ◽  
Control Group ◽  
Strength Development ◽  
Character Strength ◽  
Significant Group ◽  
Randomized Controlled ◽  
Time Interaction ◽  
Experimental Group

This study assessed the effectiveness of a strengths-based randomized controlled trial focused on fostering all 24 character strengths in a group of 75 participants from a University in Tunisia. Participants randomly assigned to the challenge condition (n = 40) received an email each day for 24 days, that highlighted a particular strength of the day including why the strength is valuable, how to implement the strength behaviourally, and a motto related to that strength. Those in the control condition (n = 35) simply received emails containing the motto for each strength daily for 24 days. We assessed all participants’ levels of happiness before the experiment (T0), the day following the experiment (T1), and one-month following the experiment (T2). Results from a 2 (group) X 3 (time) split plot ANOVA revealed a significant group-by-time interaction, such that at T2 the experimental group had greater happiness scores than the control group. These findings provide some evidence that even “minimalist” interventions (involving the receipt of emails encouraging character-strength development), might be effective for promoting gains in happiness even one month after the intervention.

scholarly journals Effects of Monopolar Dielectric Radiofrequency Signals on the Symptoms of Fibromyalgia: A Single-Blind Randomized Controlled Trial

2020 ◽  
Vol 17 (7) ◽  
pp. 2465
Author(s):  
Alfonso Javier Ibáñez-Vera ◽  
Jerónimo Carmelo García-Romero ◽  
José Ramón Alvero-Cruz ◽  
Rafael Lomas-Vega
Keyword(s):  
Randomized Controlled Trial ◽  
Usual Care ◽  
Sham Group ◽  
Controlled Trial ◽  
Depression Scale ◽  
Physical Factor ◽  
Control Group ◽  
Local Pain ◽  
Randomized Controlled ◽  
Experimental Group

Monopolar dielectric radiofrequency (MDR) is a non-invasive treatment for pain based on the local application of electromagnetic signals. The study’s goal was to analyze the effects of MDR on the symptoms of fibromyalgia. For this aim, a randomized controlled trial was conducted on 66 female participants (aged 47 ± 17.7) diagnosed with fibromyalgia. Participants were randomly allocated to either an experimental group (n = 23), which received eight 20-minute sessions of MDR; a sham group, which received the same number of sessions of a sham MDR therapy (n = 22); or a control group (n = 21), which received usual care. The outcome variables included pain measured by the visual analogue scale (VAS), score on the hospital anxiety and depression scale (HADS) and quality of life measured by the combined index of fibromyalgia severity (ICAF). A large effect size was observed for the local pain (R2 = 0.46), total ICAF (R2 = 0.42) and ICAF physical factor scores (R2 = 0.38). Significant mean differences were found for the local pain (p = 0.025) and ICAF physical factor (p = 0.031) scores of the experimental group in comparison with the sham group. No statistically significant differences between groups were found in HADS. In conclusion, MDR is more effective than either sham treatment or usual care in the short-term improvement of pain and the physical wellbeing of participants with fibromyalgia.

scholarly journals Effectiveness of Hydrogalvanic Bath on Improving Pain, Disability, and Quality of Life in Individuals with Chronic Nonspecific Neck Pain: A Randomized Controlled Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Mastour Saeed Alshahrani ◽  
Jaya Shanker Tedla ◽  
Ravi Shankar Reddy ◽  
Faisal Asiri
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Control Group ◽  
Randomized Controlled ◽  
Pain Disability ◽  
Sf 36 ◽  
Neck Disability ◽  
Experimental Group

Background. Neck pain is one of the world’s leading factors in years lived with disability. Ambiguity in the effect of electrotherapy modalities for the treatment of chronic nonspecific neck pains (CNSNP) needs to be examined further. This study sought to elucidate the effectiveness of hydrogalvanic bath on improving pain, disability, and quality of life among individuals with CNSNP. Methods. Thirty-four individuals with a diagnosis of CNSNP were selected through convenient sampling and randomly divided into two groups by block randomization. The control group treatment underwent low Transcutaneous Electrical Nerve Stimulation (TENS) and exercise, and the experimental group was subjected to hydrogalvanic bath therapy (HGBT) and exercise. Individuals were evaluated for pain using a visual analog scale (VAS), disability with the Neck Disability Index (NDI), and quality of life with Short Form-36 (SF-36). These measures were applied at baseline and after 12 weeks of treatment. Results. The pretreatment and posttreatment results for VAS, NDI, and SF-36 were compared for both control and experimental groups. We found that all the three variables showed significant differences between the two time points with p < 0.05 in both the groups but the experimental group improvements were more significant than the control group with p < 0.05 . Conclusion. Twelve weeks of low TENS or HGBT along with exercises can decrease pain and neck disability and increase the quality of life in individuals with CNSNP. However, HGBT along with exercise has superior effects relative to low TENS along with exercise. This randomized controlled trial was registered in the International Standard Randomized Controlled Trials Number-ISRCTN29695190 and registered on 05/02/2020. This study is a retrospective registration.

Long-term efficacy of indicated prevention of depression in non-professional caregivers: randomized controlled trial

2014 ◽  
Vol 45 (7) ◽  
pp. 1401-1412 ◽  
Author(s):  
P. Otero ◽  
F. Smit ◽  
P. Cuijpers ◽  
A. Torres ◽  
V. Blanco ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Caregiver Burden ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Indicated Prevention ◽  
Randomized Controlled ◽  
Term Efficacy

BackgroundAlthough depression is a common problem among non-professional caregivers, only one trial has evaluated the efficacy of indicated prevention targeting this population and the long-term efficacy is unknown. The aim of this study was to evaluate the long-term efficacy of a brief intervention for the indicated prevention of depression in a sample of female caregivers.MethodA randomized controlled trial was conducted involving 173 participants (mean age 53.9 years) who were allocated to the intervention (n = 89) or the usual-care control group (n = 84). Blinded interviewers conducted assessments at 1, 3, 6 and 12 months of follow-up. The main outcome measure was the incidence of major depression and the secondary outcomes were compliance with treatment, depressive symptoms, emotional distress and caregiver burden.ResultsAt the 12-month follow-up, a lower incidence of depression as evaluated using the Structured Clinical Interview for Axis I Disorders of the DSM-IV was found in the intervention group compared with the control group (10.1%v.25.0%). The relative risk was 0.40 and statistically significant [χ2 = 6.68, degrees of freedom = 1,p = 0.010, 95% confidence interval (CI) 0.20–0.81], and the number needed to treat was 7 (95% CI 4–27). There was a significant delay in the onset of depression in the intervention group (p = 0.008). The good complier caregivers had a lower incidence of depression. The intervention effect on depressive symptoms, emotional distress and caregiver burden were maintained for 12 months.ConclusionsThis is the first study to demonstrate that a brief problem-solving intervention can prevent the onset of depression among non-professional caregivers over the longer term.

scholarly journals Effects of an Interactive Computer Game Exercise Regimen on Balance Impairment in Frail Community-Dwelling Older Adults: A Randomized Controlled Trial

2011 ◽  
Vol 91 (10) ◽  
pp. 1449-1462 ◽  
Author(s):  
Tony Szturm ◽  
Aimee L. Betker ◽  
Zahra Moussavi ◽  
Ankur Desai ◽  
Valerie Goodman
Keyword(s):  
Randomized Controlled Trial ◽  
Video Game ◽  
Dynamic Balance ◽  
Controlled Trial ◽  
Community Dwelling ◽  
Control Group ◽  
Day Hospital ◽  
Randomized Controlled ◽  
Balance Exercises ◽  
Experimental Group

Background Due to the many problems associated with reduced balance and mobility, providing an effective and engaging rehabilitation regimen is essential to progress recovery from impairments and to help prevent further degradation of motor skills. Objectives The purpose of this study was to examine the feasibility and benefits of physical therapy based on a task-oriented approach delivered via an engaging, interactive video game paradigm. The intervention focused on performing targeted dynamic tasks, which included reactive balance controls and environmental interaction. Design This study was a randomized controlled trial. Setting The study was conducted in a geriatric day hospital. Participants Thirty community-dwelling and ambulatory older adults attending the day hospital for treatment of balance and mobility limitations participated in the study. Interventions Participants were randomly assigned to either a control group or an experimental group. The control group received the typical rehabilitation program consisting of strengthening and balance exercises provided at the day hospital. The experimental group received a program of dynamic balance exercises coupled with video game play, using a center-of-pressure position signal as the computer mouse. The tasks were performed while standing on a fixed floor surface, with progression to a compliant sponge pad. Each group received 16 sessions, scheduled 2 per week, with each session lasting 45 minutes. Measurements Data for the following measures were obtained before and after treatment: Berg Balance Scale, Timed “Up & Go” Test, Activities-specific Balance Confidence Scale, modified Clinical Test of Sensory Interaction and Balance, and spatiotemporal gait variables assessed in an instrumented carpet system test. Results Findings demonstrated significant improvements in posttreatment balance performance scores for both groups, and change scores were significantly greater in the experimental group compared with the control group. No significant treatment effect was observed in either group for the Timed “Up & Go” Test or spatiotemporal gait variables. Limitations The sample size was small, and there were group differences at baseline in some performance measures. Conclusion Dynamic balance exercises on fixed and compliant sponge surfaces were feasibly coupled to interactive game-based exercise. This coupling, in turn, resulted in a greater improvement in dynamic standing balance control compared with the typical exercise program. However, there was no transfer of effect to gait function.

scholarly journals A Randomized Controlled Trial of a Passive Accessory Joint Mobilization on Acute Ankle Inversion Sprains

2001 ◽  
Vol 81 (4) ◽  
pp. 984-994 ◽  
Author(s):  
Toni Green ◽  
Kathryn Refshauge ◽  
Jack Crosbie ◽  
Roger Adams
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Step Length ◽  
Control Group ◽  
Joint Mobilization ◽  
Randomized Controlled ◽  
Ankle Inversion ◽  
Before And After ◽  
Experimental Group ◽  
Support Time

Abstract Background and Purpose. Passive joint mobilization is commonly used by physical therapists as an intervention for acute ankle inversion sprains. A randomized controlled trial with blinded assessors was conducted to investigate the effect of a specific joint mobilization, the anteroposterior glide on the talus, on increasing pain-free dorsiflexion and 3 gait variables: stride speed (gait speed), step length, and single support time. Subjects. Forty-one subjects with acute ankle inversion sprains (&lt;72 hours) and no other injury to the lower limb entered the trial. Methods. Subjects were randomly assigned to 1 of 2 treatment groups. The control group received a protocol of rest, ice, compression, and elevation (RICE). The experimental group received the anteroposterior mobilization, using a force that avoided incurring any increase in pain, in addition to the RICE protocol. Subjects in both groups were treated every second day for a maximum of 2 weeks or until the discharge criteria were met, and all subjects were given a home program of continued RICE application. Outcomes were measured before and after each treatment. Results. The results showed that the experimental group required fewer treatment sessions than the control group to achieve full pain-free dorsiflexion. The experimental group had greater improvement in range of movement before and after each of the first 3 treatment sessions. The experimental group also had greater increases in stride speed during the first and third treatment sessions. Discussion and Conclusion. Addition of a talocrural mobilization to the RICE protocol in the management of ankle inversion injuries necessitated fewer treatments to achieve pain-free dorsiflexion and to improve stride speed more than RICE alone. Improvement in step length symmetry and single support time was similar in both groups.

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