scholarly journals A Telerehabilitation Intervention for Youths With Arthrogryposis Multiplex Congenita: Protocol for a Pilot Study (Preprint)

2020 ◽  
Author(s):  
Marianne Gagnon ◽  
Jessica Collins ◽  
Caroline Elfassy ◽  
Gabriela Marino Merlo ◽  
Jacquelyn Marsh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pilot Study ◽  
Data Collection ◽  
Range Of Motion ◽  
Large Scale ◽  
Goal Attainment ◽  
Exercise Program ◽  
Home Exercise ◽  
Arthrogryposis Multiplex Congenita ◽  
Home Exercise Program

BACKGROUND Arthrogryposis multiplex congenita (AMC) is characterized by joint contractures present in at least two body areas. In addition to these contractures, individuals with AMC can have decreased muscle mass, leading to limitations in activities of daily living. Exercise has the potential to maintain or improve the range of motion and muscle strength. However, this type of intervention necessitates frequent follow ups that are currently difficult to provide for youths with AMC because they often live far from a specialized hospital. To overcome this distance challenge, telecommunication technologies can be used to deliver rehabilitation remotely, which is called telerehabilitation. The study protocol for one such type of rehabilitation will be presented in this paper. OBJECTIVE This pilot study aims to (1) evaluate the feasibility of using telerehabilitation to provide a home exercise program for youths with AMC, and (2) assess the effectiveness of a home exercise program. METHODS A total of 10 youths aged 8-21 years with AMC will be recruited. The intervention consists of a 12-week individualized home-based exercise program delivered remotely using telerehabilitation. At baseline, youths will complete the Physical Activity Questionnaire for Adolescents and the Pediatrics Outcomes Data Collection Instrument to assess pain, function, and level of physical activity. During the first telerehabilitation meeting, the rehabilitation therapists will measure range of motion using a virtual goniometer and assess the youth’s functional level. The therapists will then use the Goal Attainment Scale to set objectives and develop the individualized intervention. Follow ups will occur every 3 weeks to make sure exercises are performed safely and to progress the exercises when needed. At the end of the 12-week intervention, rehabilitation therapists will re-evaluate the youth using the same outcome measures as the initial evaluation. The youths will be asked to complete the same questionnaires, with the addition of questions about their satisfaction regarding the intervention. Nonparametric and descriptive statistics will be used to evaluate the feasibility and effectiveness. RESULTS Ethics approval was obtained in October 2018. Recruitment and data collection started in January 2019 and was completed in May 2020. CONCLUSIONS This pilot study will help us learn how a large-scale project may work in practice to improve outcomes in physical activity, pain, and function, and goal attainment among youths with AMC, thus informing a future clinical trial. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/18688

scholarly journals A Telerehabilitation Intervention for Youths With Arthrogryposis Multiplex Congenita: Protocol for a Pilot Study

10.2196/18688 ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. e18688
Author(s):  
Marianne Gagnon ◽  
Jessica Collins ◽  
Caroline Elfassy ◽  
Gabriela Marino Merlo ◽  
Jacquelyn Marsh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pilot Study ◽  
Data Collection ◽  
Range Of Motion ◽  
Large Scale ◽  
Goal Attainment ◽  
Exercise Program ◽  
Home Exercise ◽  
Arthrogryposis Multiplex Congenita ◽  
Home Exercise Program

Background Arthrogryposis multiplex congenita (AMC) is characterized by joint contractures present in at least two body areas. In addition to these contractures, individuals with AMC can have decreased muscle mass, leading to limitations in activities of daily living. Exercise has the potential to maintain or improve the range of motion and muscle strength. However, this type of intervention necessitates frequent follow ups that are currently difficult to provide for youths with AMC because they often live far from a specialized hospital. To overcome this distance challenge, telecommunication technologies can be used to deliver rehabilitation remotely, which is called telerehabilitation. The study protocol for one such type of rehabilitation will be presented in this paper. Objective This pilot study aims to (1) evaluate the feasibility of using telerehabilitation to provide a home exercise program for youths with AMC, and (2) assess the effectiveness of a home exercise program. Methods A total of 10 youths aged 8-21 years with AMC will be recruited. The intervention consists of a 12-week individualized home-based exercise program delivered remotely using telerehabilitation. At baseline, youths will complete the Physical Activity Questionnaire for Adolescents and the Pediatrics Outcomes Data Collection Instrument to assess pain, function, and level of physical activity. During the first telerehabilitation meeting, the rehabilitation therapists will measure range of motion using a virtual goniometer and assess the youth’s functional level. The therapists will then use the Goal Attainment Scale to set objectives and develop the individualized intervention. Follow ups will occur every 3 weeks to make sure exercises are performed safely and to progress the exercises when needed. At the end of the 12-week intervention, rehabilitation therapists will re-evaluate the youth using the same outcome measures as the initial evaluation. The youths will be asked to complete the same questionnaires, with the addition of questions about their satisfaction regarding the intervention. Nonparametric and descriptive statistics will be used to evaluate the feasibility and effectiveness. Results Ethics approval was obtained in October 2018. Recruitment and data collection started in January 2019 and was completed in May 2020. Conclusions This pilot study will help us learn how a large-scale project may work in practice to improve outcomes in physical activity, pain, and function, and goal attainment among youths with AMC, thus informing a future clinical trial. International Registered Report Identifier (IRRID) DERR1-10.2196/18688

scholarly journals Using Telerehabilitation to Deliver a Home Exercise Program to Youth With Arthrogryposis: Single Cohort Pilot Study

10.2196/27064 ◽  
2021 ◽  
Vol 23 (7) ◽  
pp. e27064
Author(s):  
Marianne Gagnon ◽  
Gabriela Marino Merlo ◽  
Rita Yap ◽  
Jessica Collins ◽  
Caroline Elfassy ◽  
...  
Keyword(s):  
Physical Activity ◽  
Data Collection ◽  
Correlation Coefficient ◽  
Intraclass Correlation ◽  
Exercise Program ◽  
Daily Activities ◽  
Home Exercise ◽  
Home Exercise Program ◽  
Data Collection Instrument ◽  
Activity Questionnaire

Background Arthrogryposis multiplex congenita (AMC) is characterized by joint contractures and muscle weakness, which limit daily activities. Youths with AMC require frequent physical therapeutic follow-ups to limit the recurrence of contractures and maintain range of motion (ROM) and muscle strength; however, access to specialized care may be limited because of geographical distance. Telerehabilitation can offer a potential solution for delivering frequent follow-ups for youth with AMC, but research on the use of telerehabilitation in children with musculoskeletal disorders is scarce. Objective The study aims to evaluate the feasibility of delivering a home exercise program (HEP) by using telerehabilitation for youth with AMC. We also aim to explore the effectiveness of the HEP as a secondary aim. Methods Youths aged between 8 and 21 years with AMC were recruited at the Shriners Hospitals for Children–Canada. The participants completed baseline and post-HEP questionnaires (the Physical Activity Questionnaire for Adolescents, Pediatrics Outcomes Data Collection Instrument, and Adolescent and Pediatric Pain Tool), and clinicians assessed their active ROM using a virtual goniometer. Clinicians used the Goal Attainment Scale with the participants to identify individualized goals to develop a 12-week HEP and assess the achievement of these goals. Follow-ups were conducted every 3 weeks to adjust the HEP. Data on withdrawal rates and compliance to the HEP and follow-ups were collected to assess the feasibility of this approach. The interrater reliability of using a virtual goniometer was assessed using the intraclass correlation coefficient and associated 95% CI. Nonparametric tests were used to evaluate feasibility and explore the effectiveness of the HEP. Results Of the 11 youths who were recruited, 7 (median age: 16.9 years) completed the HEP. Of the 47 appointments scheduled, 5 had to be rescheduled in ≤24 hours. The participants performed their HEP 2.04 times per week (95% CI 1.25-4.08) and reported good satisfaction with the approach. A general intraclass correlation coefficient of 0.985 (95% CI 0.980-0.989) was found for the web-based ROM measurement. Individualized goals were related to pain management; endurance in writing, standing, or walking; sports; and daily activities. In total, 12 of the 15 goals set with the participants were achieved. Statistically significant improvements were observed in the pain and comfort domain of the Pediatrics Outcomes Data Collection Instrument (preintervention: median 71; 95% CI 34-100; postintervention: median 85; 95% CI 49-100; P=.08) and Physical Activity Questionnaire for Adolescents (preintervention: median 1.62; 95% CI 1.00-2.82; postintervention: median 2.32; 95% CI 1.00-3.45; P=.046). Conclusions The remote delivery of an HEP for youth with AMC is feasible. Promising results were found for the effectiveness of the HEP in helping youths with AMC to achieve their goals. The next step will be to assess the effectiveness of this exercise intervention in a randomized controlled trial. International Registered Report Identifier (IRRID) RR2-10.2196/18688

scholarly journals Using Telerehabilitation to Deliver a Home Exercise Program to Youth With Arthrogryposis: Single Cohort Pilot Study (Preprint)

2021 ◽  
Author(s):  
Marianne Gagnon ◽  
Gabriela Marino Merlo ◽  
Rita Yap ◽  
Jessica Collins ◽  
Caroline Elfassy ◽  
...  
Keyword(s):  
Physical Activity ◽  
Data Collection ◽  
Correlation Coefficient ◽  
Intraclass Correlation ◽  
Exercise Program ◽  
Daily Activities ◽  
Home Exercise ◽  
Home Exercise Program ◽  
Data Collection Instrument ◽  
Activity Questionnaire

BACKGROUND Arthrogryposis multiplex congenita (AMC) is characterized by joint contractures and muscle weakness, which limit daily activities. Youths with AMC require frequent physical therapeutic follow-ups to limit the recurrence of contractures and maintain range of motion (ROM) and muscle strength; however, access to specialized care may be limited because of geographical distance. Telerehabilitation can offer a potential solution for delivering frequent follow-ups for youth with AMC, but research on the use of telerehabilitation in children with musculoskeletal disorders is scarce. OBJECTIVE The study aims to evaluate the feasibility of delivering a home exercise program (HEP) by using telerehabilitation for youth with AMC. We also aim to explore the effectiveness of the HEP as a secondary aim. METHODS Youths aged between 8 and 21 years with AMC were recruited at the Shriners Hospitals for Children–Canada. The participants completed baseline and post-HEP questionnaires (the Physical Activity Questionnaire for Adolescents, Pediatrics Outcomes Data Collection Instrument, and Adolescent and Pediatric Pain Tool), and clinicians assessed their active ROM using a virtual goniometer. Clinicians used the Goal Attainment Scale with the participants to identify individualized goals to develop a 12-week HEP and assess the achievement of these goals. Follow-ups were conducted every 3 weeks to adjust the HEP. Data on withdrawal rates and compliance to the HEP and follow-ups were collected to assess the feasibility of this approach. The interrater reliability of using a virtual goniometer was assessed using the intraclass correlation coefficient and associated 95% CI. Nonparametric tests were used to evaluate feasibility and explore the effectiveness of the HEP. RESULTS Of the 11 youths who were recruited, 7 (median age: 16.9 years) completed the HEP. Of the 47 appointments scheduled, 5 had to be rescheduled in ≤24 hours. The participants performed their HEP 2.04 times per week (95% CI 1.25-4.08) and reported good satisfaction with the approach. A general intraclass correlation coefficient of 0.985 (95% CI 0.980-0.989) was found for the web-based ROM measurement. Individualized goals were related to pain management; endurance in writing, standing, or walking; sports; and daily activities. In total, 12 of the 15 goals set with the participants were achieved. Statistically significant improvements were observed in the pain and comfort domain of the Pediatrics Outcomes Data Collection Instrument (preintervention: median 71; 95% CI 34-100; postintervention: median 85; 95% CI 49-100; <i>P</i>=.08) and Physical Activity Questionnaire for Adolescents (preintervention: median 1.62; 95% CI 1.00-2.82; postintervention: median 2.32; 95% CI 1.00-3.45; <i>P</i>=.046). CONCLUSIONS The remote delivery of an HEP for youth with AMC is feasible. Promising results were found for the effectiveness of the HEP in helping youths with AMC to achieve their goals. The next step will be to assess the effectiveness of this exercise intervention in a randomized controlled trial. INTERNATIONAL REGISTERED REPORT RR2-10.2196/18688

scholarly journals Yoga versus Home Exercise Program in Children with Enthesitis Related Arthritis: A Pilot Study

2021 ◽  
pp. 102696
Author(s):  
Ezgi Yasar ◽  
Erdogan Kavlak ◽  
Serkan Turkucar ◽  
Deniz Bayraktar ◽  
Ceyhun Acari ◽  
...  
Keyword(s):  
Pilot Study ◽  
Exercise Program ◽  
Home Exercise ◽  
Home Exercise Program ◽  
Enthesitis Related Arthritis

scholarly journals Adherence to Self-managed Exercises for Patients with Persistent Subacromial Pain: The Ad-Shoulder Feasibility Study

2020 ◽  
Author(s):  
Daniel H. Major ◽  
Margreth Grotle ◽  
Chris Littlewood ◽  
Jens Ivar Brox ◽  
Dagfinn Matre ◽  
...  
Keyword(s):  
Physical Activity ◽  
Adverse Events ◽  
Feasibility Study ◽  
Exercise Program ◽  
Exercise Adherence ◽  
The Self ◽  
Home Exercise ◽  
Home Exercise Program ◽  
Activity Measures

Abstract Background: Exercise is recommended for patients with subacromial pain. It has been suggested that good exercise adherence improves clinical outcomes. Despite this, little attention has been paid to the need for behavioural frameworks to enhance adherence to home exercise programs for patients with subacromial pain.Methods: A feasibility study with pre-post design was used. Participants aged > 18 years, with subacromial pain, who had received conservative treatment during the past six months, were recruited. The Ad-Shoulder intervention consisted of 1-5 individual sessions provided over 3 months and was based on 5 self-management skills, which aimed to enhance the patients’ self-efficacy and adherence to self-managed exercises. The primary objectives were assessed according to predefined progression criteria: 1) The recruitment rate (10 patients enrolled within 12 weeks); 2) Follow-up rate (≥80% on all self-reported measures); 3) Objective physical activity measures (≥80% of participants would contribute valid data at each time point), 4) Adherence with the self-managed exercises (≥80% of the participants would adhere to ≥80% of the assigned home exercise program); 5) Fidelity of the delivery of the intervention (The therapists delivered the intervention according to the protocol); 6) Adverse events (<30% would report adverse events (including mild)). The results were reported using descriptive statistics.Results: Eleven patients were recruited during 16 weeks. Ten patients completed the self-reported measures at baseline and Week 12. Objective physical activity measures were successfully obtained for 100% at baseline, 64% at week six and 82% at week 12. 55% of the participants satisfactorily completed at least 80% of their home exercise program. All sessions were delivered according to the protocol. None of the patients reported any adverse events. Conclusions: Objective physical activity data measures at baseline and week 12, follow-up, the physiotherapists’ fidelity to the intervention and adverse events met our pre-specified progression criteria. Recruitment and adherence to the self-managed exercise program were both below the anticipated level. Further intervention development is necessary to understand whether adherence to the self-managed exercises could be enhanced and additional methods of recruitment would need to be considered, including additional recruitment sites, in any planning for a future main trial.Trial registration: ClinicalTrials.gov NCT04190836, Registered December 9, 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04190836

Range of motion after total knee arthroplasty: the effect of a preoperative home exercise program

2012 ◽  
Vol 22 (3) ◽  
pp. 703-709 ◽  
Author(s):  
Fabrizio Matassi ◽  
Joris Duerinckx ◽  
Hilde Vandenneucker ◽  
Johan Bellemans
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Exercise Program ◽  
Home Exercise ◽  
Home Exercise Program ◽  
Total Knee

scholarly journals Effect of Motivation by “Instagram” on Adherence to Physical Activity among Female College Students

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Einas Al-Eisa ◽  
Asma Al-Rushud ◽  
Ahmad Alghadir ◽  
Shahnawaz Anwer ◽  
Bashayer Al-Harbi ◽  
...  
Keyword(s):  
Physical Activity ◽  
College Students ◽  
Intervention Group ◽  
Exercise Program ◽  
Female College Students ◽  
Home Exercise ◽  
Control Group ◽  
Home Exercise Program ◽  
Female College ◽  
Activity Program

Objective.To investigate the efficacy of using “Instagram application” with a “home-exercise program” as a motivational stimulus in improving physical activity (PA) adherence levels among female college students.Methods.Fifty-eight female undergraduate students with the mean age20.3±0.96years participated. Participants were divided into two groups: intervention and the control group; both the groups received an exercise program and the intervention group was additionally motivated by “Instagram.” Adherence to PA was measured by using an adherence sheet. The Exercise Motivation Inventory (EMI-2) was used to assess the motivational factors.Results.The most frequent motivational factors were extrinsic as assessed using the EMI-2. “Positive health” was the most frequent factor mentioned of the two types with 47% of the sample. The intervention group adhered with 17% more to the activity program compared to the control group. Moreover, 72% of the participants in the intervention and control groups found the activity program flexible enough to be performed at home; they agreed about its effectiveness on adherence (53%).Conclusions.The use of Instagram with the home exercise program as a motivational modality could be attractive and effective to reinforce adherence and maintain an appropriate PA level.

scholarly journals Effectiveness of Intra-articular Steroid Injection in Treatment of Idiopathic Frozen Shoulder Followed by Physiotherapy and Home Exercise Program.

2019 ◽  
Vol 4 (1) ◽  
pp. 611-615
Author(s):  
Shambhu Sah ◽  
Shivam Karn ◽  
Deepak Sigdel ◽  
Mukunda Dahal ◽  
Ragin Kathet ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Pain ◽  
Steroid Injection ◽  
Frozen Shoulder ◽  
Treatment Protocol ◽  
Exercise Program ◽  
Oral Steroid ◽  
Home Exercise ◽  
Home Exercise Program ◽  
The Mean

Introduction: Idiopathic frozen shoulder (IFS) is a common chronic and disabling condition of shoulder pain characterized by progressive loss of active and passive range of motion (ROM) with unclear pathogenesis. The ideal treatment protocol is still controversial but commonly used treatment includes single agent or combination of oral non-steroid anti- inflammatory drugs (NSAIDS), oral steroids, intra-articular steroid injection and physiotherapy. Objective: The objective of this study was to evaluate the effectiveness of intra-articular methylprednisolone injection for pain and ROM in patients suffering from idiopathic frozen shoulder who did not respond to oral NSAIDS with or without oral steroid. Methodology: A total of 70 patients suffering from IFS were enrolled in this cross sectional study from May 2017–October 2018 from outpatient department of orthopaedic and physiotherapy of Koshi Zonal Hospital. All the patients underwent treatment protocol that comprised of Intra-articular steroid injection followed by five days of oral NSAIDS along with five days regime of physical therapy at the physiotherapy centre, followed by home exercise program. Each patient was followed up at every two weeks interval from intra-articular injection till 6th week. Each patient was evaluated for range of motion (ROM), Numerical Pain Rating Scale (NPRS) and Shoulder Pain and Disability Index (SPADI) before the treatment protocol and at every follow up visit. Data was analyzed using Microsoft Excel Program. Results: All patients enrolled for the study had satisfactory response. The mean age of the patient was 51.8 years (range 40-65 years). The mean age of the 26 male patients was 54 years (range 45-65), whereas the mean age of 44 female patients was 50.5 years (range 45-60). Mean duration of illness was 26.5 weeks (range 18-32 weeks), SPADI before medication was 83.14, at 2nd week was 50.92, at 4th week was 38.63 and at 6th week was 27.22. Conclusion: Combination of intra-articular methylprednisolone injection, physiotherapy and home exercise program is effective in IFS for rapid improvement in pain and ROM.

PILOT STUDY OF TELEHEALTH HOME EXERCISE PROGRAM

2006 ◽  
Vol 26 (4) ◽  
pp. 270
Author(s):  
Jill Winters ◽  
Mary Ann Papp ◽  
Susan Cashin
Keyword(s):  
Pilot Study ◽  
Exercise Program ◽  
Home Exercise ◽  
Home Exercise Program
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