BACKGROUND AND OBJECTIVES

Telerehabilitation is the remote delivery of rehabilitation services using telecommunication technologies. Its local adoption was catalyzed by the COVID-19 pandemic, prompting the need to assess user acceptance. This study aimed to determine the acceptance of stroke telerehabilitation among patients, carers, and rehabilitation providers in the Department of Physical Medicine and Rehabilitation at St. Luke’s Medical Center – Global City and Quezon City.

METHODS

This descriptive cross-sectional study used purposive sampling to recruit 73 rehabilitation providers and 10 consumers. Data were collected using a self-administered survey based on the Technology Acceptance Model, covering perceived ease of use, usefulness, and behavioral intent. Descriptive and inferential statistics were used for analysis.

RESULTS

Most providers (94.4%) were familiar with telerehabilitation, while only half of the consumers were aware of it. Acceptance was moderate among providers (mean score: 35.75 ± 8.67) and high among consumers (mean score: 31.6 ± 7.52). Female providers were less likely to accept telerehabilitation (p=0.049). Consumers identified financial constraints and lack of a companion as key barriers, while providers cited internet issues and technology use. Both groups viewed telerehabilitation positively for teleconsultation, teletherapy, and telemonitoring. Smartphones were the preferred device; Viber and Facebook Messenger were the most commonly chosen platforms.

CONCLUSION

Stroke telerehabilitation was moderately to highly accepted by rehabilitation stakeholders in two tertiary private hospitals in Manila. Findings may guide institutional planning for telerehabilitation services. Training, infrastructure support, and awareness campaigns can help address implementation barriers.

Human ; Male ; Female ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Remote Consultation ; Physical And Rehabilitation Medicine ; Tertiary Care Centers ; Telecommunications ; Telerehabilitation ; Cross-sectional Studies ; Technology ; Stroke ; Covid-19

Effective discharge planning is crucial for ensuring safe transitions and sustained occupational participation as clients transition from professional care to their desired community settings. Despite its importance, current discharge practices in occupational therapy remain inconsistent, often relying on informal communication, variable team coordination, and unstructured decision-making. These gaps contribute to client–caregiver unpreparedness, fragmented services, and increased readmissions. This manuscript presents the Building Rehabilitation Into Discharge Goals and Engagement (BRIDGE) Framework, a client-centered, occupation-focused conceptual model designed to structure and support the discharge planning process in occupational therapy.

The BRIDGE framework was developed through an iterative process of literature review, theoretical grounding, and integration of clinical experience. It synthesizes principles from the Canadian Practice Process Framework, Person–Environment–Occupation frameworks, the Kawa Model, and Bioecological Systems Theory. The framework outlines six discharge planning steps, ranging from goal and timeline setting to follow-up and monitoring, supported by four foundational pillars: patient and family factors, occupational therapy factors, interdisciplinary team factors, and environmental or system influences. Together, these components provide a comprehensive guide for clinical reasoning, collaborative planning, caregiver preparation, and transitional support.

The framework clarifies the role of occupational therapy, enhances interprofessional coordination, and promotes consistent transition planning. Future work should include empirical testing, case-based application, and population-specific adaptations.

Human ; Patient Discharge ; Residence Characteristics ; Rehabilitation ; Communication ; Clinical Reasoning

Abstract Background: This study aims to determine the effectiveness of programmed exercise with telerehabilitation at home in patients with obesity and knee osteoarthritis on visual analogue scale scores, body mass index, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Methods: This research is a pre–post study in patients with obesity and knee osteoarthritis. Research subjects performed a series of exercise programs at home for 28 days. Before the program, there was an initial assessment from a psychologist and a nutritionist. During the program, there was tele-education, telemonitoring, and teleconsultation from doctors. Twenty-six female subjects participated. Results: Visual analogue scale scores decreased statistically significantly every week, until the end of the fourth week, compared with before the intervention (p<0.001). Body mass index and WOMAC scores decreased statistically significantly at the end of the fourth week compared with before the intervention (both p<0.001). Further analysis of all WOMAC components in the intervention group, including pain, stiffness, and physical function, also showed a statistically significant decrease (p<0.001). Conclusion: Programmed exercise as part of telerehabilitation at home has been statistically proven to reduce visual analogue scale scores, body mass index, and WOMAC in patients with obesity and knee osteoarthritis.
Telerehabilitation ; Knee Osteoarthritis ; Obesity ; Body Mass Index ; Visual Analogue Scale ; WOMAC

BACKGROUND

Patients with severe nontraumatic brain injuries often present with disorders of unconsciousness. Immediate neurologic care, neuroprotection, and early neurorehabilitation are core principles for better outcomes. Neurorehabilitation, through both pharmacological and non-pharmacological strategies, aims to enhance neuroplasticity for faster recovery. Amantadine, primarily known as an antiviral and used in Parkinson’s treatment, has shown a potential role for accelerating neuronal recovery and neurorehabilitation.

OBJECTIVE

Available literature on the use of amantadine for nontraumatic brain injury patients is limited. This scoping review aims to identify the potential benefits and limitations of amantadine in neurorehabilitation.

METHODOLOGY

In the literature review, the keywords "Amantadine" AND "Neurorehabilitation" were used to search PubMed, EBSCO, and the Cochrane Library for articles published between January 1, 2003, and August 2024. Inclusion criteria required that articles have clear research objectives, strict subject eligibility criteria, a detailed methodology, and the administration of amantadine for nontraumatic brain injuries. Out of 57 identified articles, only 7 were included in the study.

RESULTS AND DISCUSSION

Its benefits include improving the level of consciousness, accelerating recovery, decreasing mortality, managing delayed post-hypoxic encephalopathy, and improving verbal fluency in nonfluent speech. Its adverse effects and the paucity of available literature recommending amantadine for neurorehabilitation are the possible limitations.

CONCLUSION

Amantadine accelerates the neurologic recovery of patients with disorders of unconsciousness secondary to nontraumatic brain injuries.

RECOMMENDATION

Future studies may conduct meta-analyses, systematic reviews, and randomized controlled trials of amantadine in patients with nontraumatic brain injury to further strengthen its promising role in neurorehabilitation.

Human ; Amantadine ; Neurological Rehabilitation ; Neurorehabilitation

INTRODUCTION

Strength is a key modifiable risk factor for hamstring strains with significant differences between injured and non-injured sides in the lengthened position. Ensuring the test-retest reliability of measurement protocols ensures consistent injury prevention, rehabilitation and return-to-sport planning.

OBJECTIVE

To evaluate the test-retest reliability of hamstring strength protocols in both standardized and lengthened positions among healthy adults.

STUDY DESIGN

Test-retest reliability study.

SETTING

Human Performance Laboratory, Fr. Roque Ruano building, University of Santo Tomas, Espana Manila.

PARTICIPANTS

Ten healthy adults (six males and four females; mean age: 26.5 ± 4.03 years).

MAIN OUTCOME MEASURES

Absolute and relative peak torque for concentric and eccentric hamstring and quadriceps were measured at 60°/sec, 180°/sec and 240°/sec in the standardized position (hip and knee flexed at 90°). In the lengthened position (hip flexed at 85° and knee at 30°), isometric knee flexion and peak torque for concentric and eccentric hamstring and quadriceps were assessed at 60°/sec and 180°/sec. Strength ratios were calculated for both positions.

RESULTS

Intraclass Correlation Coefficient (ICC) values demonstrated good to excellent reliability for peak torque measurements, with higher reliability in the standardized position (ICC 0.83-0.94) than in the lengthened position (ICC 0.79-0.96). Conventional and functional ratios varied, with lower ICCs for the right leg in the standardized position (ICC 0.32-0.92) and moderate to good reliability in the lengthened position (ICC 0.63-0.87).

CONCLUSION

Standardized and lengthened positions provide reliable assessments of absolute and relative peak torque for hamstring and quadriceps muscles during concentric and eccentric contractions across all speeds, including conventional and functional strength ratios.

Human ; Rehabilitation

Repetitive transcranial magnetic stimulation （rTMS） is an emerging technique for noninvasive brain stimulation and plays an increasingly important role in the rehabilitation treatment of post-stroke aphasia due to its advantages of noninvasiveness，safety，and targeting ability. With reference to related articles in China and globally in recent years，this article elaborates on the role，mechanism，and target of rTMS in post-stroke aphasia，in order to provide a reference for the rehabilitation treatment of patients with post-stroke aphasia.
Rehabilitation

BACKGROUND

Acute ICH represents a serious form of stroke, associated with high morbidity and mortality. Early rehabilitation has been recommended in order to improve motor function recovery and functional independence of the patients with ICH. However, the timing at which rehabilitation should be initiated remains unclear.

OBJECTIVES

This study aims to determine the effectiveness of early rehabilitation in motor function recovery and functional independence as well as to investigate the ideal timing for initiating rehabilitation post-ICH.

METHODS

Four RCTs were retrieved in this meta-analysis (Bai et al – 364 patients, Liu et al – 243 patients, Yen et al – 60 patients, Zhu et al – 84 patients). Selection criteria included early rehabilitation intervention for acute ICH patients, with measurable objective assessment of motor function and evaluation of ADLs at 1 and 3 months post-rehabilitation. Data extraction was done from the selected studies, followed by statistical analysis, using a random effects model, calculating the SMD with 95% CI.

RESULTS

Early rehabilitation significantly improved motor function at 1 month [SMD = 0.55, 95% CI 0.09, 1.00, p = 0.02] and independence in ADLs at 1 month [SMD = 0.57, 95% CI 0.10, 1.05, p = 0.02]. However, this did not persist at 3 months [SMD = 0.17, 95% CI 0.00, 0.35, p = 0.05].

CONCLUSION

Results of this meta-analysis support that early rehabilitation within 72 hours post-ICH significantly improved motor recovery and independence in ADLs at 1 month but uncertainties still surround benefits at 3 months.

Human ; Cerebral Hemorrhage ; Hemorrhage ; Rehabilitation ; Patients

BACKGROUND

A substantial number of COVID-19 recoverees are working-aged individuals, which makes return-towork (RTW) an essential part of rehabilitation. Many COVID-19 recoverees must deal with physical and mental symptoms of post-COVID conditions such as fatigue, dyspnea, difficulty concentrating, memory lapses, and anxiety. These symptoms coupled with often insufficient support from employers and the government can make the RTW process complicated. Although research related to RTW after COVID-19 has begun to emerge over the years, few primary studies have come out from developing countries.

OBJECTIVES

This exploratory study aims to describe perceived work ability and health-related quality of life, lived experiences of the RTW process, and role of rehabilitation in a limited sample of Filipino COVID-19 recoverees. 

METHODS

Using purposive sampling and a convergent parallel mixed-method design, the study draws on an online survey and group interviews to understand expectations, experiences, and self-rated work ability of working-age adults with post-COVID condition. We report the findings of the questionnaire data using descriptive statistics. From the questionnaire respondents, eight participants were interviewed to explore the RTW experiences from multiple perspectives. The group interview was conducted online, and narrative analysis was used to explore the data. This analytic process involved an iterative and inductive process between data gathering and data analysis.

RESULTS

Findings from our narrative analysis are reported under four themes: 1) The period of liminality; 2) A ‘positive’ problem; 3) Health as a psychosocial and justice issue; and 4) The reimagination of paid work. The narratives gathered document an overview of how selected Filipinos overcame the COVID-19 infection and their recovery and RTW process.

CONCLUSION

Results call for a re-examination of the concept of health and paid work for individuals undergoing rehabilitation and recovery.

Human ; Pandemics ; Rehabilitation, Vocational ; Occupational Therapy

BACKGROUND

Different activity restrictions in older adults are caused by various factors and these can lead to a lower quality of life. The determination of these factors will provide baseline data in the local setting to help health care workers identify which are significantly associated with daily activity restriction. 

OBJECTIVES

To determine the different factors such as age, sex, living arrangement, educational level, more than one hospitalization per year, multimorbidity, polypharmacy, dementia risk, depression, malnutrition, history of fall, visual, and hearing impairment, bladder, and bowel incontinence; if significant association exist between these factors and the development of restriction on activities of daily living (ADL) and instrumental activities of daily living (IADL). Also, to determine the most common ADL and IADL restricted activities among older adults. 

METHODS

Five hundred forty (540) patients aged 60 and above were interviewed where 270 participants were included in the study through systemic random sampling. The different factors and activity restrictions were collected through one time interview using questionnaires (MGS, AD8, Katz and Lawton scale). Data collected were analyzed and interpreted using t -test, chi square and odds ratio.

RESULTS

The significant factors associated with both ADL and IADL restriction are age (p = .011; p = <0.001), visual impairment (p = 0.01; p = 0.042), bladder incontinence (p = 0.002; p = 0.018) and bowel incontinence (p = 0.01; p = 0.033). Lower educational level (p = 0.032) and fall history (p = 0.036) are significantly associated with IADL restriction, while depression (p = 0.0109) is significantly associated with ADL restriction. For ADL, the most restricted activity is continence control followed by dressing, bathing, eating, and transferring. In terms of IADL, the most restricted activity is doing house works, followed by doing laundry, travelling beyond walking distance, handling finances and shopping.

CONCLUSION

Older adults with more advanced age, visual impairment, bladder, and bowel incontinence are significantly associated with both ADL and IADL, indicating that health related conditions affect mobility. Lower educational level is associated with IADL restriction possibly because IADL activities are more complex and require thinking. Fall history is also significantly associated with IADL restriction because visual problems can affect balance and spatial awareness while depression is significantly associated with ADL due to lower quality of life. 

Human ; Activities Of Daily Living

OBJECTIVE: To observe the effects of enhanced rehabilitation on the prognosis of critically ill patients in the intensive care unit (ICU). METHODS: A single-center retrospective historical controlled study was conducted, patients admitted to the ICU of Peking University First Hospital from May 1, 2020, to April 30, 2021, and from October 1, 2021, to September 30, 2022 were enrolled. According to the different rehabilitation treatment strategies during different periods, patients were divided into the conventional rehabilitation group (patients receiving conventional rehabilitation treatment from May 1, 2020, to April 30, 2021) and the enhanced rehabilitation group (patients receiving the therapy of multidisciplinary team, ie medical care-rehabilitation-nursing care from October 1, 2021, to September 30, 2022). General data, acute physiology and chronic health evaluation II (APACHE II), and study endpoints were collected. Primary endpoints included rehabilitation-therapy rate, intervention time for rehabilitation, rehabilitation-related adverse events, and prognostic indicators such as (length of stay in hospital, length of stay in the ICU, and duration of mechanical ventilation). Secondary endpoints included incidence of deep vein thrombosis and hospital mortality. Kaplan-Meier curves were used to analyze cumulative discharge rates within 50 days. RESULTS: A total of 539 ICU patients were enrolled, with 245 in the conventional rehabilitation group and 294 in the enhanced rehabilitation group; 322 patients had an APACHE II score ≤ 15, while 217 patients had an APACHE II score > 15. Compared to the conventional rehabilitation group, the enhanced rehabilitation group demonstrated significantly higher rehabilitation-therapy rate [51.70% (152/294) vs. 11.43% (28/245)], earlier intervention time for rehabilitation [days: 2.00 (1.00, 3.00) vs. 4.00 (3.00, 7.00)]; shorter length of stay in hospital [days: 18.00 (12.00, 30.00) vs. 21.00 (13.00, 36.00)] and lower incidence of DVT [17.01% (50/294) vs. 24.08% (59/245)]. The differences were all statistically significant (all P < 0.05). There were no rehabilitation-related adverse events occurred in either group. Kaplan-Meier analysis demonstrated a significantly higher cumulative discharge rate within 50 days in the enhanced rehabilitation group compared to the conventional rehabilitation group [86.7% (255/294) vs. 82.9% (203/245); Log-Rank test: χ² = 4.262, P = 0.039]. Subgroup analysis showed that for patients with APACHE II score ≤ 15, the enhanced rehabilitation subgroup had higher rehabilitation-therapy rate [44.32% (78/176) vs. 6.16% (9/146), P < 0.05]. For patients with APACHE II score > 15, compared to the conventional rehabilitation group, the enhanced subgroup demonstrated higher rehabilitation-therapy rate [62.71% (74/118) vs. 19.19% (19/99), P < 0.05] and shorter length of stay in hospital [days: 20.50 (12.00, 31.25) vs. 26.00 (16.00, 43.00), P < 0.05]. CONCLUSIONS Enhanced rehabilitation therapy with medical care, rehabilitation and nursing care, improved rehabilitation-therapy rate, advanced time of rehabilitation treatment, reduced length of stay in hospital and incidence of deep vein thrombosis in critically ill patients, particularly benefited those with APACHE II score > 15. The enhanced rehabilitation was beneficial to the patient in the intensive care unit with safety and worth more investigation.
Humans ; Retrospective Studies ; Critical Illness/rehabilitation* ; Intensive Care Units ; Prognosis ; Length of Stay ; APACHE ; Historically Controlled Study ; Male ; Female ; Middle Aged ; Aged