The suspension of facility-based rehabilitation services and restricted mobility at the onslaught of the coronavirus disease 2019 (COVID-19) pandemic forced healthcare workers to explore new methods of providing patient care. This case report presents a 40-year-old female who underwent osteotomy with iliac crest bone graft and intramedullary nailing with quadricepsplasty to correct the leg length discrepancy and knee extension contracture that developed secondary to multiple bone injuries sustained in a vehicular accident 17 months before admission. The in-hospital postoperative rehabilitation was prematurely terminated due to the COVID-19 lockdown. The client was discharged with pain and swelling of the right lower limb, knee flexion of 0–25°, and an ankle plantar flexion contracture. She had moderate to severe difficulty in walking, bathing, toileting, and lower garment dressing, needing assistance to complete these tasks. Telerehabilitation was done over three months using both synchronous and asynchronous methods. Gains from the remote program were independence in all the self-care activities with no difficulty in performing them. The patient was able to return to work. Gains in knee and ankle mobility were minimal. Telerehabilitation using available technologies can be used to continue patient care amidst barriers to face-to-face rehabilitation in a low-resource country
Telerehabilitation ; Telemedicine ; COVID-19 ; Osteotomy

BACKGROUND AND OBJECTIVE

The Gross Motor Function Classification System – Expanded and Revised (GMFCS-E&R) is a valid tool commonly used by physicians, therapists, and potentially also by other healthcare workers even at the primary care and grassroots levels to facilitate immediate screening, appropriate referral, and management of children with disability needing mobility devices. As Filipinos comprise one of the largest diaspora populations, this study aimed to provide a Filipino version of the GMFCS-E&R and determine its internal consistency and inter- and intra-rater reliability.

METHODS

A multidisciplinary group of rehabilitation professionals at Philippine General Hospital worked with linguists to translate the original English GMFCS-E&R to Filipino/Tagalog, the Philippines’ official language. Several steps were done: authorization from the original tool developers (CanChild™); forward and backward translations; semantic analysis; content analysis; pilot testing; and submission of final version to CanChild™. Internal consistency and inter- and intra-rater reliability were determined.

RESULTS

The Filipino GMFCS-E&R translation was formulated and underwent several modifications. The final version yielded high internal consistency (Cronbach’s alpha: 0.96) and inter- and intra-rater reliability (interclass correlation coefficients: 0.895 and 0.928, respectively).

CONCLUSION

The Filipino GMFCS-E&R is a reliable tool for use among pediatric Filipino patients for communication, clinical decision-making, registries, and research.

Human ; Children With Disabilities ; Disabled Children ; Cerebral Palsy